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Applications and Forms

Note:  All forms are in PDF Format
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The
Infectious Medical Waste Rule can be obtained here.

NEW!  

On-line Application and Payment Option for Renewal of Infectious Medical Waste Facility Permit

To Complete an Online Application for Renewal of Infectious Medical Waste Facility Permit;

You will need:

● Current Infectious Medical Waste (IMW) Permit number

● Credit Card: VISA, MASTERCARD, AMERICAN EXPRESS, DISCOVER

Click here to begin Application and Payment Page.

Procedure To Renew A Permit

       No Changes In Your Infectious Medical Waste Management Plan

To renew a permit with no changes to the Infectious Medical Waste Plan simply complete an application form and submit it with the required fee from appendix A of the Infectious Medical Waste Rule, 64CSR56.

 

       With Minor Changes To Your Infectious Medical Waste Management Plan

A copy of the Infectious Medical Waste Management Plan must be submitted with a completed application from and fee. A copy of the management plan will be returned with your permit if it is adequate when reviewed. If there is a problem with the plan the IMW program personnel will correspond with you until it meets the requirements. You may operate under your old plan until the new one is compliant.

 

       Major Changes Must Be Approved Before Implementation

 

Please Contact for Questions or Additional Information:

Office of Environmental Health Services, 350 Capital Street, Room 313, Charleston, WV 25301-3713

Phone No. 304-558-2981

Fax No. 304-558-1071

Or email: Donna.R.Gorbey-Michael@wv.gov

 

Coming Soon! On-Line Applications and Payment for Infectious Medical Waste Haulers.

 

Applications

bullet Infectious Medical Waste Management Facility - Application Package for a New Permit
 
bullet  Application only
bullet Infectious Medical Waste Management Facility - Application Package for a Major Change to Management Plan
 
bullet  Application only
bullet Infectious Medical Waste Management Facility - Permit Renewal
bullet Infectious Medical Waste Transport Vehicle Permit
 
bullet Fill - In Application in Word
bullet Incinerator Operator Registration Application
bullet Evaluation of Alternative Medical Waste Treatment Technologies
bullet Permit Fee Schedule
   

For additional information contact:

Donna Gorbey-Michael, R.S. - Infectious Medical Waste Program

Email:  donna.r.gorbey-michael@wv.gov
(304) 365- 4420 ext. 79404
(304) 367-2755 fax

 

Forms

bullet IW-3  Infectious Medical Waste Shipping Manifest
bullet IW-10  Infectious Medical Waste Management Facility Annual Report in PDF
bullet IW-10  Infectious Medical Waste Management Facility Annual Report in Word
bullet IW-11  Transporter Quarterly Report in Excel
bullet IW-11  Transporter Quarterly Report in PDF
bullet IW-11  Transporter Quarterly Report in Word
bullet IW-11A  Transporter Quarterly Customer Information Report in Excel
bullet IW-16  Commercial Waste Treatment Facility Quarterly Report
bullet 180 Day Evaluation Agreement
   
   

 

 

 

Infectious Medical Waste Applications and Forms