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SAN JOAQUIN COUNTY Date 0 <br />ENVIRONMENTAL HEALTH DEPARTMER PR 11_S-MC)c2 <br />600 East Main Street, Stockton, CA 95202 <br />(209) 468-3420 <br />MEDICAL WASTE INSPECTION FORM <br />FacilityName Lr"L t e_xn nes ll acilityAddress &C s, z_a-it - .,sat mr,yi,16 6D. <br />FacilityContactl=ajA�e_ Y1o_-es Title,'y,66,j _�a",4•R—Phone# <br />INSPECTION TYPE: Moutine []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 />enforcement agency required to treat medical <br />waste. <br />HSC Section 117890 -No large LQG shall <br />O f C -YT—f t P <br />y <br />_3. <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 />waste unless registered or obtained LQHE. <br />_6.HSC Section 117903 -Shall not treat med <br />�' Y1�7 �. ,i1/l '�� d �?�L'' 7r'_'e— <br />,- <br />- - �. <br />_ T <br />yC.t V'4% s� <br />waste without permit from enforcement agency.�- <br />_7.HSC Section 117908 -Common Storage <br />iiC1f� <br />r\ 44r �1 Q �� [�-�.: Liz, rq-� - t a <br />facility shall be registered with local enforcement <br />agency. <br />—t <br />Procedures <br />_8.HSC Section 117935-SQG MWMP <br />Section 117943-SQG Shall keep <br />� <br />_9.HSC <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 />- o - A&[ • ( <br />\ <br />14— <br />\ , <br />_12.HSC Section 117975-LQG shall keep <br />records for 3 years. <br />Transportation <br />P n P E jCj stn ft <br />_13. HSC Section 118030-LQHE application. <br />Treatment/Storage <br />_14.HSC Section 118135 -Shall obtain a permit <br />_ c�_.o yn r-I��v� r � nYt <br />­- <br />from the enforcement agency to treat medical <br />waste prior to treating the waste. <br />, <br />Q LW 1_,, <br />wv i L.�G l <br />_15.HSC Section 118765 -All treatment records <br />shall be kept for 3 years. <br />_16.HSC Section 118215 -All medical waste <br />_ M` C/ ..r �o ✓ (_.1 '1 J V <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 />l <br />_18.HSC Section 118225 -Treated sharps shall <br />be destroyed or somehow prevent public access. <br />L, <br />_19.HSC Section 118275 -MW red bags, path, <br />chemo shall be labeled properly. <br />_X?O.HSC Section 118280 -MW label & contain <br />_21.HSC Section 118285 -Sharps label/contain <br />22.HSC Section 118295 -Proper decon used. <br />�Ct,(J f' Y"_ G r I .S�'1t7t,c� `� G <br />:Z23.HSC Section 118307 -Interim storage labeled <br />Section 118310 -Enclosure labeled. <br />_24.HSC <br />_25.HSC Section 118305 -Cannot reuse drums <br />26.HSC Section 117630 -Approved biohazard <br />ba_g used. <br />�&27.HSC Section 118275(g)-Pharm label/store <br />73 <br />28.HSC Section 118222 -Incineration Required <br />x(,29 Other -Describe in narrative. <br />I or Signature Re I ed y Date <br />U <br />