1. Waste Management Issues for Hospitals/Healthcare Facilities

2. Agenda !Hospitals and Healthcare Facilities Varying Waste Stream Types !Needs and Solutions - Technology and Service Based !Liability Management !Summary !Questions

3. Typical Waste Streams Non-Hazardous Waste Laboratory Chemicals DEA Controlled Substances Catalysts and Reagents Polychlorinated Biphenyls - Ballasts Low-Level Radioactive Waste Returned Goods/Off-Spec/Out-Of-Date Products Cylinders Recyclables – Lamps, Batteries, Computer Equipment Mercury Medical Waste

4. NEEDS and SOLUTIONS Technology and Service Based Hazardous, Non-Hazardous, Medical, Low Level Rad

5. NEED: Provide cost effective solution for the management of NH debris/out of spec materials and pharmaceutical products. Waste-To-Energy Incinerators Waste-To-Energy Plant Operations-Including-- waste delivery, unloading, separation, feeding, combustion, energy recovery, residue management, and pollution controls Assured destruction of Non- Regulated Waste

6. NEED: Find alternatives for the management of organic waste streams which include deregulation(Beneficial Reuse Program), reduction in HW status and cost savings. FUELS BLENDING/RECLAIM/RECYCLE High temperature industrial furnaces and cement kilns Reduction of overall waste management costs Recycling and Resale Options – Bulk Tankers/Drums Waste Types Solvents Solids Glycols/Water Resale Solvents to include: Alcohols Ketones Chlorinated Solvents

7. NEED: Find a cradle to grave liability protection solution that can handle RCRA material, reactives and specialty chemicals in a compliant manner. INCINERATION RCRA, TSCA, CERCLA and Non-Hazardous Capabilities Rotary kilns and fixed hearth incineration technology Cradle to grave liability protection MACT Compliant/September 2003 Waste Types Cylinders Laboratory Chemicals Drum Waste Streams Reactives

8. NEED: Identification of a cost effective, service orientated solution based alternative for medical waste disposal. INCINERATION/AUTOCLAVE Your choice of disposal technology LTL and Full Truck load options Red Bag, Sharps, Chemo On-site management to ensure proper segregation.

9. NEED: Identify options for the proper management of mixed rad waste to include: cost effective processing solutions, liability protection and on-site assistance. Low Level Rad Management Disposal and Services Swipe Testing/Decon work Identification and Classification of Wastes Technology/Facilities – Incineration, solidification, landfill Packaging Assistance and Regulatory Paperwork Completion Radioactive Compounds such as: Uranium acetate Thorioum nitrate Dry active waste Sealed sources Scintillation vials and fluids

10. NEED: The proper management of recyclable materials to ensure “green solutions”, compliant universal waste management and reduction in HW generation. RECYCLING OPTIONS Waste Mercury Reduction Efforts. Mercury Recycling Computer/electronic precious metals recovery. Batteries recycle Power distribution equipment decon and recycle. Lamps recycling Acids, caustics and metal-bearing sludges metal recovery programs for resale.

11. NEED: To focus on core site competencies, reduce liability associated with hazardous materials management activities and compliance with generator status. ON-SITE SERVICE Enables customer to focus on core business. Manage HW storage areas. Manage satellite accumulation inspections Ensure proper training. Minimization of waste generated Highly trained environmental professionals Single source access to all capabilities and services Administration: customized site waste management program Report completion.

12. NEED: To proactively identify potentially reactive/explosive compounds. Specialized reactive sweeps to identify potential problems/hazards and management solutions. Reduction of remote openings and special permitting. High Hazard Chemical Management Cylinders Monomers Temperature sensitive compounds Oxidizers Azides Multi-nitrated compounds Extreme toxins Shock sensitive Peroxide forming compounds Water and air sensitive materials Multiple hazard

13. Risk Management

14. Facility Reviews Liability Management !Part B Permit/Application !Waste Analysis Plan to include state and local restrictions. !Closure Plan !Past Management Practices !Air, Stormwater, Groundwater Management/Monitoring. !Tracking !Financial Stability/Assurance !Insurance !Community Relations !Fire and Safety Performance

15. Liability Management Environmental Compliance Financially Sound Superfund Indemnification Audited Third Party Sites Regulatory Support Low OSHA Incident Rate Profitable Company

16. Questions?