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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: same ou <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: es❑No <br /> i. Describe training provided to staff regarding handling, storage,disposal,and record <br /> keeping of edical waste,including ph rmaceuti al waste,at your faciliI WA <br /> ty: <br /> 9 <br /> 0 <br /> j. Describe your medical waste emergency action plan includin�pproce�dure: for <br /> �andlin spills, ex osur s equipen failures, etc:. ' ' <br /> 4 Is 1 <br /> ?, l <br /> fi <br /> I hereby certify to the best of my know dge and belief that the statements ma a herein are <br /> correct and true. <br /> Signature: <br /> Printed Name: <br /> Title• <br /> Date: <br /> EHD 45-03 7 <br /> 10/6/2006 <br />