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SAN JAUIN COUNTY <br />1868 E. Hazelton Avenue <br />Stockton, California 95205 <br />Telephone: (209) 468-3420 <br />Fax: (209) 468-8392 <br />Small quantity generators that provide onsite treatment and all large quantity generators shall have a <br />Medical Waste Management plan on file with the San Joaquin County Environmental Health Department. <br />The Medical Waste Management Plan shall contain the following information as appropriate for your <br />facility: <br />Business Name: California Health Care Facility <br />Business Address: 7707 South Austin Road <br />Stockton CA 95215 <br />City State Zip Code <br />Phone Number: ( 209 ) 467-2500 <br />Type of Facility or Business: Correctional Facility <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: Title: <br />Phone: C?9 Date: <br />1. List the types of medical waste generated at your facility (i.e. laboratory wastes, blood or body <br />fluids, sharps, contaminated animals, surgical specimens, trace chemo or isolation wastes): <br />Pharmaceutical waste, laboratory, blood, body fluids, sharps, surgical specimen, Isolation waste, chemotherapy wastes <br />a) Do you generate gLny pharmaceutical waste (expired, spent, partials, patient returns)? X Yes ❑ No <br />If yes, describe the type of pharmaceutical waste (expired, spent, partials, patient returns): <br />Returned through reverse distributer INMAR 30lbs/ month <br />And estimate the monthly amount of pharmaceutical waste generated at your facility: 1000 lbs/month <br />EHD 45-03 5 <br />2015 <br />