Get Application For Notification For Registration Of Onsite Pharmaceutical ... - Elibrary Dep State Pa

This guide provides a comprehensive overview of how to fill out the Application For Notification For Registration Of Onsite Pharmaceutical Collection Program. It aims to assist pharmacies in completing the form accurately and efficiently online.

Follow the steps to complete the application process.

1. Click ‘Get Form’ button to obtain the form and open it in the online editor.
2. In the first section, provide your pharmacy name and address. Ensure all details are accurately entered to prevent any delays in processing your application.
3. Enter the lead contact person's name, phone number, and email address. This information is essential for communication regarding your application.
4. Specify the dates of the collection event in the provided fields. Note that the event cannot exceed five years in duration.
5. Fill in the transporter information, including the name of the hazardous waste transporter and their license number. Include the license expiration date and full address of the transporter.
6. List each collection site's information, including the licensed pharmacy name, license number, pharmacist's name, and address for each location.
7. In the sponsor certification section, ensure that you initial each condition that must be satisfied for compliance. This includes understanding waste handling and storage requirements.
8. Proceed to fill out the affidavit section by providing the name, title of the official, and the accurate date of submission. Don't forget to sign the application.
9. Review all information for accuracy. Once completed, you can save changes, download, print, or share the form as necessary.

Complete your application online today for a seamless registration process.