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<br />G~uarttity. To the extent applicable to~the facility, management plans must be accompanied by a <br />statement of the quantity of infectious and pathological waste generated, decontaminated, stored, <br />• incinerated, or disposed of at the facility during the previous two-year period. Quantities must be <br />reported in gallons or pounds. (Minn. Stat. § 116.79, subd. 1 [d]) <br />Complete the following information for each generating facility stating whether <br />gallons or pounds: <br />Generated (total) <br />Decontaminated on-site <br />Disposed of {sewered} <br />Stored on-site <br />(maximum at any one time) <br />Incinerated on-site <br />Disposed of <br />(transported off-site) <br />i• <br />-, <br />z~ <br />Signature per n <br />~C~ ~~ 7w <br />Tiff e <br />i• <br />Infectious, Waste ~tholc~ical Waste h r <br />~- <br />_~ __~ <br />-- - ifi <br />/" <br />_~-- <br />`_ <br />~~_ ~ ~~~ ~ <br />;ib a for the fa 't~ /(ies) <br />Phone Number <br />Date <br />5 <br />