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1�1
<br />�t ? ;� }>• ;I t;r_'rl rate. 200 or n ).ore pounds per ;Month of
<br />medical v',aste listed wi Page ? Yc,.;X-I)i)
<br />S. 1a you. plan to treat you -T niedEcal waste c�nsit
<br />Ca )Cur I-aCI�. '�' �, 1"Y i?Ilt lfla`vril3,Y„
<br />Or l?SIiS; :I:JCTC?'eV;l`i� iC'c}1:IC;ii)S;j'? V ':
<br />_.
<br />If ?lir iI?>`1'V(:I".`i tC)C1!•f'�tl(I).'i .ia_.._L c3�I1C1^r� arL i _, ihfl' (_C'i?:tiiet:: llf
<br />S'Certlficaiiion Statc'i: i :l V on P gc_ 5 and return It With tidy quesvioI1: mire to
<br />the F.',ddrecs sho4m , at the bcani l of Page 2, You do iv -)t need to coi pie(e
<br />the. re.sa c)f tii c: for -ins in thi:
<br />l: y(::.:i �:.n:;vlei"i to qiftsliomz 4 or � are vc,,!3, pl...ase cols pIct fileRcg: sr�.,t
<br />ioll
<br />1"or licdi 'al. Vv'aste" for,-ri oii. Page b and subnii-t a "1,412dic:; l 'Wi,fte
<br />M417'agc-rneiit T'lan" as spccific.& on Pages % i>
<br />zi If yot'_ gc r.,.of atc less than 20 pounds of I'i cdical
<br />va.ste per we-elv., transport less than >o pounds
<br />ai one time, and have a haulms; itifo.nriation
<br />c.o=hent on file in your office, you In iy apply
<br />for a Limited Quantity l-iauling Exeniptic?I:. This
<br />c �,,nipticn ��,1?ows )'��ti cryour staffynilig,to t.an. -jort
<br />�tedi,..Cl `1'�Y G.✓li.� 1�oursciv:.s, x1Jthoul J1.Ia
<br />re'-7Lit_I'cd h':1zardcti..s waste hauie.r, to It medical
<br />vva::te tread`! er: t. Iacillty. 'Do you -want to apply
<br />1) ,_.i. t�'a {?utli)titj' H�,LiIIlg l ;x:ei"iiptiC7n'
<br />If you, pans ,,er is I)n, you v,,Hl be reclt red to Or v reg:srerc d hazardous
<br />waste hauler to transport your waste for trcatment cii:sposz h
<br />If your answer is ai , rc lurT1 this questionnaire e.tnd the Trart.I- Icat c n
<br />Statemc_Iit" o.i Page 5 to the achiness shows, below, anal "l_1,::^,itcd i k-ulirlg
<br />rxerl pilon" ,:ppiica tion will be Inailcd to you.
<br />IJ'iosafct j' bevel 4 viruses and diseases are: Congo -Cru -near l: enao:-aha,t is Fcvcr, Tick-
<br />borne rnccphalitis Virus Complex (Absettarov, Hanzalova, Hypr, Kum!inge, Kyasanur
<br />forest Disease, Omsk Hemorrhagic Fever, and Russian Jpiirig-Jumnin 'r Encc,,)halitl`;),
<br />i`JlZnl`urg Lis;; asC, I�bOla, .Jllnii-i Virus, miss:] Fever `Virus, and Mach.upo Virus.
<br />No : z>.
<br />Tl^ s ULicr, i .,aire acts as a guideline only. I'lcase refer to the encl.Csed ",Mt'_dicad
<br />Waste'.�iY!''n1 IS�t'_rii: i.t Act:" for i-nore $f) '.Clfi r(' 'iSlr':"�t1Ul��ie::Cmption inirori:)ation.
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