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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: L- <br /> Address: nr. G <br /> City State Zip Code <br /> Phone: ( 16k) 'Z 3� LL <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: 'es❑No <br /> i. Describe training provided to staff regarding handling,storage,disposal,and record <br /> keeping of all medical waste,including pharmaceutical waste,at your facility: <br /> a ( O <br /> 2{ F t <br /> j. Describe your medical waste emergency action plan, including procedures for <br /> handling spills, exposures, equipment failures, etc: <br /> de-44& O & (J' ' &'r uj"7/` ._ <br /> ClJt tra cctrfr P f." R. <br /> I hereby certify to the best of my knowledge and belief that the statements made herein are <br /> correct and true. <br /> Signature: ('j <br /> Printed Name: <br /> Title: �� //,9 �' <br /> Date: � � <br /> EHD 45-03 7 <br /> 10/6/2006 <br />