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    MEDICAL WASTE SERVICES

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    Company Name

    Contact Name

    Title

    Phone

    Email

    Service Address

    City

    State

    Zipcode

    Comment

    Current Vendor

    Service Frequency

    Type of Medical Waste

    BiohazardSharpsPharmaceuticalChemotherapyPathology

    Size of Containers

    Quantity of Containers

    Average Monthly Weight in Pounds

    Current Monthly Costs

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