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Phone: 4zc� <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: KYes❑No <br /> L Describe training provided to staff regarding handling,storage,disposal,and record <br /> keeping of all medical waste,including pharmaceutical waste,at your facility: <br /> 8 <br /> U rSa S r6 -r, d i n L <br /> z G✓ <br /> � C <br /> j. Describe your medical waste emergency action plan, including procedures for <br /> handling spills, exposures,equipment failures,etc: <br /> C6ZI <br /> 1 " J pi S 6-'t O <br /> 11 , 41 ine <br /> I hereby certify to the best of my knowledge and belief that the statements made herein are <br /> correct and true. <br /> Signature: <br /> Printed Name:&C-% la <br /> Title: Qe c�j'lCt, <br /> Date: <br /> EHD 45-03 7 <br /> 10/6/2006 <br />