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• SAN JOAQUIN COUNTY Date <br />ENVIRONMENTAL HEALTH DEPARTMEP PR KStrcY�� <br />600 East Main Street, Stockton, CA 95202 <br />(209) 468-3420 <br />MEDICAL WASTE INSPECTION FORM <br />FacilityName.+r 'f-�a_. �s� , FacilityAddress IZiaO Al , ' iCrAz 1& vc� . <br />ct,yi j� ��� �� � CA Ph <br />FacilityContact i <br />� Title .��, s.y, i<f� � Phone# °3���-:�.�t�x' <br />INSPECTION TYPE: []Routine ❑Complaint ❑Re -inspection <br />VIOLATION(S) <br />Registration <br />_ 1. HSC Section 117955 -Large Quantity <br />THE ITEMS BELOW REPRESENT VIOLATIONS OF THE CALIFORNIA <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 />HSC Section 117903 -Permit from the <br />_2. <br />enforcement agency required to treat medical <br />/1 <br />�"` f7 i�/�?��' Am, --,AA i-, z/ -Y La - <br />waste. <br />HSC Section 117890 -No large LQG shall <br />\ 1 <br />_3. <br />generate medical waste unless registered with the <br />enforcement agency.1 <br />HSC Section 117895-SQG that treats med <br />Yvv1 C� n -j VI..� _< < �- n,-, ,n <br />_4. <br />waste shall register with enforcement agency. <br />HSC Section 117900 -Shall not haul med <br />��=-�� J <br />J - <br />_5. <br />waste unless registered or obtained LQHE. <br />Section 117903 -Shall not treat med <br />.60 <br />_6.HSC <br />waste without permit from enforcement agency. <br />_THSC Section 117908 -Common Storage <br />facility shall be registered with local enforcement <br />-1- �. � <br />agency. <br />Procedures <br />Section 117935-SQG MWMP <br />_8.HSC <br />_9.HSC Section 117943-SQG Shall keep <br />records for 3 years. <br />_10.HSC Section 117945-SQG not required to <br />'— - <br />register shall keep records for 2 years. <br />_11.HSC Section 117960-LQG shall file MWMP <br />With enforcement agency. <br />Section 117975-LQG shall keep <br />-412.HSC <br />records for 3 years. <br />Transportation <br />_13. HSC Section 118030-LQHE application. <br />Treatment/Storage- <br />Section 118135 -Shall obtain a permit <br />U�2'fVtiC�ef ,+,) C`101ry <br />_14.HSC <br />from the enforcement agency to treat medical <br />J <br />waste prior to treating the waste. <br />_15.HSC Section 118765 -All treatment records <br />4e t <br />shall be kept for 3 years. <br />_16.HSC Section 11821 5 -All medical waste <br />shall be treated pursuant to this section. <br />_17.HSC Section 118220 -Recognizable human <br />6 //'►►_ `,, <br />anatomical parts shall be disposed of by interment <br />unless otherwise hazardous. <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,I-P <br />\ <br />chemo shall be labeled properly. <br />r/ <br />Section 118280 -MW label & contain <br />�v � �^�- -4 - ,ta /i T►'C�Gt'41�/1L� <br />_X20.HSC <br />Section 118285 -Sharps label/contain <br />_21.HSC <br />Section 118295 -Proper decon used. <br />I i <br />_22.HSC <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 />_&ba used. <br />27.HSC Section 118275(g)-Pharm label/store <br />_28.HSC Section 118222 -Incineration Required <br />Ir a Or I a t u r e Received By Date <br />X29 Other -Describe in narrative. <br />d v -� Z'/ <br />