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APR-06-11 10:34 FROM- 0 0 T-853 P.09/13 F-873 <br /> Phone: <br /> g. Name,address and phone number of Mite Treatment Facility where pharmaceutical <br /> waste is transported for treatment,if different than pharmaceutical waste hauler: <br /> Name: <br /> Address: <br /> City State Zip 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 ea to <br /> be maintained and available for review during inspection for three(3)years. you <br /> have tracking doeumetns for all medical wastes handled at your facility: es❑No <br /> i. Describe training provided to staff regarding handling,storage, disposal,and record <br /> keeping of all medical waste,including pharmaceutical waste,bt your facility: <br /> zI fi % <br /> e-A AAA <br /> j. Describe your medical waste emergency action pian,including procedures for <br /> handling spills,exposures,equipment fail es,elc- <br /> n'ZI <br /> a <br /> Y hereby certify to the bespdrmilknowl a d belief that the statements made herein are <br /> correct and true. <br /> Signature: <br /> Printed Name: <br /> Title: i'/�G t d 17-- <br /> Date: <br /> eHD 45.03 7 <br /> 10/62006 <br />