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7 of 8 Environmental Health Department Phone: ( ) Registration #: h. Do you handle pharmaceutical waste that is classified by the federal Drug Enforcement Agency (DEA) as “controlled substances”? Yes No If yes, describe how the “controlled substances” are disposed: ______________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ i. All medical waste generators are required to keep accurate records regarding containment, storage, hauling, treatment and disposal. All medical waste records are to be maintained and available for review during inspection for two (2) years. Do you have tracking documents for all medical wastes handled at your facility? Yes No j. Describe training provided to staff regarding handling, storage, disposal, and record keeping of all medical waste, including pharmaceutical waste, at your facility: _________________________________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________ k. Describe your medical waste emergency action plan, including procedures for handling spills, exposures, equipment failures, etc. (attach information as necessary): _________________________________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________ l. Describe how reusable medical waste carts or containers are cleaned and decontaminated (see below for approved cleaning methods): _________________________________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________ Approved cleaning methods include agitation to remove visible soil combined with one of the following: 1. Exposure to hot water of at least 82 degrees Centigrade (180 degrees Fahrenheit) for a minimum of 15 seconds. 2. Exposure to chemical sanitizer by rinsing with, or immersion in, one of the following for a minimum of three minutes: • Hypochlorite solution (500 ppm available chlorine) • Phenolic solution (500 ppm active agent) • Iodoform solution (100 ppm available iodine) • Quaternary ammonium solution (400 ppm active agent) m. Describe, if medical waste is treated onsite, a closure plan for the termination of treatment, using at a minimum, one of the above referenced approved cleaning methods: I hereby certify to the best of my knowledge and belief that the statements made herein are correct and true. Printed Name: ____________________________ Signature: ___________________________ Title: ____________________________ Date: ___________________________ 800 765-1277 Annual Biomedical waste trainign to include Definition and Identification of Biomedical Waste, Segregation, storage and contaminant. Labeling. Disposal, Transport, Contingency Transport and Teatment Hold. Decontaminating Biomedical Waste Spills. Training records are kept for a minimum of 3 years. Put on normal PPE which may include but is not limited to gloves, eye protection, lab coats and face shield. Clean surfaces with solutions of industrial strength detergent to remove visible soil. In the event of a larger spill we use Red or Green Z. Decontaminate the surfaces with EPA registered disinfectant. RR0191902 Not applicable Barbara Wunder Director EHS 3/24/2021