Laserfiche WebLink
CERTIFICAITON STATEMENT <br />FOR NON-MBDICAL WASTE GENERATORSAND MEDICAL GENERATORS <br />NOT REQUIRED TO REGISTER <br />Type or Print) <br />NAME: <br />ADDRESS: <br />(Pleaseappropriate <br />•• not generate any medical <br />I generate less than /1 • • • u� <br />• not treat any medical <br />incineratingor • <br />I' - r • -M=-, <br />month. <br />,ty by means of •; <br />• r •r •; ♦; • • -•• • belief,•• not <br />_ DATE: <br />