ࡱ> =?< @ H$bjbjPP (&::$,>f* * * *  T ,!######$|RlG97  77G* * mmm7* * !m7!mmm* Z NMm$0m:c:m:m ^m L9  GGD.c .May, 2010  MISSISSIPPI DEPARTMENT OF ENVIRONMENTAL QUALITY OFFICE OF POLLUTION CONTROL SOLID WASTE DIVISION P. O. BOX 2261 JACKSON, MS 39225 REGISTRATION FORM HOME-GENERATED SHARPS COLLECTION STATION Instructions: Type directly into the fields below. When completed, save to your computer. Print a copy of the completed form and mail to the above address or return by email to  HYPERLINK "mailto:bill_barnett@deq.state.ms.us" bill_barnett@deq.state.ms.us. If you are registering multiple locations for one entity (e.g. fire departments, chain pharmacies, etc.), you may attach a typed listing of locations with physical addresses and phone numbers for each location.  Name of Business or Organization:  FORMTEXT       Street Address:  FORMTEXT       City/Town:  FORMTEXT       Zip Code:  FORMTEXT       Phone:  FORMTEXT       ************************************************************************ Name of Person Responsible for Operating the Station:  FORMTEXT       Mailing Address of Person Above:  FORMTEXT       (if different from street address) City/Town:  FORMTEXT       Zip Code:  FORMTEXT        FORMCHECKBOX  Check this box only if you wish for this collection station to be excluded fr    3;<m  ) < F h  ͸ͳpdPp&jhh4Xh_5CJUaJh4Xh_5CJaJ jh4Xh_5CJUaJh8h_5CJaJh_5CJaJh8hFS5CJaJ hRG5h$h2|5CJ aJ h2|5h2|hI'5CJaJh>5CJaJh2|h]%5CJaJh]%jhU`Uh2|h]%CJaJh_CJaJhTCJaJ  <Xm|P $$Ifa$gd v$a$gd2|$a$gd]%$a$gd2| H$ $ H N P R ʾsdXN>NjSh<h@5Ujh<5UhRGh<5CJaJjhT5UmHnHujhuUhQ(5U huU5jhuU5U h<5 hU`5hFShFSCJaJh8hFSCJaJh8h85CJaJh8h$5CJaJh8h_5CJaJh_5CJaJ jh4Xh_5CJUaJh4Xh_0J5>*CJaJP R T   l n rwrrrrrrrrrrrgdU`$a$gd]%kd_$$IflrL$D%  t 0644 l` ap   ( * > @ B L N ^ h n p l n {oh?Ih@5CJaJ h@׷қґ|בwgw[hRGh@Bx"z"|"H$ $h^ha$gduU &dPgd$gd$gd* hZ:5 huU5jhThT5U hP*95jhP*95Uh?IhuU5CJaJom the MDEQ s published list of sharps collection stations? THANK YOU FOR REGISTERING AND OPERATING A SHARPS COLLECTION STATION. YOUR EFFORTS TO DO SO REPRESENT A SERVICE TO EVERY PERSON WHO USES SHARPS IN THEIR HOME AND A COMMITMENT TO A SAFER ENVIRONMENT FOR EVERYONE IN YOUR COMMUNITY. &1h:pFS/ =!"#$%hDd# ^  C ,ADEQ LOG 2"`RO:͠ƒNȕzD20FO:͠ƒNȕzJFIF,,C    $.' ",#(7),01444'9=82<.342C  2!!22222222222222222222222222222222222222222222222222r" }!1AQa"q2#BR$3br %&'()*456789:CDEFGHIJSTUVWXYZcdefghijstuvwxyz w!1AQaq"2B #3Rbr $4%&'()*56789:CDEFGHIJSTUVWXYZcdefghijstuvwxyz ?( ( ( (=(⢚hBȨc++\`2gڸrڷ#??t9i;GÉƜ4,rj2<БzK3GO ݝ%2xoupJi˅Z])㞼^c~?Ѯ<7tڿ9<|^<["ȶdѿƦxTI~%J2W ҝ\QEQEQEQEQEQE^\ii-ę u>`sŚe?fp݀pt5ʽEJqw-ܖw,\爘=z\(lBI"(OkCM_lV5_,9!Tt8=jIm[l\ʭj˕ݙ†K7"QakЗ/-%PZFu2t/ʽ&!-S!a9FR$e(L((((LYz޷e6KB_.%1;ВE2UFK|r,^H<&})s+{8س =v?Ak{लGt3£i}]/>yif2'׌4mKnBGh= ((([-tVO}t5q8[C4gГ?\o[hϦv6?_Bx1s>\ؤDwԙ>XΝ[D׫cҼ;F?|^u[E\ czWl 4—]4:Ϩ9ӡVsUn=[G;Bt{HFϡ[٩fkQi7, IJbQ?@3q.>&yU~S͓zM`WxxqroTg){W/6wѲ4>ḅvӒ#ӁұuOZ}ƚd]ّ{<^X4-Wz mǛIߟL֫i_ԕې3ֵXBs-NhcH%PȥYOBWc$̯lS]Uh&[-wwzBVk{`,2]Cm#8 R8MY4pӨ*nH֖zRט{EPEPA~(imxn{F[=K~O ;PRQ4o+vz`פ9h@+ PkOh>YBd"Q#t=Қ!E&qJ7)_gۈ?s:~sxn7herh:EuViH]Ů8(˼QҶI?}ڇ⍔iNkoj#=yK|LegQ?8Իh<5-6ҳԈlɟ½Ż;X`Kx=UWɧ[[[i^mQEH:PrzIo}ag 2`:d}(cµCxi6[["mecX񤪸챫oRKM3KEd2/B?ϛb{궚ΦXq̅>AW]:_Xi}4^Ė>%dFEvdʞ9n#q_cכ M0a܏Țݰ4ȼ+{d=VZ.s Vr< %Rj~&ù;Զ2OB,|C69|}EnQN3dft MA3.?"V = l|[.zA!_tX9;_9{2Gnbֻ~NwhqJ'vz\-'JyBSYZ(LpNJ7?Ey3 T2O\Eo`)SgQE"[>Q~J( hDyK bill_barnett@deq.state.ms.usyK Hmailto:bill_barnett@deq.state.ms.us|$$If!vh5D%#vD%:Vlr  t 65D%` ap vDText12tDText2tDText3tDText4tDText5tDText6vDText14vDText13tDText9tDeCheck1@@@ NormalCJ_HaJmH sH tH DA@D Default Paragraph FontRi@R  Table Normal4 l4a (k(No Listj@j FS Table Grid7:V06U@6 _ Hyperlink >*B*ph$& <Xm|lm9^_<=>&000000000000 0 000000000000000000 0x0h0 <Xm|&?00?00?00?00?00?00;00 `.`;000000?00;0 0 0s ' @00s ' @H$ P rH$ H$  &7CIXdj%17kw}$XFFFFFFFFFG 8@0(  B S  ? Text12Text2Text3Text4Text5Text6Text14Text13Text9Check18Y&l& 'Jk8~& *l*ı*d?#*D|#*l*"* *D*!sss||&vv{&>*urn:schemas-microsoft-com:office:smarttags PostalCode:*urn:schemas-microsoft-com:office:smarttagsStreet8*urn:schemas-microsoft-com:office:smarttagsCity;*urn:schemas-microsoft-com:office:smarttagsaddress9*urn:schemas-microsoft-com:office:smarttagsState9*urn:schemas-microsoft-com:office:smarttagsplace? *urn:schemas-microsoft-com:office:smarttags stockticker    &:<&3 3;'7JPUXk%8k~<=&&)&XU`U0p2|_uU~Q(T@<$I'RG8|4@ v:8]%4Xeu&@,34$P@P PP"UnknownGz Times New Roman5Symbol3& z Arial"qhԆFԆ: : !24d!!;QK)?eREGISTRATION FORMBBARNETTBBARNETTOh+'0 ( D P \ ht|REGISTRATION FORM BBARNETT Normal.dot BBARNETT15Microsoft Word 10.0@VP@VOfF@ !N1@R<:՜.+,D՜.+,< hp|  DEQ ! REGISTRATION FORM Title 8@ _PID_HLINKSAok$mailto:bill_barnett@deq.state.ms.us  "#$%&'()*+-./012356789:;>Root Entry F(N@Data k1Table!:WordDocument(&SummaryInformation(,DocumentSummaryInformation84CompObjj  FMicrosoft Word Document MSWordDocWord.Document.89q