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• 0 <br />SAN JOAQUIN COUNTY Date 91151)Ai <br />ENVIRONMENTAL HEALTH DEPARTMENT PR oLtrO o S <br />1868 East Hazelton Ave., Stockton, CA 95205 <br />(209) 468-3420 <br />MEDICAL WASTE INSPECTION FORM <br />Facility a e cZ: (,Y--nyal Hpsej�CO cili A resssb0 W-)4t2Sr-'cm <br />FacilityContact 9 ,,,1 (`n a ski nc t Title p'fco6, Phone#hMj14(o <br />III&IU40111• <br />EiComplaint ■' - <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 />KI c96 5 1- Fate C <br />waste. <br />_3. HSC Section 117890 -No large LQG shall <br />1_ <br />L1 X ►l N k NA1 reOn? <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. NSC Section 117900 -Shall not haul medS— <br />waste unless registered or obtained LQHE. <br />%•AA`1 <br />�Uii1 USS r G1 17 1'1'01A I <br />_6.HSC Section 117903 -Shall not treat med <br />t <br />wt <br />�h u�® M v,; ,Jl ' „ --! rw t 1 U <br />waste without permit from enforcement agency. <br />_7.HSC Section 117908 -Common Storage <br />- <br />Ta shall be registered with local enforcement <br />agency. <br />g <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. <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 />Torn the enforcement agency to treat medical <br />waste prior to treating the waste. <br />Section 118765 -All treatment records <br />-shall <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 />_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 />� <br />bag used. <br />_27.HSC Section 118275(g)-Pharm label/store <br />Insp ctor Signature RecABy Date <br />Mtge E <br />_28.HSC Section 118222 -Incineration Required <br />_29 Other -Describe in narrative. <br />