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Phone: <br /> g. Name,address and phone number of Offsite Treatment Facility where pharmaceutical <br /> waste is transported for treatment, if different than pharmaceutical waste hauler: <br /> Name: <br /> Address: <br /> CItV State Zie Code <br /> Phone: <br /> h. All medical waste generators are required to keep accurate records regarding <br /> containment,storage,hauling,treatment and disposal. All medical waste records area to <br /> be maintained and available for review during inspection for three(3) ars. Do you <br /> have tracking documents for all medical wastes handled at your facility: ElYes El No <br /> L Describe training provided to staff regarding handling,storage,disposal,and record <br /> kee in of all medical waste includin harmaceutical waste at your facili : <br /> s <br /> j. Describe your medical waste emergency action plan, including procedures for <br /> handling s ills ex osures a ui ment failures etc: <br /> I hereby certify to the best of my knowledge and belief that the statements made herein are <br /> correct and true. <br /> Signature <br /> C. <br /> Printed Name: <br /> Title: A <br /> Date: 4 1 a•i l <br /> 6F{D 45-03 7 <br /> 10/6/2006 <br />