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Jan.31, 2012 10:32AM LD <br />MEDICAL <br />ENGINEERING <br />No,5494 P. 8 <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: G�G1 <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: X Yes ❑ No <br />Describe training provided to staff regarding handling, storage, disposal, and record <br />keeppin of all, medical waste, including pharmaceutical waste at your facility: <br />r0lS T t - & I -- '% A _ i 1 s r N — _ _ a a . . <br />j. Describe your medical waste emergency action plan, including procedures for <br />handling, s ills, exposures, equipment failures, etc: <br />-fir oLcii aF mutty& <br />I hereby certify to the best of my knowledge and belief that the statements made herein are <br />correct and true. <br />Signature: <br />Printed Name: <br />Title: <br />Date: 1 t 'i— / Z� <br />EHD A5-03 <br />]0/6/2006 <br />