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Jan, 24. 2019 11 : 35AM SUTTER TRACY HOSPITAL No, 8271 P. 4/6 <br /> SA N 11JOAQU IN Environmental Health Department <br /> i COUNTY i <br /> GUIDELINES FOR THE MEDICAL WASTEMANAGEMENT PLAN <br /> Small quantity generators that provide onsite treatment and all large quantity generators shall have a Medical Waste <br /> Management pian on file with the San Joaquin County Environmental Health Department, The Medical Waste <br /> Management Plan shall contain the following Information as appropriate for your facility: <br /> Business Name- <br /> e // A819 '.S'f- 11e, i'0 a ,. ns - A <br /> Business Address; .,,o Al. r <br /> ' <br /> City State ZIP Code <br /> Phone Number: (.26q Baa -• (u 0-5-1 <br /> Contact Person: b 6u�)o I�eo-w 4-- Phone Number(If different from above): (,203 1 t-S �'60 <br /> Type of Facility or Business: 80,04, 1�0-59214(0 <br /> Registration for: <br /> ❑ Small Quantity Generator with Onsite Treatment(Generates less than 200 lbs/month). <br /> Large Quantity Generator Only(Generates 200 lbs or more/month). <br /> ❑ Large Quantity Generator with Onsite Treatment(Generates 200 lbs or more/month), <br /> Person responsible for Implementation of the Medical Waste Management Plan: <br /> Name: 4", rs 9'Z 'J- Title. ✓s° 1"ANva 6C& <br /> Phone: �) 6 9 - �-3 Q —(, o La .� Date: 3- 19 <br /> 1. List the types of medical waste generated at your facility(i.e. laboratory wastes, blood or body fluids,sharps, <br /> contaminated animals, surgical specimens,trace chemo or Isolation wastes); <br /> I I .1d'L,"&?,o J t-r-l:j C11 r C.0 e <br /> 0"• r. <br /> Do you generate any pharmaceutical waste (expired, spent, partlels,patient returns—)Tf!]Yes❑ No <br /> If yes, describe the type of pharmaceutical waste(expired, spent, partials, patient returns): / <br /> �a'P/2Ei> r SA6—AJ7+ ; QAe �.cQl ,/a �/i rt12a al /,ct ..t��crat Lo-'-i✓S <br /> And estimate the monthly amount of pharmaceutical waste generated at your facility:_ 45 S U /1�-S <br /> 2. Estimate the monthly amount of medical waste (excluding waste pharmaceuticals)generated at your faelllty: cDOdy 16 <br /> 3. Describe the medical waste handling procedures utilized by and applicable to your facility, including, but not limited <br /> to the following: <br /> a. Onsite location and method for segregation, containment, packaging, labeling and collection, including <br /> pharmaceutical waste: ' ) <br /> 2i•.r rite, , (d'S9eA4A1" i /Iecll �c ��NC1Cyl� x+i LJs Y44 7 / <br /> �u1rN..L S n ., 0 R'4 M r® 4 0/S'L'G LJ a i �� �w�C /�'Qin/J �/i✓5 <br /> 6 ofe <br />