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SAN JOAQUIN COUNTY Date 5 -ht -t( <br />E RONMENTAL HEALTH DEPARTMER PR 4j5-crr),2 <br />600 East Main Street, Stockton, CA 95202 <br />(209) 468-3420 <br />MEDICAL WASTE INSPECTION FORM <br />FacilityName 4,c) di-manciI 6,. Lt) FacilityAddress &D, L cx, ,,of .sr,c,�,m�,�.F�- <br />FacilityContact 6aL41t! <br />- -766,3? <br />INSPECTION TYPE: gRoutine ❑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 />HEALTH & SAFETY CODE (HSC): <br />Generator shall register with the enforcement <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 />1D• <br />waste. <br />_3. HSC Section 117890 -No large LOG shall <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 />waste without permit from enforcement agency. <br />_7.HSC Section 117908 -Common Storage <br />1 LL <br />t�7t',YI P �(?'� ;fT7�� �`!�t A.�. SUS iYl i _T— A)II� lY1 <br />\ ��� t �� Ct.tZ" <br />�J C.1 l 1 C Gt �Il'7'1 <br />L <br />!A) � P N 1-0 �YYIG( j / ! �1 1 <br />facility shall be registered with local enforcement <br />agency. <br />. ' <br />_ <br />(t/ y <br />�Procedures <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 />�-- 1 ; `�� ,y) ' r1 7C-) C -AZA .4 A +ZO <br />' <br />11.HSC Section 117960-LQG shall file MWMP <br />with enforcement agency. <br />Section 117975-LQG shall keep/L <br />_12.HSC <br />records for 3 years. <br />Transportation <br />�T +m< r� . t� 1`�� v,,►� ►VI"a <br />_13. HSC Section 118030-LQHE application. <br />TreatmentlStorage <br />r� j \ <br />_14.HSC Section 118135 -Shall obtain a permit <br />- ;2 !? �l".> tN1 ;i cc <br />from the enforcement agency to treat medical <br />waste prior to treating the waste. <br />12')e <br />- <br />_16.HSC Section 118765 -All treatment records <br />shall be kept for 3 years. <br />_16.HSC Section 118215 -All medical waste <br />IL <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 />l ^ _ <br />+ <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 />420.HSC Section 118280 -MW label & contain <br />_21.HSC Section 118285 -Sharps Iabel1contain <br />22.HSC Section 118295 -Proper decon used. <br />�23.HSC Section 118307 -Interim storage labeled <br />' I <br />24.HSC Section 118310 -Enclosure labeled. <br />' l <br />_25.HSC Section 118305 -Cannot reuse drums <br />_26.HSC Section 117630 -Approved biohazard <br />bag used. <br />X27.HSC Section 118275(g)-Pharm label/store <br />3 <br />l r Signature Recei By Date <br />28.HSC Section 118222 -Incineration Required <br />�29 Other -Describe in narrative. <br />G) <br />