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M;1. <br />• <br />g <br />Seq Generator No. <br />Daniels Sharpsmenc. <br />WM Healthcare Solutions, Inc. Applicable permit number/s: Escondido- 6688—MW-172 4144 E Therese Ave. <br />24 -Hour Emergency Response <br />n7A. Transfer Facility: <br />1996 Don Lee Place Ste. C <br />(800) 424-9300 <br />Wry Healthcare Solutions, Inc. <br />Escondido, CA 92029 <br />Vernon- 5688 — MW -157 Phone (559) 834-6252 <br />0 <br />Transporter 1 Acknowledgement of Receipt of Materials <br />Phone #: (323) 307-0514 Permit #: MOST 55 <br />3670 Enterprise Ave. <br />Signature <br />Haard, CA 94545 <br />Signature <br />Print/ Typed Name <br />Date 'i Date <br />— <br />State Generator's ID No. <br />Phonywe (512) 356-8901 <br />Treatment Facility Printed Certification of Receipt and Treatment <br />2J."I <br />01 4) <br />Permit #: TS -96 <br />and disposed of In accordance with all local, state, and federal regulations." <br />Signature <br />Print Name <br />0 <br />Generator's US EPA ID No. <br />¢Date <br />W <br />Permit number:— <br />Q 713. Transfer Facility: <br />2a. Description of Waste <br />2b. Container Type <br />2c. No of <br />2d. lb. or <br />C <br />M (D <br />Containers <br />Volume <br />VVM Healthce Solutions, Inc, <br />rL E <br />E ® <br />5337 Luce Avevenue, SLOG 243E <br />00 <br />McClellan, CA 95652 <br />Phone(512)356.8907 <br />6 <br />1:1 TO terminated <br />'Wi (�'i I <br />Signature Date <br />Permit #: TS -98 <br />I <br />Signature <br />77 7777!7 <br />Date_ <br />t <br />7C. incineration Facility: <br />WMRRRC <br />7505 State HWy 65 <br />Anahuac, TX 77614 <br />Phone(409)267-3913 <br />Permit #. MSW 2239-A <br />A': <br />7D. Alternate Facility: <br />L[�!rTransporter <br />I Is to check box If this Is a through shipment R I <br />TOTALS <br />1 7E. Destinatlo n Facility: <br />Transporter I Address: <br />Daniels Sharpsmenc. <br />WM Healthcare Solutions, Inc. Applicable permit number/s: Escondido- 6688—MW-172 4144 E Therese Ave. <br />1996 Don Lee Place Ste. C <br />Phone #: (760) 489-5009 Fresno, CA 93725 <br />qw, <br />Escondido, CA 92029 <br />Vernon- 5688 — MW -157 Phone (559) 834-6252 <br />0 <br />Transporter 1 Acknowledgement of Receipt of Materials <br />Phone #: (323) 307-0514 Permit #: MOST 55 <br />2 <br />Signature <br />1 <br />Signature <br />Print/ Typed Name <br />Date 'i Date <br />— <br />5. i Transporter 2 Address: <br />Phone #: <br />Treatment Facility Printed Certification of Receipt and Treatment <br />2J."I <br />01 4) <br />certify that the contents of the listed containers have been received, treated <br />and disposed of In accordance with all local, state, and federal regulations." <br />0 <br />a. E <br />Print Name <br />0 <br />Signature <br />Permit number:— <br />Print/ Typed Name <br />Date <br />06. <br />— <br />C <br />Discrepancy <br />C <br />M (D <br />rL E <br />E ® <br />Comments <br />00 <br />6 <br />1:1 TO terminated <br />New TO # <br />Signature Date <br />