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Z <br />FROM : <br />FAX NO. :2092394919 <br />FF L'4,i : PAT'r i P i CCARDO FAX NO. . gi.67363543 <br />un. 28 2004 09:59AM P5 <br />Jars. 14 P -W4 d4:19PM P4 <br />C r^a� 6FiL.+i6C3ir° wi�.+��'ti.+`ega e�"i�w��-E P a :rRMA�iMI i iC�r"0�. <br />-� aterocycle, Inc. Pharrnacellfcel Waste Acceptance PrOtOCOI <br />The information contained Within this Stericyci�3 Protocai refieots the rsqu�rertilents necessary to <br />cornpiy with the California hleatt^ atm Safety Cade GMSC) as We�j as h ordinances <br />Conservation anResource <br />d Recovery Act of 1976 (RCP.AI and related laws, recd <br />ulatlons 2tt <br />Governing on t) ironmerrtaily responsible managem. ent of waste Pharmaceutic als. <br />aha "ca,enerator Certification" statement below provides for Complianc s with CHSC and RCRA <br />when signed by the generating customer's auth-;�rized rspreseltative having knowledge of the <br />oharar.`ter of the waste and resp nsibiftty and authority to exKute this oertificati®n. it is <br />irnpoi tart that this document be signed 0,11d r6turned to Stericycle where it will be maintained in <br />the appropriate rusiamer file. This action will also further acknowledge receipt and <br />understanding of the Steheyoie Phs,"aceuftai Waste Acceptance Protocol. <br />1NS7'RUCTIONs: <br />♦ Read the attacnad Stericycie Pharmaceutical VVaste Acaeptartoe PratOW- <br />O Execute this Certification of Non-Hazardotas Wl aste PharMatau*211S <br />4 Return original CertfcatiOn imme-d .a ely to your Ster'c le, Inc. District or Sales <br />Representative, <br />Nosy your local sta daycle C -strict office ir1mediately when the authorized faeifity <br />representative chances. <br />We appreciate your assistance in assuring �ulatciry compliance for your facility and ours- if <br />you have any questions or concerns -risjarding this document or its contents, please do not <br />hesitate to calf our Customer Service Ce,10sirtment or your Sterlcycie Sales Representative. <br />GENERATOR CaRTIFICA77ON: 71HISB a TO CERTIFY THAT NO iIVAStr"E PkA CEUr1C:ALS <br />rgNDE'RE3 By THE CuSrOMER PdlC &1tY.. REFF.R9A10ED BELOW, FOR COLLEC770M BY <br />9TERICYCLE, INC., ARE COMPRISM INW!' O49, 0i.jN PAR'r, OF WASTES WHICH ARE EITHER <br />SUBJECT To REGULATION PURSUANT M TjjZ RESOURCE cONSERV.A'TION AND RECOVERY <br />ACr of 1976, AS AMENDED OR THE CALIPOP I,A NADIAT ON CONTROL LAW <br />Customer Faciitty ......... <br />_��- <br />' Address: <br />City' _ 5 1 Zip, /�i'J��✓'�� <br />Nerne of Authorized Representative. <br />Title of Art#he►r'izad Reprq�Qr.#�tivs: ...._. <br />Signature of Authorized Representptive. te:. <br />