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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: 44 .es❑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 /> D� <br /> j. Describe your medical waste emergency action plan, including procedures for <br /> handling spills, exposures, equipment failures,etc: <br /> 7 OL- <br /> 4 , CL <br /> rs"� c✓der.r �UL+� , <br /> I hereby certify to the best of my knowledge and belief that the statements made herein are <br /> correct and true. <br /> n <br /> Signature: <br /> Printed Name: lc:i€o, All,Q4-,-ct( <br /> Title: <br /> Date: <br /> EHD 45-03 7 <br /> 10/6/2006 <br />