Environmental Services Department

/ Director of Environmental, Economy & Housing
Marc Cole

Environmental Services Department

Head of Neighbourhood Services
Mr Tony Neul

Clinical Waste Dept

Doughty Depot

Doughty Road

Grimsby

DN32 0LL

12th October 2012

Dear Sir/Madam

If telephoning or calling please ask for: Paul Paton

Dear Sir/Madam

Clinical Waste Collection Service

This property is registered as requiring a Clinical Waste Collection, as part of the “Duty of Care” with regard to the collection of waste under the 1990 Environmental Protection Act we are required to provide details of the type of waste we are collecting and from whom and where it is collected.

Please could you complete the enclosed form and return in the free-post envelop provided

The information provided will be protected under the Data Protection Act and will only be used in ensuring the collection of your waste is carried out within the “Duty of Care”

If you require any clarification please do not hesitate to contact me on 01472 323423/325779

Yours faithfully

Paul Paton

Clinical Team Manager

Clinical waste collection form

“Duty of Care”

Name of person producing the waste: ……………………………………………………………..

Contact No………………………………………………………………………………………………

Address

Bagged Waste Number of bags produced per week

(No glass vessels to be placed inside bags)

Self-Administer Nurse Administer Stoma Bags

Incontinence pads Dialysis waste PPE (gloves etc)

Other (Please describe)

Wound Dressings or materials containing: (see back of form)

High Risk Fluids Please specify

Low Risk Fluids Please specify

Syringe Waste Quantity of needles produced per week i.e. how full box (indicate in boxes below)

Orange lid Yellow Lid Purple Lid

Signed;……………………………………..Date……………………………………………………..

If you are unsure of the description of your waste and have a care/health support worker who calls please ask them to complete this section on your behalf, if you have no assistance please contact Paul Paton, Clinical Team Manager who will be happy to advise by telephoning 01472 323423 / 325779

Please return this form in the envelope provided

High Risk Fluids

·  Blood and visibly blood stained fluid

·  Breast milk

·  Amniotic fluid

·  Vaginal secretions

·  Seamen

·  Synovial fluid

·  Pericardial fluid

·  Pleural fluid

·  Peritoneal fluid

·  Unfixed tissues/organs

·  Salvia (when associated with dentistry)

Low risk Fluids

·  Vomit

·  Sputum

·  Saliva (when not associated with dentistry)

·  Urine

·  Faeces

·  Tears

·  Sweat