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SAN JOAQUIN COUNTY 0 Date -14 1111111 <br />ENVIRONMENTAL EALTH DEPARTMENT PR OkSt) n5> 1 <br />600 East Main Street, Stockton, CA 95202 <br />(209) 468-3420 <br />MEDICAL WASTE INSPECTION FORM <br />s , ' ► rStatistd dW <br />FacilityContact <br />Title <br />P o; a 010 <br />Registration <br />THE ITEMS BELOW REPRESENT VIOLATIONS OF THE CALIFORNIA <br />_ 1. HSC Section 117955 -Large Quantity <br />Generator shall register with the enforcement <br />HEALTH & <br />SAFETY CODE (HSC): <br />agency prior to commencement of the generation of <br />medical waste. <br />_2. HSC Section 117903 -Permit from the <br />enforcement agency required to treat medical <br />i <br />(W WuG C <br />P n P <br />(� !j ry anS S <br />1 n tis. <br />tV 1 <br />C 1 t �l <br />waste. <br />_3. HSC Section 117890 -No large LQG shall <br />generate medical waste unless registered with the <br />enforcement agency. <br />_4. HSC Section 117895-SQG that treats med <br />waste shall register with enforcement agency. <br />_5. HSC Section 117900 -Shall not haul med <br />a Iry k (- Lm <br />9 04-, t c <br />waste unless registered or obtained LQHE. <br />Section 117903 -Shall not treat med <br />° +1 cul (� <br />C S <br />.. {�( <br />s <br />'uo 01 <br />St " 1�4 l <br />_6.HSC <br />waste without permit from enforcement agency. <br />_7.HSC Section 117908 -Common Storage <br />facility shall be registered with local enforcement <br />agency. <br />Procedures <br />Qt -q to oS -- } <br />i F <br />iaAr-. A ?Sr SU <br />i <br />Amh i ;b 0AIL5 • , <br />SIA.__ `n;k 21 X, <br />_1.t�r(lp luny <br />_8.HSC Section 117935-SQG MWMP <br />_9.HSC Section 117943-SQG Shall keep <br />records for 3 years. <br />i <br />_10.HSC Section 117945-SQG not required to <br />register shall keep records for 2 years. <br />kll.HSC Section 117960-LQG shall file MWMP <br />with enforcement agency. <br />_12.HSC Section 117975-LQG shall keep <br />records for 3 years. <br />Transportation <br />G 1 <br />1 n J C ci1t <br />1 <br />8 <br />—t- <br />MU 61C At`(' <br />Wu, it 131- <br />M/��V%IVA <br />"'a �u�lYlI <br />go <br />_13. HSC Section 118030-LQHE application.`ecr <br />Treatment/Storage <br />_14.HSC Section 118135 -Shall obtain a permit <br />From the enforcement agency to treat medical <br />waste prior to treating the waste. <br />_15.HSC Section 118765 -All treatment records <br />shall be kept for 3 years. <br />— <br />lqeD1 4 4'1 <br />, <br />CL 7 e� <br />�, <br />,�� , <br />41 <br />W <br />'A Gi ' <br />t fS <br />11 SCS ine, <br />t, <br />, A 'Avt <br />_16.HSC Section 118215 -All medical waste <br />shall be treated pursuant to this section. <br />_17.HSC Section 118220 -Recognizable human <br />anatomical parts shall be disposed of by interment <br />unless otherwise hazardous. <br />18.HSC Section 118225 -Treated sharps shall <br />b_e destroyed or somehow prevent public access. <br />,19.HSC Section 118275 -MW red bags, path, <br />chemo shall be labeled properly. <br />Section 118280 -MW label & contain <br />, <br />UJ <br />a Vt <br />J 1 <br />L <br />SO <br />_20.HSC <br />_21.HSC Section 118285 -Sharps label/contain <br />_22.HSC Section 118295 -Proper decon used. <br />_23.HSC Section 118307 -Interim storage labeled <br />X24.HSC Section 118310 -Enclosure labeled. <br />Section 118305 -Cannot reuse drums <br />_25.HSC <br />_26.HSC Section 117630 -Approved biohazard <br />All <br />r-- <br />bag used. <br />K27.HSC Section 118275(g)-Pharm label/store <br />- <br />InspeUor Signature <br />Received By <br />bate, <br />_28.HSC Section 118222 -Incineration Required <br />29 Other -Describe in narrative. <br />1 <br />