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0 0 <br /> Medical Waste Management Policy,Appendix#I <br /> QUEST DIAGNOSTICS INCORPORATED <br /> Northern California Business Unit <br /> MEDICAL WASTE MANAGEMENT PLAN <br /> Generators Name: Quest Diagnostics <br /> Type of business: X Clinical Laboratory or ❑ Specimen Collection Site <br /> Business Address: 2`2-cl1 W March Lane f 4S <br /> f0 +on CA g5ao <br /> Telephone: E0q_ 9-51-5S31 <br /> Person responsible for implementing the plan: L'I'ndQ m Ck!;-) <br /> Type of waste: Laboratory waste consisting blood, body fluid, infectious material and Sharps. <br /> Amount of waste generated/month: 3 Opounds. <br /> This facility is a X Large Quantity Generator or❑ Small Quantity Generator. (check one) <br /> See the Medical Waste Management Policy for segregation, containment labeling and storage <br /> information. <br /> Describe waste treatment at this facility(autoclaving, isolyzer, etc.) or . Not Applicable <br /> (See emergency back up plan for information,if applicable) <br /> Disposal Plan: <br /> 1. Name, Address and phone number of the licensed hauler or attach the Limited 0 antity Hauling <br /> Exemption. T 1 CL <br /> (Name) <br /> z��rald ® gCtncjj0°cpLA Vo- C 85742- <br /> (Street address) (City,State,Zip) <br /> 2. Name, Address and phone number receiving and/or disposal facility if different from hauler. <br /> (Name) (Phone#) <br /> (Street address) (City,State,Zip) <br /> Site Signature: ( Date: IWOO <br /> ®C7 <br /> BiowasteFormApp 1 <br />