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MEDICAL WASTE PROGRAM <br /> business Name �osDICL of San Jbmuin Phone <br /> usiness Address 38$8 006GL AcVe <br /> ity S Icfon Zip 45Z04 -1153 <br /> ontact Person Phone <br /> wner Phone <br /> wner Address <br /> ity Zip <br /> Program Element Code <br /> Record ID # <br /> Onsite Treatment? Y N (Circle) 4� <br /> if Yes, Treatment Unit Type <br /> LQHE? Y N (Circle) <br /> WMP in EHD file? Y N (circle) <br />