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<DIV><FONT face=Arial size=2><FONT size=2>
<P><FONT color=#0000ff><SPAN
class=343001313-24012006>Ms.</SPAN> Otteni<SPAN
class=343001313-24012006>?</SPAN></FONT></P>
<P><FONT color=#0000ff><SPAN class=343001313-24012006>was the brief (below) on
the CWA's national pretreatment program's objectives what you were looking for
back in December?</SPAN></FONT></P>
<P><FONT color=#0000ff><SPAN class=343001313-24012006><SPAN
class=343001313-24012006>thanx again to Dr. Gressitt for pointing out other
costs that are real but, hard (impossible at this time?) to
tabulate</SPAN>.</SPAN></FONT></P>
<P><FONT color=#0000ff><SPAN class=343001313-24012006>this has probably already
been posted but, see interesting article: <B><FONT face=AGaramond-Bold
size=5><FONT size=3>Emerging Liabilities from Pharmaceuticals<SPAN
class=343001313-24012006> </SPAN>and Personal Care Products @</FONT></P>
<P></B></FONT><A
href="http://www.howrey.com/docs/liabilitiespharmaceuticals20020401.pdf">http://www.howrey.com/docs/liabilitiespharmaceuticals20020401.pdf</A><FONT
face=Arial><FONT size=2> <SPAN
class=343001313-24012006></SPAN></FONT></FONT></SPAN></FONT></P>
<P><FONT color=#0000ff><SPAN class=343001313-24012006>allen
g</SPAN></FONT></P></FONT></FONT></DIV>
<BLOCKQUOTE dir=ltr style="MARGIN-RIGHT: 0px">
<DIV></DIV>
<DIV class=OutlookMessageHeader lang=en-us dir=ltr align=left><FONT
face=Tahoma size=2>-----Original Message-----<BR><B>From:</B> Stevan Gressitt
[mailto:gressitt@uninets.net] <BR><B>Sent:</B> Monday, January 23, 2006 9:39
PM<BR><B>To:</B> Gilliam, Allen; 'H2E - Hospitals for a Healthy Environment -
Info Exchange Listserv'<BR><B>Cc:</B>
pharmwaste@lists.dep.state.fl.us<BR><B>Subject:</B> RE: [h2e] RE: any
legislation/ordinances banning disposal of pharmaceuticals to sanitary
sewer?<BR><BR></FONT></DIV>
<DIV class=Section1>
<P class=MsoNormal><FONT face=Arial color=navy size=2><SPAN
style="FONT-SIZE: 10pt; COLOR: navy; FONT-FAMILY: Arial">Apologies for being
late in replying but I had been saving this for when I had a few minutes to go
over the regs. I’ll defer on those for now. <o:p></o:p></SPAN></FONT></P>
<P class=MsoNormal><FONT face=Arial color=navy size=2><SPAN
style="FONT-SIZE: 10pt; COLOR: navy; FONT-FAMILY: Arial"><o:p> </o:p></SPAN></FONT></P>
<P class=MsoNormal><FONT face=Arial color=navy size=2><SPAN
style="FONT-SIZE: 10pt; COLOR: navy; FONT-FAMILY: Arial">At the bottom where
you comment on the economics. Could I suggest that the paradigm for costing
out the value is missing variables that actually make this a very simple
sell.<o:p></o:p></SPAN></FONT></P>
<P class=MsoNormal><FONT face=Arial color=navy size=2><SPAN
style="FONT-SIZE: 10pt; COLOR: navy; FONT-FAMILY: Arial"><o:p> </o:p></SPAN></FONT></P>
<OL style="MARGIN-TOP: 0in" type=1>
<LI class=MsoNormal style="COLOR: navy; mso-list: l0 level1 lfo1"><FONT
face=Arial color=navy size=2><SPAN
style="FONT-SIZE: 10pt; FONT-FAMILY: Arial">Cost of childhood accidental
poisonings.<o:p></o:p></SPAN></FONT>
<LI class=MsoNormal style="COLOR: navy; mso-list: l0 level1 lfo1"><FONT
face=Arial color=navy size=2><SPAN
style="FONT-SIZE: 10pt; FONT-FAMILY: Arial">Cost of burglary for drugs, and
teenage pharming<o:p></o:p></SPAN></FONT>
<LI class=MsoNormal style="COLOR: navy; mso-list: l0 level1 lfo1"><FONT
face=Arial color=navy size=2><SPAN
style="FONT-SIZE: 10pt; FONT-FAMILY: Arial">Cost of patient medication
errors from having accumulated a confusing pile<o:p></o:p></SPAN></FONT>
<LI class=MsoNormal style="COLOR: navy; mso-list: l0 level1 lfo1"><FONT
face=Arial color=navy size=2><SPAN
style="FONT-SIZE: 10pt; FONT-FAMILY: Arial">Cost of environmental injury
goes here…someday<o:p></o:p></SPAN></FONT> </LI></OL>
<P class=MsoNormal><FONT face=Arial color=navy size=2><SPAN
style="FONT-SIZE: 10pt; COLOR: navy; FONT-FAMILY: Arial"><o:p> </o:p></SPAN></FONT></P>
<P class=MsoNormal><FONT face=Arial color=navy size=2><SPAN
style="FONT-SIZE: 10pt; COLOR: navy; FONT-FAMILY: Arial">But there is now a
5<SUP>th</SUP>: The cost of disposal in third world countries of badly donated
drugs that don’t meet the 1999 WHO Guidelines and that now for example have a
price tag of over 1 million Euros in Banda Aceh alone for the 340 tons of
unusable “donations.” <o:p></o:p></SPAN></FONT></P>
<P class=MsoNormal><FONT face=Arial color=navy size=2><SPAN
style="FONT-SIZE: 10pt; COLOR: navy; FONT-FAMILY: Arial"><o:p> </o:p></SPAN></FONT></P>
<P class=MsoNormal><FONT face=Arial color=navy size=2><SPAN
style="FONT-SIZE: 10pt; COLOR: navy; FONT-FAMILY: Arial">Maybe I’m overstating
a bit, but those seem compelling arguments and I simply added the word cost to
each for the sake of this email.<o:p></o:p></SPAN></FONT></P>
<P class=MsoNormal><FONT face=Arial color=navy size=2><SPAN
style="FONT-SIZE: 10pt; COLOR: navy; FONT-FAMILY: Arial"><o:p> </o:p></SPAN></FONT></P>
<P class=MsoNormal><FONT face=Arial color=navy size=2><SPAN
style="FONT-SIZE: 10pt; COLOR: navy; FONT-FAMILY: Arial">Seems actually to
make it more starkly important.<o:p></o:p></SPAN></FONT></P>
<P class=MsoNormal><FONT face=Arial color=navy size=2><SPAN
style="FONT-SIZE: 10pt; COLOR: navy; FONT-FAMILY: Arial"><o:p> </o:p></SPAN></FONT></P>
<P class=MsoNormal><FONT face=Arial color=navy size=2><SPAN
style="FONT-SIZE: 10pt; COLOR: navy; FONT-FAMILY: Arial">Stevan Gressitt,
M.D.<o:p></o:p></SPAN></FONT></P>
<P class=MsoNormal><FONT face=Arial color=navy size=2><SPAN
style="FONT-SIZE: 10pt; COLOR: navy; FONT-FAMILY: Arial">207-441-0291
<o:p></o:p></SPAN></FONT></P>
<P class=MsoNormal><FONT face=Arial color=navy size=2><SPAN
style="FONT-SIZE: 10pt; COLOR: navy; FONT-FAMILY: Arial"><o:p> </o:p></SPAN></FONT></P>
<DIV>
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face="Times New Roman" size=3><SPAN style="FONT-SIZE: 12pt">
<HR tabIndex=-1 align=center width="100%" SIZE=2>
</SPAN></FONT></DIV>
<P class=MsoNormal><B><FONT face=Tahoma size=2><SPAN
style="FONT-WEIGHT: bold; FONT-SIZE: 10pt; FONT-FAMILY: Tahoma">From:</SPAN></FONT></B><FONT
face=Tahoma size=2><SPAN style="FONT-SIZE: 10pt; FONT-FAMILY: Tahoma">
Gilliam, Allen [mailto:GILLIAM@adeq.state.ar.us] <BR><B><SPAN
style="FONT-WEIGHT: bold">Sent:</SPAN></B> Tuesday, November 22, 2005 2:25
PM<BR><B><SPAN style="FONT-WEIGHT: bold">To:</SPAN></B> H2E - Hospitals for a
Healthy Environment - Info Exchange Listserv<BR><B><SPAN
style="FONT-WEIGHT: bold">Cc:</SPAN></B>
pharmwaste@lists.dep.state.fl.us<BR><B><SPAN
style="FONT-WEIGHT: bold">Subject:</SPAN></B> [h2e] RE: any
legislation/ordinances banning disposal of pharmaceuticals to sanitary
sewer?</SPAN></FONT><o:p></o:p></P></DIV>
<P class=MsoNormal><FONT face="Times New Roman" size=3><SPAN
style="FONT-SIZE: 12pt"><o:p> </o:p></SPAN></FONT></P>
<P class=MsoNormal><FONT face="Times New Roman" size=3><SPAN
style="FONT-SIZE: 12pt">H2E -- Hospitals for A Healthy Environment Info
Exchange Listserve<BR>(h2e@email.sparklist.com)<o:p></o:p></SPAN></FONT></P>
<DIV>
<P class=MsoNormal><FONT face=Arial color=blue size=2><SPAN
style="FONT-SIZE: 10pt; COLOR: blue; FONT-FAMILY: Arial">tough questions
Dan!</SPAN></FONT><o:p></o:p></P></DIV>
<DIV>
<P class=MsoNormal><FONT face="Times New Roman" size=3><SPAN
style="FONT-SIZE: 12pt"> <o:p></o:p></SPAN></FONT></P></DIV>
<DIV>
<P class=MsoNormal><FONT face=Arial color=blue size=2><SPAN
style="FONT-SIZE: 10pt; COLOR: blue; FONT-FAMILY: Arial">easy, but time and
resource intensive anwer? City Pretreatment programs and their
inspectors (doubt the epa will come up with the regs). 40 cfr 403 (the
national pretreatment regs which are self-implementing) apply to all
"non-domestic dischargers": </SPAN></FONT><B><FONT face=Arial
size=1><SPAN
style="FONT-WEIGHT: bold; FONT-SIZE: 7.5pt; FONT-FAMILY: Arial"><o:p></o:p></SPAN></FONT></B></P></DIV>
<P><B><FONT face="Times New Roman" color=blue size=2><SPAN
style="FONT-WEIGHT: bold; FONT-SIZE: 10pt; COLOR: blue">§
</SPAN></FONT></B><B><FONT face=NewCenturySchlbk-Bold color=blue size=2><SPAN
style="FONT-WEIGHT: bold; FONT-SIZE: 10pt; COLOR: blue; FONT-FAMILY: NewCenturySchlbk-Bold">403.2
Objectives of general pretreatment regulations.</SPAN></FONT></B><B><FONT
face=NewCenturySchlbk-Bold size=1><SPAN
style="FONT-WEIGHT: bold; FONT-SIZE: 7.5pt; FONT-FAMILY: NewCenturySchlbk-Bold"><o:p></o:p></SPAN></FONT></B></P>
<P><FONT face="Times New Roman" color=blue size=2><SPAN
style="FONT-SIZE: 10pt; COLOR: blue">By establishing the responsibilities of
government and industry to implement National Pretreatment Standards this
regulation fulfills three objectives:</SPAN></FONT><o:p></o:p></P>
<P><FONT face="Times New Roman" color=blue size=2><SPAN
style="FONT-SIZE: 10pt; COLOR: blue">(a) To prevent the introduction of
pollutants into POTWs [publicly owned treatment works] which will
interfere with the operation of a POTW, including interference with its use or
disposal of municipal sludge; </SPAN></FONT><o:p></o:p></P>
<P><FONT face="Times New Roman" color=blue size=2><SPAN
style="FONT-SIZE: 10pt; COLOR: blue">(b) To prevent the introduction of
pollutants into POTWs which will pass through [cause toxicity] the
treatment works or otherwise be incompatible with such works;
and</SPAN></FONT><o:p></o:p></P>
<P><FONT face="Times New Roman" color=blue size=2><SPAN
style="FONT-SIZE: 10pt; COLOR: blue">(c) To improve opportunities to recycle
and reclaim municipal and industrial wastewaters and
sludges.</SPAN></FONT><o:p></o:p></P>
<DIV>
<P class=MsoNormal><FONT face=Arial color=blue size=2><SPAN
style="FONT-SIZE: 10pt; COLOR: blue; FONT-FAMILY: Arial">best management
practices or general permits can and might be required, paperwork (daily
procedure logs, manifests and/or bills of laden) will have to be
available for review upon request by the city's inspectors that all meds/lab
chems were disposed of off-site. these cities have the
authority for implementing the same type enforcement options that epa and the
states do including civil and/or criminal penalties, administrative
orders, severing your sewer service, imprisonment, publishing your
facility's name in the local newspaper for being
non-compliant, etc. </SPAN></FONT><o:p></o:p></P></DIV>
<DIV>
<P class=MsoNormal><FONT face="Times New Roman" size=3><SPAN
style="FONT-SIZE: 12pt"> <o:p></o:p></SPAN></FONT></P></DIV>
<DIV>
<P class=MsoNormal><FONT face=Arial color=blue size=2><SPAN
style="FONT-SIZE: 10pt; COLOR: blue; FONT-FAMILY: Arial">that's why
the clean water act created the program. let the cities decide at
their own discretion, what's allowed into their sewage collection
systems. who better to make the judgement than the folks protecting its
publicly own assets and have a chance to interact with their next door
neighbors, business leaders, civic clubs, council members, etc on a daily
basis?</SPAN></FONT><o:p></o:p></P></DIV>
<DIV>
<P class=MsoNormal><FONT face="Times New Roman" size=3><SPAN
style="FONT-SIZE: 12pt"> <o:p></o:p></SPAN></FONT></P></DIV>
<DIV>
<P class=MsoNormal><FONT face=Arial color=blue size=2><SPAN
style="FONT-SIZE: 10pt; COLOR: blue; FONT-FAMILY: Arial">it's in this office's
lowly opinion that a federal or state decision would side with the
city. if you get down to the Act's Pretreatment reg. bare
bones, a city with a publicly owned sewer systerm is not obligated to take ANY
non-domestic wastewater.</SPAN></FONT><o:p></o:p></P></DIV>
<DIV>
<P class=MsoNormal><FONT face="Times New Roman" size=3><SPAN
style="FONT-SIZE: 12pt"> <o:p></o:p></SPAN></FONT></P></DIV>
<DIV>
<P class=MsoNormal><FONT face=Arial color=blue size=2><SPAN
style="FONT-SIZE: 10pt; COLOR: blue; FONT-FAMILY: Arial">inducements/incentives?
environmental stewardhip and doing the right thing is a hard sell when
there's no immediate monetary gains mentioned in the same sentence (and,
as previously mentioned, no absolute proof of toxicity after it passes
thru a city's w.w. treatment plant). avoiding fines would be my reward
and a plaque in the window an article in your
newletters/ads that your facility is a recognized environmental friendly
facility with a certified <st1:place w:st="on">EMS</st1:place> (go
H2E!) should help your bottom line in the long
run. </SPAN></FONT><o:p></o:p></P></DIV>
<DIV>
<P class=MsoNormal><FONT face="Times New Roman" size=3><SPAN
style="FONT-SIZE: 12pt"> <o:p></o:p></SPAN></FONT></P></DIV>
<DIV>
<DIV>
<P class=MsoNormal><FONT face=Arial color=blue size=2><SPAN
style="FONT-SIZE: 10pt; COLOR: blue; FONT-FAMILY: Arial">[sorry, but i've
taken the liberty of cc'ing the pharmawaste listserve at the risk of violating
any unknown cross talking policies as i know many of you are on both
anyway. somebody chew me out if i did bad....got my leather on
today....].</SPAN></FONT><o:p></o:p></P></DIV>
<DIV>
<P class=MsoNormal><FONT face="Times New Roman" size=3><SPAN
style="FONT-SIZE: 12pt"> <o:p></o:p></SPAN></FONT></P></DIV>
<DIV>
<P class=MsoNormal><FONT face=Arial color=blue size=2><SPAN
style="FONT-SIZE: 10pt; COLOR: blue; FONT-FAMILY: Arial">alot of eyes still
need to be opened and more information gained
nationwide.</SPAN></FONT><o:p></o:p></P></DIV>
<DIV>
<P class=MsoNormal><FONT face="Times New Roman" size=3><SPAN
style="FONT-SIZE: 12pt"> <o:p></o:p></SPAN></FONT></P></DIV>
<DIV>
<P class=MsoNormal><FONT face=Arial color=blue size=2><SPAN
style="FONT-SIZE: 10pt; COLOR: blue; FONT-FAMILY: Arial">have a great
holiday,</SPAN></FONT><o:p></o:p></P></DIV>
<DIV>
<P class=MsoNormal><FONT face="Times New Roman" size=3><SPAN
style="FONT-SIZE: 12pt"> <o:p></o:p></SPAN></FONT></P></DIV>
<DIV>
<P class=MsoNormal><FONT face=Arial color=blue size=2><SPAN
style="FONT-SIZE: 10pt; COLOR: blue; FONT-FAMILY: Arial">allen
gilliam</SPAN></FONT><o:p></o:p></P></DIV>
<DIV>
<P class=MsoNormal><FONT face=Arial color=blue size=2><SPAN
style="FONT-SIZE: 10pt; COLOR: blue; FONT-FAMILY: Arial">adeq state
pretreatment coordinator</SPAN></FONT><o:p></o:p></P></DIV>
<DIV>
<P class=MsoNormal><FONT face=Arial color=blue size=2><SPAN
style="FONT-SIZE: 10pt; COLOR: blue; FONT-FAMILY: Arial">501.682.0625
</SPAN></FONT><o:p></o:p></P></DIV>
<DIV><FONT face=Arial color=#0000ff
size=2></FONT> </DIV></DIV></DIV></BLOCKQUOTE></BODY></HTML>