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a ° MEDICAL WASTASPECTION REPORT Date: Z 1 Zbl b { San Joaquin County Environmental Health Department Program �j j 1868 E. Hazelton Ave., Stockton, CA 95205 Record: ` t 6 S 37 258 (209)468-3420 Program l� +FOR�P www.s'ogv.org/ehd Element: 1 S ZZ Facility Name Address City Zip Code California Health Care Facility 7707 s.austin road Manteca 95215 Facility Contact Title Phone Number Email Inspection Type Shelly Prater Licensing Compliance Unit 209-467-6916 shelly.prater@cd Routine Analyst cr.ca.gov The above facility is inspected for compliance with Division 104,Part 14 of California Health and Safety Code(HSC). Registration Treatment HSC 117890-No LQG shall generate medical waste unlessHSC 118130-All onsite medical waste treatment facilities shall ❑ 1• registered with the EA. El17' be permitted by the EA. HSC 117950-LQG shall register with the EA prior to ❑ 2. ❑ 18. HSC 118165-All treatment records shall be kept for 3 years. generating medical waste. HSC 117903-Permit from the EA is required prior to treatingHSC 118215-All medical waste shall be treated pursuant to ❑ 3. medical waste. ❑ 19' I this section. HSC 117925-SQG that treats medical waste onsite shall HSC 118220-Pathology waste of a human nature shall be ❑ 4. register with the EA. ❑ 20. disposed of by interment, incineration, or an approved alternative. HSC 117900-Shall not haul medical waste unless registered, HSC 118222-Contaminated pathology waste,trace chemo ❑ 5. common carrier,trauma scene practitioner,or exempted ❑ 21. waste,or pharm waste from health care settings shall be treated under the MOT exemption. by incineration or an approved alternative. HSC 117928-Common Storage Facility shall have permit HSC 118225-Sharps waste shall be treated pursuant to this E:1 6' issured by the EA. 22 section. HSC 117890-LQG shall notify EA 72 hours prior to ❑ 7. Contain ment/Storage participating in temporary event. HSC 117895-SQG shall notify EA 72 hours prior to HSC 117630-Biohazard bag shall meet the standards set forth E:1 8' participating in temporary event. ® 23. in this section. HSC 118275-Medical, biohazardous,sharps,trace chemo, Records/Documentation ® 24 pathology,or pharmaceutical waste shall be segregated and contained pursuant to this section. The container shall be properlylabeled. ❑ 9. HSC 117935-Registered SQG shall file MWMP with the EA. ® 25 HSC 118280- Biohazard bags shall be containerized and stored pursuant to this section. HSC 117943-SQG required to register shall maintain HSC 118285-Sharps waste shall be containerized and stored E-1 10. 26 treatment and shipping and tracking records for 3 years. . pursuant to this section. HSC 117945-SQG not required to register shall maintain HSC 118295-Containers shall be washed and decontaminated El 11. 27 information document and transportation records for 3 years. ❑ pursuant to this section. HSC 118305- Reuseable drums or conainters used for medical ❑ 12. HSC 117960-LQG shall file MWMP with the EA. ❑ 28. waste shall not be used for other storage. HSC 117975-LQG shall maintain treatment and shipping and HSC 118307- Intermediate storage area shall be secured and El 13. 29 tracking documents for 2 years. ® marked with proper signage. HSC 118310-Designated accumulation area shall be secured Transportation El 30 and marked with proper signage. ❑ 14. HSC 117946-MOT exemption requirements for SQG. Other ❑ 15. HSC 117976-MOT exemption requirements for LQG. ❑ 31. ❑ 16. HSC 118032-Pharmaceutical waste hauling exemption. ❑ 32. Received by: Print: Shelly Prater Signature: rgYyCL" Phone:(209)467-6916 Specialist: Print: Harprit Mattu Sr REHS Signature: T Phone: (209)468-3284 Reinspecion on/about: A reinspection fee of$130 per hour may be charged. Page 1 of 3 EH-08/2015