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��� <br /> �� <br /> | ~�' `�' <br /> � � � � �� � ���� <br /> � ���K�J��&����U� Environmental Health Department <br /> --[[}UNTY--- <br /> Phomz <br /> Registration#: <br /> � h. Do you handle pharmaceutical waste that is classified by the federal Drug Enforcement Agency(OGA)as <br /> .controlled aubstenmao^?0 YeaFl No <br /> If yes, describe how the"controlled substances'are disposed: Narcotic medication is stored in n tinithla,locked Sto .On medication <br /> isdisconfinuedftisve6�:11:,i:ii�il��y 2 licensed nurses(the counin5ii of the an=ntof n;qi!!p1!,,!!;ii:! iiII111,11!11 111,11 11�1 111innecist visit the Dire 1orof Nursigg and <br /> i All medical waste generators are requiredhokeep accurate records regarding containment, storage, hauling, <br /> treatment and v/�pp�w/. * meo�e|wo�enaoordmamatoben�oinba|nodmndavei|mb|eforreview duhnQ <br /> x <br /> / two(2)years. Doyou have tracking docume�wfor aUn�ed�o wastes hond�dyour facility? <br /> [l <br /> ] <br /> Describe training provided to staff regarding handling, storage, disposal, and record keeping of all medical <br /> waste, including pharmaceutical waste, otyour facility: <br /> All-Staff are in-serviced at leii!il Dnoe a yearon Bl1:it11Mt11:11 11:!�! and�alr�Aththat topic,Bi0ha7al'(1134111,waste MaMement,in <br /> 0*11MUM Dharmaceutical waste hav 29e of pharmaceutical waste durinEoOentation and <br /> b. Describe your medical waste emergency action plan, including procedures for handling spills,exposures, <br /> equipment failures, etc. (attach information eenemammary): <br /> See attached 'Waste Disposal Disruption P"hi&Procedure" <br /> |. Describe how reusable medical waste carts orcontainers are cleaned and decontaminated(see below for <br /> approved cleaning medhodo): <br /> WA <br /> Approved cleaning methods include agitation to remove visible soil combined with one of the following: <br /> 1. Exposure to hot water of at least 82 degrees Centigrade(180 degrees Fahrenheit)for a minimum of 15 seconds. <br /> 2. Exposure to chemical sanitizer by rinsing with,or immersion in,one of the following for a minimum of three minutes: <br /> Hypochlorite solubon(500 ppm available chlorine) <br /> Phenolic solution(500 ppm active agent) <br /> lodoform solution(100 ppm available iodine) <br /> Quaternary ammonium solution(400 ppm active agent) <br /> m. Describe, ifmedical waste iotreated onsite, eclosure plan for the termination oftnaatmmnt uainQ*�ominimumn <br /> one ofthe above referenced approved cleaning me�odm: ' ' <br /> Vhemmby certify tothe best of my knowledge and belief that the and true. <br /> Printed Name: Janina KihhhauSignature- <br /> Title: <br /> ignadu <br /> Tit/e' <br /> � <br /> _LVN,DSD Date: <br /> 7ova <br />