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4. Do you generate 200 or morepounds per month• <br />typesthe of medical -i on '.•' • <br />S. Do you plan to treat your medical waste onsite <br />your by autoclaving, <br />incinerating •, using microwave• • • <br />if your • i ter• and 5 are no then complete <br />"Certification Statemeneon Page 5 <br />ireturn it with thisquestionnaire is <br />the address • • bottom • 1 . • ^2. Youi • not i •complete <br />the rest of the forms• <br />If your • • or 5 are yes please complete• r•►; <br />ForMedical Wasteform •:.. Page f. and submit a "Medical Waste <br />Management Plan7 as specified on Pages 7 & 8. <br />you generate less than <br />1 pounds <br />•• •medical <br />waste per week, transport less than 20 pounds <br />at one time, •have a hauling information <br />document on file in your office, you may apply <br />for a Limited Quantity Hauling Exemption. This <br />exemption allpws you or your staff to transport <br />medical waste yourselves, without hiring a <br />registered hazardous• a medical <br />waste treatment facility. Do to a <br />for a Limited Quantity Hauling Exem I ption? yes,--no— <br />If your answer is no u will be req i d to hire a registered hazardous <br />yo luire <br />waste hauler to transport your waste for treatment and disposal. <br />If your :wreturn this questionnaire•"Certification <br />Staternene on Page 5 to the address shown below, and a "Limited Hauling <br />±GI ►r•iapplication will be mailed to you. <br />MarburgBiosafety Level 4 viruses and diseases are: Congo -Crimean Hemorrhagic Fever, Tick- <br />borne Encephalitis Virus, Complex � (Absettarov, Hanzalova, Hypr, Kumlinge, Kyasanur <br />Forest Disease, Omsk Hemorrhagic Fever, and Russian Spring -Summer Encephalitis), <br />r• .„ • Machupo <br />This questionnaire acts, as a guideline only. Please refer to the enclosed "Medical <br />Waste Management Act" for more specific registration/exemption information. <br />4 <br />