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Date—� <br />Record ID 4 G <br />Prog Elern q5, ZZ-/ <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 Facility Add <br />c <br />W <br />Facility Contact`ion'l CLx'� _Title f�S Phone # L� H� <br />INSPECTION TYPE: [DRoutine <br />Registration <br />_ 1. HSC Section 117955 -Large Quantity <br />Generator shall register with the enforcement <br />agency prior to commencement of the generation <br />of medical waste. <br />_2. HSC Section 117903 -Permit from the <br />enforcement agency required to treat medical <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 />S.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 />rVester 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-AII 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 Ostroyed or somehow prevent public access. <br />9 -HSC Section 118275 -MW red bags, path, <br />chepio shall be labeled properly. <br />O.HSC Section 118280 -MW label & contain <br />_21.HSC Section 118285 -Sharps Iabel/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 />OComplaint <br />VIOLATION(S) <br />OReinspection <br />THE ITEMS BELOW REPRESENT VIOLATIONS OF THE CALIFORNIA <br />HEALTH & SAFETY CODE (HSC): <br />rd <br />0 <br />X <br />Signatu <br />Received By <br />