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V CVSHealth <br /> Ms . Florido <br /> March 8, 2019 <br /> Page 3 <br /> managed as non-hazardous waste pharmaceuticals , so long as the pharmaceutical product <br /> has been fully dispensed . The specific studies – two from stakeholders ; one from <br /> Riverside County, California ; and one from EPA ' s Office of Research and Development <br /> – and EPA ' s conclusions regarding these studies are discussed at 80 Federal Register <br /> 58051 through 58054 of the proposed Pharmaceuticals Rule . These pages are attached . <br /> 2 . EPA emphasizes that allowing empty containers to be managed as non-hazardous waste <br /> without first triple rinsing the containers will decrease sewering of warfarin residues. <br /> EPA notes that in healthcare settings , if containers are triple rinsed, the rinsate will likely <br /> be poured down the drain, which is not good environmental practice . " [EPA] think [s] it <br /> is important that the residues be managed in a more controlled manner—such as in <br /> municipal solid waste landfills—rather than poured down the drain . <br /> 3 . EPA carefully assessed whether destruction of empty warfarin containers is warranted <br /> and ultimately determined that destruction is not necessary. Although EPA ' s proposed <br /> rule would have required destruction of empty containers , EPA ultimately did not finalize <br /> the requirement to destroy the empty containers prior to disposal , given the potential for <br /> worker safety concerns if required to crush or shred the containers . <br /> We emphasize the above points from the Pharm Rule because EPA carefully considered <br /> whether residue and empty containers should be managed as hazardous (or acute hazardous) <br /> waste . Based on (i) data (such as the studies that EPA reviewed) supporting the conclusion that <br /> very little residue remains in containers after the pharmaceuticals are dispensed, and (ii) for <br /> policy reasons (such as avoiding sewering of residues after triple-rinsing) , EPA determined that <br /> it is not appropriate to manage the residues or containers as hazardous (or acute) hazardous <br /> waste . <br /> California. We are aware that prior to EPA ' s publication of the Pharm Rule , DTSC <br /> issued a December 24 , 2015 interpretation rejecting EPAs November 4 , 2011 memorandum <br /> regarding empty containers . DTSC interpreted California' s regulations as more stringent than <br /> federal regulations and stated : "The distinction between the regulations is that the federal <br /> regulation specifically addresses the ` Residues of hazardous waste in empty containers ' . . . and <br /> California ' s regulation addresses the ` Contaminated Containers ' as whole entities . " <br /> The DTSC letter quoted California Code of Regulations , title 22 , section 662613 (r) : <br /> Any container, or inner liner removed from a container, which previously <br /> held a hazardous material , including but not limited to hazardous waste, and which <br /> is not empty as defined in subsection [ . . . ] (d) of this section, . . . shall be managed <br /> as a hazardous waste in accordance with this division and Chapter 6 . 5 of Division <br /> 20 of the Health and Safety Code (commencing with Section 25100) . <br /> CVS pharmacy / caremark / minute clinic / specialty <br /> I <br />