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6,1 <br />C <br />1868 E. Hazelton Avenue <br />Stockton, California 95205 <br />Telephone: (209) 468-3420 <br />Fax: (209) 468-8392 <br />Small quantity generators that provide onsite treatment and all large quantity generators shall have a <br />Medical Waste Management plan on file with the San Joaquin County Environmental Health Department. <br />The Medical Waste Management Plan shall contain the following information as appropriate for your <br />facility: <br />Business Name: <br />Business Address: <br />Phone Number: <br />n <br />0 <br />ES <br />L <br />City State Zip Code <br />Q_001) 9 cts <br />Type of Facility or Business: V7Y)e_&'c.cL_( <br />❑ Small Quantity Generator with Onsite Treatment (Generates less than 2001bs/month). <br />Large Quantity Generator Only (Generates 200 lbs or more/month). <br />❑ Large Quantity Generator with Onsite Treatment (Generates 200 lbs or more/month). <br />Person responsible for implementation of the Medical Waste Management Plan: <br />Name: n ^lel Title: A, cA I dll tkf- oC <br />Phone: Date: Q-_ 3 1 <br />1. List the types of medical waste generated at your facility (i.e. laboratory wastes, blood or body <br />fluids, sharps, contaminated animals, surgical specimens, trace chemo or isolation wastes): <br />a) Do you generate gRy pharmaceutical waste (expired, spent, partials, patient returns)? es ❑ No <br />If yes, describe the type of pharmaceutical waste (expired, spent, partials, patient returns): <br />And estimate the monthly amount of pharmaceutical waste generated at your facility: <br />EHD 45-03 <br />2015 <br />