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SAN JOAQUIN COUNTY Date7-trig I,( <br />E IRONMENTAL HEALTH DEPARTMA PR <br />600 East Main Street, Stockton, CA 95202 <br />(209) 468-3420 <br />MEDICAL WASTE INSPECTION FORM <br />FacilityName Z_cx New, -t FacilityAddress Om izq A <br />FacilityContact 6r,&j1e f lr,ll�,, <br />INSPECTION TYPE: Iffloutine <br />3n 76"1 A <br />[]Complaint ❑Re -inspection <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 of <br />'19 0. l <br />medical waste. <br />_2. HSC Section 117903 -Permit from the <br />Ni, <br />enforcement agency required to treat medical <br />waste. <br />_3. HSC Section 117890 -No large LQG shall <br />oj� <br />generate medical waste unless registered with the <br />enforcement agency. <br />_4. HSC Section 117895-SQG that treats med <br />Q <br />waste shall register with enforcement agency. <br />_5. HSC Section 117900 -Shall not haul med <br />1 ,, <br />4- CC'Yl, ZA Qne �5 (Ak b C, �Ded&_(1 <br />waste unless registered or obtained LQHE. <br />_6.HSC Section 117903 -Shall not treat med <br />22 ' <br />--\AA P _ 6,,' cYn\ S �� E7 :'D �,e, ?CJ )Z, .J 17' _ � ��✓" <br />rt1 <br />waste without permit from enforcement agency. <br />_7.HSC Section 117908 -Common Storage <br />�, .+ " ['� ,_ c -t\ <br />cwi <br />facility shall be registered with local enforcement <br />agency. <br />Procedures <br />_C_f') Int S, -k-) Ifs <br />O L to J1& _ s 1 LiC�ff <br />-- ( <br />_8.HSC Section 117935-SQG MWMP <br />_9.HSC Section 117943-SQG Shall keep <br />records for 3 years. <br />_10.HSC Section 117945-SQG not required to <br />register shall keep records for 2 years. <br />/ _ <br />a" L � ( _ 1 1 G.I lm e c)X� & (J P,.),'L \ �e -yn r 4 . Me ✓S <br />11.HSC Section 117960-LQG shall file MWMP <br />with enforcement agency. <br />i <br />\ ` 1 i <br />1 <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 />_ <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 />l <br />r, . .72 hct J M ca t- f, I J+7? c1. 6J C1 i� k'_ 6in .11/1 - 3 <br />e/ <br />(i Vl () Y�YI f ►711.,/l�i7U "IL L'Q_n f7a 1�1 2-/3 <br />_15.HSC Section 118765 -All treatment records <br />shall be kept for 3 years. <br />_16.HSC Section 118215 -All medical waste <br />shall be treated pursuant to this section. <br />6 , <br />Section 118220 -Recognizable human <br />�' <br />_17.HSC <br />anatomical parts shall be disposed of by interment <br />unless otherwise hazardous. <br />` ' 6na&ct ��n <br />1 <br />_18.HSC Section 118225 -Treated sharps shall <br />be destroyed or somehow prevent public access. <br />_19.HSC Section 118275 -MW red bags, path, <br />chemo shall be labeled properly. <br />_K20.HSC Section 118280 -MW label & contain <br />_21.HSC Section 118285 -Sharps Iabel1contain <br />- L <br />22.HSC Section 118295 -Proper decon used. <br />:Z23.HSC Section 118307 -Interim storage labeled <br />_24.HSC Section 118310 -Enclosure labeled. <br />1 <br />rYl V1 cc_7U d%t)0 � SM ri I CN <br />_25.HSC Section 118305 -Cannot reuse drums <br />_26.HSC Section 117630 -Approved biohazard <br />bag used. <br />Ftor <br />i27.HSC Section 118275(8)-Pharm label/store <br />' t K__28.HSC <br />Section 118222 -Incineration Required <br />:.29 Other -Describe in narrative. <br />Signature Rec By Date <br />