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40 <br />r <br />SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />304 E. Weber Ave., Third Floor, Stockton, CA 95202 <br />(209) 468-3420 <br />MEDICAL WASTE INSPECTION FORM <br />Date <br />Record 1 50)1 <br />Prog Elem�� <br />Facility Namea �/�e✓rr,� n _Facility Address_ '33-1--3 Wesi- (tee Stnc�z f) <br />Facility Contacta'-C�Co' "cjSb-e'r Title C -i4 S —Mac) � Phone # �7�- <br />INSPECTION TYPE: outine ❑Complaint ❑Reinspection <br />VIOLATION(S) <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 & SAFETY CODE (HSC): <br />agency prior to commencement of the generation <br />of medical waste. <br />_2. HSC Section 117903 -Permit from the <br />Vic- t cn 116Z(�T Z- A I IlYl2l 1 C 2 ti SES. <br />_ t i L'Lo 061-r-) <br />enforcement agency required to treat medical <br />waste.. <br />.� <br />_3. HSC Section 117890 -No large LQG shall <br />C,i- <br />generate medical waste unless registered with <br />the enforcement agency. <br />�� > '. <br />�It n <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 />waste unless registered or obtained LQHE. <br />rid 't I (1J�' 1rYt -� rj j(�o . -t rPl� rpr4 !T ��w t �1 >M ZDan <br />�- <br />_6.HSC Section 117903 -Shall not treat med <br />rcl l )G i 1 r0_� <br />waste without permit from enforcement agency. <br />_7.HSC Section 117908 -Common Storage <br />�yn <br />l i i Y Pl, �� (�Pe�C,(L-� <br />facilityshall be registered with local enforcement <br />agency. <br />Procedures <br />8.HSC Section 117935-SQG MWMP <br />_9.HSC Section 117943-SQG Shall keep <br />{,a o � iS z 1-�/`l l .P., <br />GLS <br />records for 3 years. <br />_10.HSC Section 117945-SQG not required to <br />register shall keep records for 2 years. <br />11.HSC Section 117960-LQG shall file <br />-MP <br />VW with enforcement agency. <br />r n,-]C'tr--,(- ata" h[ -u -c Q VAStP. <br />- <br />_12.HSC Section 117975-LQG shall keep <br />records for 3 years. <br />Transportation <br />- <br />_13. HSC Section 118030-LQHE application. <br />Treatment/Storage <br />_14.HSC Section 118135 -Shall obtain a <br />t -e <br />permit from the enforcement agency to treat <br />medical waste prior to treating the waste. <br />_15.HSC Section 118765 -All treatment <br />re rds shall be kept for 3 years. <br />16.HSC Section 118215 -All medical waste <br />shall be treated pursuant to this section. <br />t� i <br />_17.HSC Section 118220 -Recognizable <br />human anatomical parts shall be disposed of by <br />interment unless otherwise hazardous. <br />Section 118225 -Treated sharps shall <br />-be-destroyed <br />be destroyed or somehow prevent public access. <br />_19.HSC Section 118275 -MW red bags, path, <br />chemo shall be labeled properly. <br />_20.HSC Section 118280 -MW label & contain <br />_21.HSC Section 118285 -Sharps label/contain <br />_22.HSC Section 118295 -Proper decon used. <br />23.HSC Section 118310 -Enclosure labeled. <br />_24ASC Section 118305 -Cannot reuse drums <br />_25.HSC Section 117630 -Approved biohazard <br />bag used. <br />—26. Other -Describe in narrative. <br />ns ecto Signature Received By <br />