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I2 <br />GUIDELINES FOR THE MEDICAL WASIE MANAGEMENT PLAN <br />(Please Type or Print) <br />Small quantity generators that provide onsite treatment and all large quantity generators <br />shall have a medical waste management plan on file with the local enforcement agency <br />(PHS-EHD). The medical waste management plan shall contain the following information, <br />as appropriate for your facility: <br />Business Address: 0- t ; - C - L <br />.(:3=. <br />=J= <br />a <br />Small Quantity Generator With Onsite Treatment. (Generates < 200 lbs./mo.) <br />(+-----Large Quantity Generator. (Generates 200 lbs. or more/mo.) <br />Large Quantity Generator With Onsite Treatment. (Generates 200 lbs. or more/mo.) <br />Person Responsible For Implementation Of The Plan: <br />V OMM <br />phone: Ck <br />4xvYi1w <br />.1 <br />1. List the types of medical waste generated at your facility, i.e., Laboratory Wastes, <br />Blood or Body Fluids, Sharps, Contan-dnated Animals, Surgical Specimens, or <br />Isolation Wastes. (See "Regulated Medical Wastes" on Page 3.) <br />2. Estimate the monthly amount of medical w . aste generated at your facility. <br />3. Describe the medical waste handling procedures utilized by and applicable to your <br />facility: <br />a. Onsite location and method for segregation, containment, packaging, <br />labelling, and collection. <br />-CONTU-JU M- ON RE VE RSE- <br />N <br />