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SAN JOAQUIN COUNTY Date,_ (moi -- i l <br />E IRONMENTAL HEALTH DEPARTME PR 4-15-cZX-),;2— <br />600 East Main Street, Stockton, CA 95202 <br />(209) 468-3420 <br />MEDICAL WASTE INSPECTION FORM <br />FacilityName L y t f'1evnooko &/n acilityAddress AG <br />FacilityContact�I,e. cr <br />one# S3q -'76E .W <br />INSPECTION TYPE: KRoutine []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 />medical waste. <br />_2. HSC Section 117903 -Permit from the <br />F <br />enforcement agency required to treat medical <br />waste. <br />_3. HSC Section 117890 -No large LQG shall <br />•- <br />generate medical waste unless registered with the <br />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 />14 - <br />waste unless registered or obtained LQHE. <br />_6.HSC Section 117903 -Shall not treat med <br />\_ <br />'� �- Ifs %� ti r'� 7/ 1 �r Y iZJ L s ;n <> tC C C 7�. �il .yl 1" ✓_ <br />waste without permit from enforcement agency.nn <br />_7. HSC Section 117908 -Common Storage <br />facility shall be registered with local enforcement <br />agency. <br />Procedures <br />r _ <br />( Lin �-i Yltfr° _ nirY �Ytr t CtiL� fne ��b hra7CA, rt <br />_8.HSC Section 117935-SQG MWMP <br />_9.HSC Section 117943-SQG Shall keep <br />' 't'' <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 MWMP <br />with enforcement agency. <br />oZ 6 C) '-1'lno i7 (A 1-t _ <br />_12.HSC Section 117975-LQG shall keep <br />records for 3 years. <br />Transportation <br />C i <br />_13. HSC Section 118030-LQHE application. <br />Treatment/Storage <br />_ <br />YA./ <br />_14.HSC Section 118135 -Shall obtain a permit <br />C1 j a /A} `r 160 «P ti- it <br />from the enforcement agency to treat medical <br />waste prior to treating the waste. <br />\ <br />_15.HSC Section 118765 -All treatment records <br />shall be kept for 3 years. <br />i f <br />_16.HSC Section 118215 -All medical waste <br />shall be treated pursuant to this section. <br />_17.HSC Section 118220 -Recognizable human <br />anatomical parts shall be disposed of by interment <br />unless otherwise hazardous. <br />-' <br />_18.HSC Section 118225 -Treated sharps shall <br />be destroyed or somehow prevent public access. <br />l <br />_ i Di <br />_19.HSC Section 118275 -MW red bags, path, <br />chemo shall be labeled properly. <br />-420.HSC Section 118280 -MW label & contain <br />_21.HSC Section 118285 -Sharps Iabeitcontain <br />_22.HSC Section 118295 -Proper decon used. <br />- <br />. -S <br />:23.HSC Section 118307 -Interim storage labeled <br />_24.HSC Section 118310 -Enclosure labeled. <br />_25.HSC Section 118305 -Cannot reuse drums <br />_26.HSC Section 117630 -Approved biohazard <br />lbag used. <br />27.HSC Section 118275(g)-Pharm label/store" <br />_oe <br />`' 7_�_ <br />28.HSC Section 118222 -Incineration Requiredfor <br />]K29 Other -Describe in narrative. <br />Signature Receiv y Date <br />