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4 <br />Damels Shafpstuart, 11 <br />Transporter 1 Address: WM Healthcare Solutions, Inc. Applicable permit numbeds: Escondido- 5688— MW -172 4144 E Therese Ave. <br />1996 Don Lee Place Ste. C Phone #: (760) 489-5009 Fresno, CA 93725 <br />qk-_ Escondido, CA 92029 Vernon- 5688 — MW -1 57 Phone (559) 834-6252 <br />CL Permit #.- TS/OST 55 <br />Transporter 1 Acknowledgement of Receipt of Materials Phone M (323) 307-0514 <br />Signature <br />Signature Print/ Typed Name Date Date <br />Seq Generator =No 24 -Hour Emergency Response <br />or Facility: <br />El 7A. Transfer <br />Facility Printed Certification of Receipt and Treatment <br />2d"I <br />(800) <br />WM Healthcare Solutions, Inc. <br />certify that the contents of the listed containeds have been received, treated <br />01, 424-9300 <br />3670 Enterprise Ave. <br />and disposed of in accordance with all local, state, and federal regulations." <br />V <br />Hayward, CA 94545Phone <br />State Generator's ID No. <br />(512) 356.89©# <br />Print Name <br />a <br />#. -96 <br />PerTS-96 <br />i 14 4 <br />Signature_ <br />Generator's US EPA ID No. <br />Date <br />E775. Transfer Facility: <br />2c. No of 2d. lb. or <br />2a. Description of Waste 2b. Container Type Volume <br />>, to <br />Discrepancy <br />Containers <br />WM Healthcare Solutions. Inc. <br />„I I37 <br />J, <br />Or:fo)) 1,11 <br />Luce Avenue, BLDG 243E <br />Comments <br />McClellan, CA 95652 <br />Phone (512) 350-8907 <br />Permit IV: TS -98 <br />To terminated Now To # <br />Signature Date <br />le", <br />Signature_ <br />Date <br />U6,-, 9z1 <br />Ej 7C. incineration Faclllty� <br />❑ <br />WMRRRC <br />7605 State Hwy 65 <br />I It Nit— <br />T -T 7 <br />"711i �i i ki It Itil <br />Anahuac, 77514 <br />Phone(409)267-3913 <br />s -T, i i i lit <br />Permit #: MSW 2239-A <br />7D. Alternate Facility. <br />4. <br />Transporter 1 Is to check box If this Is a through shipmentTOTALS <br />0 <br />El 7E. Destination Facility: <br />Damels Shafpstuart, 11 <br />Transporter 1 Address: WM Healthcare Solutions, Inc. Applicable permit numbeds: Escondido- 5688— MW -172 4144 E Therese Ave. <br />1996 Don Lee Place Ste. C Phone #: (760) 489-5009 Fresno, CA 93725 <br />qk-_ Escondido, CA 92029 Vernon- 5688 — MW -1 57 Phone (559) 834-6252 <br />CL Permit #.- TS/OST 55 <br />Transporter 1 Acknowledgement of Receipt of Materials Phone M (323) 307-0514 <br />Signature <br />Signature Print/ Typed Name Date Date <br />5. 1 Transporter 2 Address: Phone #:Treatment <br />Facility Printed Certification of Receipt and Treatment <br />2d"I <br />certify that the contents of the listed containeds have been received, treated <br />and disposed of in accordance with all local, state, and federal regulations." <br />V <br />q <br />Print Name <br />a <br />Signature Permit number: <br />Print IF Typed Name Date <br />:6j. <br />>, to <br />Discrepancy <br />E <br />E <br />0 <br />Comments <br />To terminated Now To # <br />Signature Date <br />0 <br />E <br />Ya <br />'D <br />o' E C <br />E <br />0 <br />N24 <br />ca 0 <br />8 <br />00- <br />zi <br />E <br />c c cc Ef <br />M , <br />Z C <br />8 CL <br />CL <br />o <br />4C <br />0 c: <br />U <br />W <br />--C <br />Out W C <br />0 > <br />z <br />r E C <br />E <br />.2E> <br />M ,r- <br />20 <br />C <br />o <br />4� 0 C C <br />0 <br />@ <br />co <br />