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40 40 <br /> Limited Quantity Hauling Exemption <br /> "Need Statement" Examples <br /> (Please submit on letterhead with signature of the responsible party.) <br /> Example 1 (Private Practice): I am a physician with a private practice located at 900 Main Street, Anywhere, CA. <br /> My practice generates less than 20 pounds of medical waste per week. Fairview Hospital, 200 Apple Street, <br /> Downtown, CA, is an acute care hospital with on-site treatment of medical waste. I am on the staff of this hospital, <br /> and this facility will accept the medical waste generated at my practice for treatment. A letter is enclosed from <br /> this hospital verifying this affiliation. The Limited Quantity Hauling Exemption is needed to transport medical <br /> waste generated at my practice to the hospital for treatment. <br /> Example 2 (Home Health): Webster Care is a home health agency located at 300 Gold Avenue, Butte Mountain, <br /> CA. This agency operates in Yolo and Yuba counties. The Limited Quantity Hauling Exemption is needed so that <br /> our professional staff can transport the medical waste generated during their patient visits in the surrounding <br /> communities back to our office in Butte Mountain for consolidation and storage. HTX Inc., 100 First Avenue, <br /> Pineland, CA, transports and treats the medical waste generated by our agency. <br /> Example 3 (Veterinary Office): Horse Care, Inc. is a veterinary clinic located at 90 South First Street, Weaver, <br /> CA. Our facility is a small quantity generator producing less than 20 pounds per week. There are two reasons why <br /> our firm requires a Limited Quantity Hauling Exemption. These are as follows: <br /> 1. Our firm makes house calls and generates medical waste—mostly sharps, as the result of treatments provided <br /> during these visits. The Limited Quantity Hauling Exemption is needed to transport this medical waste back to <br /> our office in Weaver for consolidation and storage prior to pick-up by Acme Medical Waste Services, a licensed <br /> medical waste hauler <br /> OR <br /> 2. Our firm transports its medical waste directly to Waste Inc., an off-site treatment facility located at 205 Second <br /> Street, Weaver, CA, for treatment and disposal. <br /> Page 2 of 4 <br /> DHS 8664(11103) <br />