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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 CoIIol CK— <br />Record <br />o-Record IDS <br />Prog Elem . zZ <br />Facility Name LMM 4xrn Facility Addresses ( n(kyel� <br />Facility Contact ` Title Phone <br />INSPECTION TYPE: )6lRoutine ❑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 />enforcement agency required to treat medical <br />waste.. <br />1 1- l ; \/I 'J. e =':••. - <br />_3. HSC Section 117890 -No large LOG shall <br />i <br />generate medical waste unless registered with <br />the 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 /># C( <br />waste unless registered or obtained LQHE. <br />- 6.HSC Section 117903 -Shall not treat med <br />_ <br />waste without permit from enforcement agency. <br />_7.HSC Section 117908 -Common Storage <br />/ nm► A `P� p ne'il 4t_ -A enM P— ( 0. <br />facility shall be registered with local enforcement <br />agency. <br />Procedures <br />n r <br />8.HSC Section 117935-SQG MWMP <br />V <br />_9.HSC Section 117943-SQG Shall keep <br />records for 3 years. <br />10.HSC Section 117945-SQG not required to <br />er shall keep records for 2 years. <br />Vregi <br />1.HSC Section 117960-LQG shall file <br />MWMP with enforcement agency. <br />_12.HSC Section 117975-LQG shall keep <br />records for 3 years. <br />Transportation <br />_13. HSC Section 118030-LQHE application. <br />Treatment/Storage , <br />_14.HSC Section 118135 -Shall obtain a <br />permit from the enforcement agency to treat <br />medical waste prior to treating the waste. <br />- <br />_15.HSC Section 118765 -All treatment <br />records shall be kept for 3 years. <br />- <br />_16.HSC Section 118215 -All medical waste <br />shall be treated pursuant to this section. <br />_17.HSC Section 118220 -Recognizable <br />human anatomical parts shall be disposed of by <br />interment unless otherwise hazardous. <br />_18.HSC Section 118225 -Treated sharps shall <br />estroyed or somehow prevent public access. <br />19.HSC Section 118275 -MW red bags, path, <br />7em <br />o 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 />_24.HSC Section 118305 -Cannot reuse drums <br />_25.HSC Section 117630 -Approved biohazard <br />bag used. <br />�L <br />4lnpe:c <br />—26. Other -Describe in narrative. <br />or Signature Received By <br />