Laserfiche WebLink
Jan. 24, 2019 11 : 35AM SUTTER TRACY HOSPITAL No- 8271 P. 6/6 <br /> I <br /> t <br /> SA N 10 A Q U I N Environmental Health Department <br /> -COUNTY--------- <br /> Phone- <br /> COUNTY-.--.....Phone: ( ) Registration M <br /> h. Do you handle pharm eutical waste that Is classified by the federal Drug Enforcement Agency(DEA)as <br /> 'controlled substances"?'®Yes❑ No <br /> If yes,descrlbe how the'controlled substances"are disposed: <br /> jfJPA,t,V . J.,j C . h r1„n�l LD., Z” n ✓ccs <br /> A/s— / <br /> I. All medical waste generators are required to keep accurate records regarding containment, storage,hauling, <br /> treatment and disposal. All medical waste records are to be maintained and available for review during \ <br /> inspection for two(2)years. Do you have tracking documents for all medical wastes handled at your fac(Ilty?,[F] <br /> Yes No <br /> J. Describe training provided to staff regarding handling,storage,disposal, and record keeping of all medical <br /> waste, Includingpharmaceuticalwaste, at your facility: <br /> 'A-,, 4-.� t1 .�]4/•-t &,-, Tile, A i n1/�J �' 1-r n r� n�—CC'_l�P/(LL <br /> k. Describe your medical waste emergency action plan, Including procedures for handling spills,exposures, <br /> equipment failures, etc. (attach information as necessary): <br /> I <br /> I. Descrlbe how reusable medical waste carts or containers are cleaned and decontaminated(see below for <br /> approved cleaning methods): <br /> d✓ A a / <br /> y li d i ,..C•"S• J <br /> Approved cleanlog methods include agilall n to remove visible soil combined with one of the following: <br /> 1. Exposure to hot water of at least 82 degrees Centigrade(180 degrees Fahrenhelt)for a minimum of 15 seconds. <br /> 2. Exposure to chemical sanitizer by rinsing with,or Immersion in,one of the following for a minimum of three minutes: <br /> Hypochlorlte solution(500 ppm available chlorine) <br /> • Phenolic solution(600 ppm active agent) <br /> • lodoform solution(100 ppm available Iodine) <br /> • Quaternary ammonium solution(400 ppm active agent) <br /> m. Describe,If medical waste Is treated onsite,a closure plan for the termination of treatment, using at a minimum, <br /> one of the above referenced approved cleaning methods: <br /> I hereby certibf to the best of t y know) dge and belief that the s tame is made In are correct and true. <br /> Printed Name: 1'\/, Signature: <br /> Title: Maniac I� Date.. - <br /> 7ofe <br />