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EN <br />am <br />Name, address and phone number of Ofisite Treafment Facility where pharmaceutical wgStq <br />is transported for treatmap if <br />t <br />ell.' d .rt' i► �► �� <br />74p Code <br />h. All medical waste generatoriare required to keep accurate records rewding containmen� <br />storage,t.... M`:. l.Y_.. and disposal. meoical waste • ♦ 7 to be maintainedand <br />avaffable for review during inspection for three (3) years. Do you have tracking documents for <br />i. Describe. -training provided to staff regarding handling,sto;age, disposal and r cord keeping of <br />all wedi <br />�A�vasi� WclqdMI'g.phiMaceu#caj *as f,, <br />J. Describe your medical waste emergency action plan, including procedures fonIN <br />g sp' Ps, <br />exp-sures;"eq�urp�rrerntfall ue,s,.etc,(Attach jnfg atiap:as.necessarvl: s I:�,nI <br />1x. Describe how reusable medical waste carts or containers are cleaned and decontaminatej Approved <br />methods include agitation to remove visible soil combined with one of the following: <br />L l✓Xposure to hOt water -fat least 82 degrees Ceatigtade (180 degrees Fahrenbnbeft) for a minimum <br />of 15 seconds. <br />2. Exposure to chemical saWtizer by rinsing with, or immersiotr in, one of the following for a <br />minimum of three minces: <br />• Hypochlorite solution (500 ppm available chiorine) <br />• Phenolic solution (500 ppm active agent) <br />• lodoform solution (100 ppm available iodine) <br />• Quaternary ammonium solution (400 ppm, active agent) <br />T hereby certify to the beat of my knowledge and belid that the statements Made herein are correct and true. <br />Signatare Title; <br />Date: <br />MW 45-03 <br />r ir"08 <br />