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• SAN JOAQUIN COUNTYS Date ' -„2 - ! <br />ENVIRONMENTAL HEALTH DEPARTMEN f PR! � ,,L5- <br />600 <br />, 5- <br />600 East Main Street, Stockton, CA 95202 <br />(209) 468-3420 <br />MEDICAL WASTE INSPECTION FORM <br />FacilityName &ut),Cy,, FacilityAddress I99 1 ��bcrn<1��—tel <br />FacilityContact )harz1, f_ i;� Title i;,r;1j%j 8t1mJr--' Phone# q -7`7 -0-b6t1 <br />INSPECTION TYPE: A outine []Complaint ❑Re -inspection <br />VIOLATION(S) <br />Registration <br />THE ITEMS BELOW REPRESENT VIOLATIONS OF THE CALIFORNIA <br />_ 1. HSC Section 117955 -Large Quantity <br />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 <br />1 dt�0 L L I,]��t ! LZ 1 <br />J <br />� �` <br />waste. <br />HSC Section 117890 -No large LQG shall <br />1 L Q <br />}("� p u?fel C_ )e -A,\17- , f, <br />eY1 <br />_3. <br />generate medical waste unless registered with the <br />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�f <br />y <br />waste unless registered or obtained LQHE. <br />_6.HSC Section 117903 -Shall not treat med <br />AIF-) 0 . 2/_ ,,?/)/ s <br />/I n 3�1 c <br />- <br />waste without permit from enforcement agency. <br />_7.HSC Section 117908 -Common Storage <br />, <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 />IF <br />records for 3 years. <br />_10.HSC Section 117945-SQG not required to <br />register shall keep records for 2 years. <br />11.HSC Section 117960-LQG shall file MWMP <br />with enforcement agency. <br />&A7 1A,ij -4 <br />_12.HSC Section 117975-LQG shall keep <br />records for 3 years. <br />Transportation <br />n <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 />-2' 1� <br />!mac <br />_15.HSC Section 118765 -All treatment records)/ <br />shall be kept for 3 years. <br />_16.HSC Section 118215 -All medical waste <br />/ <br />shall be treated pursuant to this section. <br />_17.HSC Section 118220 -Recognizable human <br />tT k <br />anatomical parts shall be disposed of by interment <br />unless otherwise hazardous. <br />VIA <br />_18.HSC Section 118225 -Treated sharps shall <br />be destroyed or somehow prevent public access. <br />Q1,7AAp A � U Pih 7� <br />19.HSC Section 118275 -MW red bags, path, <br />chemo shall be labeled properly.«" <br />naO.HSC Section 118280 -MW label & contain <br />_21.HSC Section 118285 -Sharps Iabeucontain <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 />/�� <br />�yJ�`� <br />27.HSC Section 118275(g)-Pharm label/store <br />S Ct r ignature R ceived B at <br />28.HSC Section 118222 -Incineration Required <br />29 Other -Describe in narrative. <br />