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ENVOSAN JOAQUIN COUNTYol Date IC� <br /> ONMENTAL HEALTH DEPARTMENTPR _n�tbQ <br /> 600 East Main Street, Stockton, CA 95202 <br /> (209)468-3420 <br /> 0 MEDICAL WASTE INSPECTION FORM <br /> Facility Name Kc%i b-&&. g2j , <br /> FacilityAddress 17-11 <br /> FacilityContact--T-or4. i ,,dA-t&m_ Phone# 9W <br /> INSPECTION TYPE: []Routine []Complaint oRe-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. <br /> —2.HSC Section 117903-Permit from the <br /> enforcement agency required to treat medical I;tLk ell <br /> waste. tt <br /> 3.HSC Section 117890-No large LQG shall <br /> generate medical waste unless registered with the ; 4— <br /> enforcement agency. stm�= t!n tt&� LER �SJSQ020, <br /> 4.HSC Section 11 7895-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' &1C) <br /> —7.HSC Section 117908-common Storage <br /> facility shall be registered with local enforcement <br /> agency. <br /> Procedures L. [_,t) <br /> —8.HSC Section 117935-SQG MWMP <br /> —9.HSC Section 117943-SQG Shall keep <br /> records for 3 years. ti2ft <br /> ___:10.HSC Section 117945-SQG not required to V6 <br /> register shall keep records for 2 years. eW4A&-Je.,eL <br /> _4_11 1.HSC Section 11 7960-LQG shall file MWMP <br /> 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 permit <br /> From the enforcement agency to treat medical <br /> waste prior to treating the waste. <br /> 15.HSC Section 118765-All treatment records <br /> ;-h—all 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 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 label/contain <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 118305-Cannot reuse drums <br /> __26.HSC Section 117630-Approved biohazard <br /> bag used. <br /> A 27.HSC Section 118275(g)-Pharm label/store <br /> —28.HSC Section 118222-Incineration Required Inspector Signature Received By Date <br /> 29 Other-Describe in narrative. <br />