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4. Do you generate 200 or more pounds month of <br /> the types of medical waste listed on Page 3? yes x no_ <br /> 5. Do you plan to tre-Rt yotr nwdicail waste onsite <br /> (at your facility), by autoclaving, <br /> incinerating or using microwave technology? yesx no <br /> If your answers to gu 4 and 5 are no, then complete the <br /> "Certification Statemene on Page 5 and return it with this questionnaire to <br /> the address shown at the bottom of Page 2. You do not need to complete <br /> the rest of the forms in this package. <br /> If your answers to guestions A or 5 are M please complete the"Registration <br /> For Medical Waste 'form on Page 6 and submit a "Medical Waste <br /> Management PIan7 as specified Pages 7 & 8. <br /> 4. if you generate less than.20 pounds of medical <br /> waste per week, transport lessthan 20 pounds <br /> at one.time,and have.a hauling o tion <br /> document on file in your office, you may <br /> apply <br /> for a Limited Quantity Hauling <br /> exemption allows you or your staff port <br /> medical waste yourselves, withouthiring a. <br /> registered hazardous waste hauler,: o ' 'cal <br /> waste e,atinent facility :. ,you o.apply <br /> for a ited Quantity Ha ? yes_.no x <br /> If your answer is--n you aired to hire a registered hazardous <br /> waste hauler to transport your waste for.treatment and disposal.. <br /> If your answer.is im. -re questionnaire, and the "certification <br /> Statement"-on Page'5 to the address shown below; and a 'ted Hauling <br /> Exemption7 application.will ed to you. <br /> * Biosafety Level 4 viruses-and:diseases . Congo-Crimean.Hemorrhagic Fever, Tick- <br /> borne Encephalitis Virus Complex .( a v, ova, Hypr, Kumlinge,.Kyasanur <br /> .Forest Disease,.Omsk Hemorrhagic Fever, and Russian Spring-SuTnmer Encephalitis), , <br /> Marburg Dis : Ebola, Junin Virus; V' u , and achupo Vuvs. <br /> NOTE: <br /> This questionnaire acts as a guideline only.- Please refer to the enclosed "Medical <br /> Waste Management Act" for more specific tion/exemption information. <br /> 4 <br />