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Phone: (oZo� _ D-764' <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: <br /> Address: <br /> City State Zip Code <br /> Phone: ( ) <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: ❑ Yes CyNo <br /> L Describe training provided to staff regarding handling, storage, disposal, and record <br /> keeping of all medical waste,including pharmaceutical waste, at your facility: <br /> Iz <br /> j. Describe your medical waste emergency action plan, including procedures for <br /> handling spills, exposures, equipment failures, etc: <br /> I hereby certify to the best of my knowledge and belief that the statements made herein are <br /> correct and true. <br /> Signature: G��L� <br /> Printed Name: Z)I GUA d,4-,jA,'FffA <br /> Title: <br /> Date: <br /> EHD 45-03 7 <br /> 10/6/2006 <br />