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MAY-03-11 09:22 FROM- 0 T-093 P.09/13 F-402 <br /> is <br /> 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 /> 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 area to <br /> be maintained and available for review during inspection for three(3)years. you <br /> have tracking documents for all medical wastes handled at your facility: es EE']No <br /> i. Describe training provided to staff regarding handling,storage,disposal,and record <br /> keeping of all medical waste,including pharmaceutical waste,at your facility: <br /> Alt— <br /> To <br /> j. Describe your medical waste emergency action plan, including procedures for <br /> handling spills,exposures, equipment fail res, <br /> k <br /> n* 71 <br /> M If <br /> r� <br /> I hereby certify to the be, m knowl ad belief that the statements made herein are <br /> correct and true. <br /> Signature: <br /> Printed Name: <br /> Title: E,4eC <br /> !Date: bG <br /> EfM 45-03 7 <br /> 10l6l27006 <br />