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4. Do you generate 200 or more pounds per month of the types of medical waste listed on Page 3? yesx no-- 5. Do you plan to treat your medical waste onsite (at your facility), by autoclaving, incinerating or using microwave technology? yesx no_ If your answers to questions 3„ 4 and 5 are no then complete the "Certification Statement" on Page 5 and return it with this questionnaire to the address shown at the bottom of Page 2. You do not need to complete the rest of the forms in this package. If your answers to questions 4 or 5 are� please complete the "Registration For Medical Waste" form on Page 6 and submit a "Medical Waste Management Plan" as specified on Pages 7 & 8. 4. If you generate less than 20 pounds of medical waste per week, transport less than 20 pounds at one time, and have a hauling information document on file in your office, you may apply for a Limited Quantity Hauling Exemption. This exemption allows you or your staff to transport medical waste yourselves, without hiring a registered hazardous waste hauler, to a medical waste treatment facility. Do you want to apply for a Limited Quantity Hauling Exemption? yes—no— n/a If your answer is no, you will be required to hire a registered hazardous waste hauler to transport your waste for treatment and disposal. If your answer is return this questionnaire and the "Certification Statement" on Page 5 to the address shown below, and a "Limited Hauling Exemption" application will be mailed to you. * Biosafety Level 4 viruses and diseases are: Congo-Crimean Hemorrhagic Fever, Tick- borne Encephalitis Virus Complex (Absettarov, Hanzalova, Hypr, Kumlinge, Kyasanur Forest Disease, Omsk Hemorrhagic Fever, and Russian Spring-Summer Encephalitis), Marburg Disease, Ebola, Junin Virus, Lassa Fever Virus, and Machupo Virus. NOTE: This questionnaire acts as a guideline only. Please refer to the enclosed "Medical Waste Management Act" for more specific registration/exemption information. ' 4