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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: <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: XYesâť‘No <br /> i. Describe training provided to staff regarding handling,storage, disposal,and record <br /> eeping of all medical waste,including harmaceutical waste,at your facility: <br /> j. Describe your medical waste emergency action plan, ' clu in procedures f r <br /> handlings ills, exposure uipment failur s, etc: f <br /> U <br /> 1'f <br /> I hereby certify to the best of my knowledge and belief that the statements made herein are <br /> correct and true. <br /> I <br /> Signature: <br /> 4 //;; / <br /> Printed Nam <br /> Title: <br /> Date: C' <br /> EHD 45-03 7 <br /> 10/6/2006 <br />