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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. Do you <br /> have tracking documents for all medical wastes handled at your facility: E j -Yes❑No <br /> L Describe training provided to staff regarding handling,storage,disposal,and record <br /> keeping of all medical wast i eluding pharmaceutical waste,at�your facility: <br /> j. Describe your medical waste emergency action plan,including procedures for <br /> handling spills,exposures, equipment failures,etc: 1 ffi1�_ <br /> _ ��_rt�k�ean• c�l��.s2�-an.� <br /> s t �o ort �4tc�acss1 rtPiY <br /> r49y nr- Pf cler�4 tiya. C' <br /> I hereby certify to the best of my knowledge and belief that the statements made herein are <br /> correct and true. <br /> Signature: V, xljuv <br /> Printed Name: <br /> �Y,�d <br /> Date: ----to��11 <br /> EHD 45-03 7 <br /> 10/6/2006 <br /> i <br />