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' • • i, Vim. N• T <br />GUIDELINES FOR THE MEDICAL WASTE MANAGEMENT <br />PLANT <br />Small quantity generators that provide Onsite Treatment and all large quantity generators <br />shall have a Medical Waste Management plan on file with the San Joaquin County <br />Envirorunental Health Department. The Medical Waste Management Plan shall contain the <br />following information as appropriate for your facility: <br />P <br />Business Name: <br />Business Address: <br />3 <br />City <br />Phone Number <br />Type of Facility or Business: <br />REGISTRATION FOR: <br />State <br />a <br />Zip Code <br />�W-_ su <br />Small Quantity Generator with Onsite Treatment (Generates less than 2001bslmonth). <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: Title: 50�� 04�oclC et— <br />Phone: r d q wt Date: %-Z/- 07 <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a) Do you generate � pharmaceutical waste (expired/outdated, spent, partials)? <br />b) 30 Yes ❑ No <br />If yes, describe the type of pharmaceutical waste (expired, spent, partials, outdated, patient <br />And estimate the monthly amount of pharmaceutical waste generated at your <br />facility: <br />EHb 45-03 5 <br />10/6p-006 <br />I1� <br />