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0 SAN JOAQUIN COUNTY is <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 East Hazelton Ave., Stockton, CA 95205 <br />(209) 468-3420 <br />MEDICAL WASTE INSPECTION FORM <br />Date 101'7 (i3 <br />PR e450ij) S <br />FacilityNameZai FacilityAddress 50n W� a <br />L•ts�owl wb �u <br />FacilityContact ietikk Mufk,���; �f+ Title e o Phone4okN UIok-S&ALon <br />INSPECTION TYPE: RRoutine []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 />_3. HSC Section 117890 -No large LQG shall <br />generate medical waste unless registered with the <br />enforcement agency. <br />r wi n� .fi CLI <br />C}; <br />LL ,11 <br />e� SM t,A Tc 11 1\L 1 l l <br />1 ' (10VISA, to r'1 Vm UI <br />S t^�'' <br />V r 341) {% K& 0 !1 <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 />np cor e_) Kt0V-'\ A - <br />_6.HSC Section 117903 -Shall not treat med <br />waste without permit from enforcement agency. <br />_THSC Section 117908 -Common Storage <br />fa <br />facility shall be registered with local enforcement <br />agency. <br />Procedures <br />` py, i <br />Nc1[c�-� }� U ' W) (r\eA MA t x� w4oii ryrS all �,,,XJ (��PL <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 />—I 1.HSC Section 117960-LQG shall file MWMP <br />with enforcement agency. <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 />_14.HSC Section 118135 -Shall obtain a permit <br />from the enforcement agency to treat medical <br />waste prior to treating the waste. <br />_15.HSC Section 11 8765 -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 />_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 />0<-21.HSC Section 118285 -Sharps Iabelfcontain <br />_22.HSC Section 118295 -Proper decon used. <br />_23.HSC Section 118307 -Interim storage labeled <br />_24.HSC Section 118310 -Enclosure labeled. <br />j© / <br />_25.HSC Section 118305 -Cannot reuse drums <br />_26.HSC Section 117630 -Approved biohazard <br />bag used. <br />_27.HSC Section 118275(8)-Pharm label/store <br />��dv� � 1 <br />Inspe or Signature ate <br />_28.HSC Section 118222 -Incineration Required <br />_29 Other -Describe in narrative. <br />MV <br />