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ry Date (�1IciI E'i✓ <br /> Record ID i <br /> Prog Elern .2 <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 304 E. Weber Ave., Third Floor, Stockton, CA 95202 <br /> (209)468-3420 <br /> MEDICAL WASTE INSPECTION FORM <br /> Facility Name PL)a4tTiAcFacility Address <br /> Facility Contact�k, l - c,�� trcel :,)r^k itle C G`G'�l`� 'r a�� -Phone# Xzc- 4S <br /> INSPECTION TYPE: ❑Routine ❑Complaint ❑Reinspection <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 <br /> of medical waste. I �� f �l 1�I LLQ i`> f�i�-t–j(i-be) <br /> _2.HSC Section 117903-Permit from the � �' ^-� I,l�Ct�� >,-�«������ <br /> enforcement agency required to treat medical a(j �i y / I kA ;�V?t�A i`i' -4) 'Z I C Z, <br /> waste. <br /> _3.HSC Section 117890-No large LQG shall <br /> generate medical waste unless registered with <br /> the enforcement agency. <br /> _4.HSC Section 117895-SQG that treats med <br /> waste shall register with enforcement agency. <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 /> 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 /> retster shall keep records for 2 years. <br /> 11.HSC Section 117960-LQG shall file <br /> MWMP 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 <br /> permit from the enforcement agency to treat <br /> medical waste prior to treating the waste. <br /> —15.HSC Section 11 8765-All treatment <br /> records 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 <br /> human anatomical parts shall be disposed of by <br /> interment 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 118310-Enclosure labeled. <br /> _24.HSC Section 118305-Cannot reuse drums <br /> _25.HSC Section 117630-Approved biohazard <br /> bag used. <br /> 26.Other-Describe in narrative. -- <br /> Ins ctor Signature ��eceiv4ed <br />