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i. <br /> i <br /> Date <br /> SAN JOAQUIN COUNTY — <br /> ?' _ O� ERONMENTAL HEALTH DEPARTMENT PR <br /> 600 East Main Street, Stockton, CA 95202 <br /> (209)468-3420 1 <br /> MEDICAL WASTE INSPECTION FORM <br /> Q�lFO�� <br /> FacilityName St- Jas 1 ,�FacilityAddress r <br /> FacilityContact: JC�1 to lei P.v���! Titl ttphone# ` -Z <br /> [INSPECTION TYPE- Routine ❑Complaint ❑Re-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. , C flYl r 2. 5 <br /> 2.HSC Section 117903-Permit from the <br /> enf_orcement agency required to treat medical <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 mad <br /> waste shall register with enforcement agency. Ij <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 /> facility shall be registered with local enforcement <br /> agency. <br /> Procedures <br /> _B.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. ,/ Ir7+ k2 <br /> _1IMSC Section 117960-LQG shall file MWMP - <br /> with enforcement agency. <br /> %<12.1-11SC Section 117975-LOG shall keep -rill <br /> records for 3 years. <br /> Transportation <br /> i _13.HSC Section 118030-LQHE application. <br /> Treatment/Storage <br /> _14.1-11SC Section 118135-Shall obtain a permitN, <br /> from the enforcement agency to treat medical <br /> 3 o, to prior to treating the waste. <br /> `f 15.HSC Section 118765 All treatment records <br /> shah be kept for 3 years. <br /> i _16.HSC Section 118215-All medical waste �. S rYl L 6-T <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 labeUcontain <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 116305-Cannot reuse drums <br /> —26.HSC Section 117630-Approved biohazard <br /> bag used. <br /> 27.HSC Section 118275(8)-Pharm label/store ,G7 <br /> �. 28.HSC Section 118222-Incineration Required I e r Signature. Received By Date <br /> �29 Other-Describe in narrative. <br /> Z- <br /> �� <br />