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' .r• •rr• •IMP, •; r • <br />O 10 0) 0491TMM <br />Laboratory Wastes specimen or • • • • . of ,, agents, <br />live • attenuated vaccines, and culture mediums <br />Blood or Body Fluids - liquid blood elements or other regulated body fluids, or <br />articles contaminated with blood or body fluids <br />Sharps - syringes, needles, blades, broken glass <br />Contaminated r m. body parts,•• <br />autopsying materials <br />Surgical Specimens - human or animal parts or tissues removed surgically or by <br />listedIsolation Wastes - waste contaminated with excretion, exudate, or secretions from <br />humans or animals who are isolated due only to the highly communicable diseases <br />by - for • •l as requiring Biosafety Levelprecautions.* <br />Does • busine ss or generate any of <br />medicalthe • above? no— <br />if <br />, please complete the "Certification Staternene on Page <br />• return it with this questionnaire t• the addressindicated. You •• not <br />need to complete the remainder of this questionnaire. <br />if your please check the types(s)of • above that <br />you or your facility generate. Please complete the rest of this questionnaire. <br />2. Do you generate less than 200 pounds of medical <br />waste per • you <br />generator. <br />generators3. Small •medical <br />in a •- • common storage <br />other small generators. Do you plan to do this <br />at your r <br />If your answer is 3M a PHS-EHD "Common Storage Facility Permit <br />-Application!' be mailed to you.Please indicateyou <br />application mail-• <br />-CONTINLM <br />ON REVEME- <br />91 <br />