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GUIDELINES R THE MEDICALAG <br /> (Please Type or t) <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-E ). The medical waste management plan shall contain the following information, <br /> as appropriate for your facility: <br /> Business e: <br /> Business Address: L <br /> Business Phone: ( ) / <br /> Type Of Facility Or Business: <br /> Registered : (Check e) <br /> ( ) Small Quantity Generator With Onsite Treatment. (Generates < 200 lbs./mo.) <br /> Large Quantity Generator. (Generates 200 lbs. or ore/ o.) <br /> ( ) Large Quantity Generator With Onsite Treatment. (Generates 200 lbs. or more/ o.) <br /> Person Responsible For Implementation Of The Plan: <br /> Name: <br /> Title: ..ate. hone: ( ) -C <br /> ATTACH D TION <br /> 1. List the types of medical waste generated at your facility, i.e., Laboratory Wastes, <br /> Blood or Body Fluids, Sharps, Contaminated Animals, Surgical Specimens, or <br /> Isolation Wastes. (See "Regulated Medical Wastes" on Page 3.) <br /> 2. Estimate the monthly amount of medical waste generated at your facility. <br /> / /35 <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. e.- e A <br /> ew- <br /> -CONTIN'= ON REVERSE- <br /> 7 <br /> ° E-A <br />