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U011*'*"C <br /> 9 SAN JOAQUIN COUNTY Date V i0-a--tzENVIRONMENTAL HEALTH DEPARTMER PRzi Tt�an.600 East Main Street, Stockton, CA 95202 <br /> (209)468-3420 <br /> MEDICAL WASTE INSPECTION FORM <br /> FacilityName t ' deratLr��,�i��iFz I ,; �tFacilityAddress ems- aces ,z,me , <br /> FacilityContact6Z% ,to Title.rk-k- . Ser:vr►!v 06&,Phone# S -7t 71-- <br /> INSPECTION <br /> 1INSPECTION TYPE: Moutine ❑Complaint oft-inspection <br /> VIOLATION(S) <br /> Registration THE ITEMS BELOW REPRESENT VIOLATIONS OF THE CALIFORNIA <br /> _1.HSC Section 117955-Large Quantity 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 AC" kyi r- nn ?M t,,Y�. �� t"me c'J <br /> enforcement agency required to treat medical QA . }�, f i[. '_ "1��+ 14.t/. per e� e��� 11 r fir <br /> waste. <br /> _3.HSC Section 117890-No large LQG shall <br /> generate medical waste unless registered with the ]]�� f ,� <br /> enforcement agency. —Air." L i 0 t—Y L'>»/e✓VL - <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 A! <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 /> facility shall be registered with local enforcement L -4 l <br /> agency. <br /> Procedures - <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 /> 11.HSC Section 117960-LQG shall file MWMP <br /> with enforcement agency. -,eg jd3',J�_CAJ �� le— ` PA &i11 b)', <br /> _12.HSC Section 117975-LQG shall keep 1 �_ <br /> records for 3 years. L <br /> 1 14 <br /> Transportation ( �4, <br /> _13.HSC Section 118030-LQHE application. <br /> Treatment/Storage ►� ^-���>�f` 1-- <br /> _14.HSC Section 118135-Shall obtain a permit .,J, 6 k%el ) vXO,M ZAle - f6 Yl ,yj)gA <br /> from the enforcement agency to treat medical <br /> waste prior to treating the waste. _ <br /> _15.HSC Section 118765-All treatment records <br /> shall be kept for 3 years. <br /> _16.HSC Section 118215-All medical waste _ 11 4 h 141-1" <br /> i �N 1 z_ J1 of <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 /> _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 /> _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 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 /> bag used. <br /> 27.HSC Section 118275(g)-Pharm label/store <br /> 28.HSC Section 118222-Incineration RequiredI e t Signature eceiv By Date <br /> 29 Other-Describe in narrative. <br />