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7�� <br />r <br />� <br />r <br />u <br />CERTIFICATION <br />FOR NON-MEDICAL WASTE GENERATORS MEDICAL •. <br />(PleaseNOT REQUIRED TO REGISTER <br />f or Print) <br />BUSINESS NAME: <br />city —x State CAL Zip <br />NAME OF . • ; <br />Am Not Required • Register r .r Generator •r <br />(Please► • • • <br />generate00 pounds of f per month. <br />incineratingI do not treat any medical waste at my facility by means of autoclaving, <br />or • <br />Please indicate TheAppropriate ani:+• <br />I declare under penalty of law that to the best of my knowledge and belief, I do not <br />generate or store any of the wastes specified on the "Pre -Application Questionnaird" <br />as "Regulated •ical, Wastes" in an amount over i1 pounds per • <br />SIGNATURE: TITLE: DAT13 <br />0 <br />