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w <br />N <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 />Date &10iL <br />Record 2-4 <br />Prog Elem --q-5 5 2� <br />Facility Namej ,,4AJCU Facility Address <br />Facility Contact p�l i �.A--- Title Ani;. pis-�/ Phone # <br />INSPECTION TYPE: outine ❑Complaint ❑Reinspection I <br />VIOLATION(S) <br />Registration <br />_ 1. HSC Section 117955 -Large Quantity <br />Generator shall register with the enforcement <br />THE ITEMS BELOW REPRESENT VIOLATIONS OF THE CALIFORNIA <br />HEALTH & SAFETY CODE (HSC): <br />agency prior to commencement of the generation <br />of medical waste. <br />HSC Section 117903 -Permit from the <br />, <br />_2. <br />enforcement agency required to treat medical <br />waste. <br />HSC Section 117890 -No large LQG shall <br />_3. <br />generate medical waste unless registered with <br />the enforcement agency. <br />HSC Section 117895-SQG that treats med <br />- <br />` <br />_4. <br />waste shall register with enforcement agency. <br />HSC Section 117900 -Shall not haul med <br />yAr- <br />_5. <br />waste unless registered or obtained LQHE. <br />Section 117903 -Shall not treat med <br />` q kit o o C <br />Zk� J �' c Q �� JS{2 U A. Gx <br />_6.HSC <br />waste without permit from enforcement agency. <br />Section 117908 -Common Storage <br />_7.HSC <br />facility shall be registered with local enforcement <br />agency. <br />Prgcedures <br />s.Hsc Section 117935-SQG MWMP <br />_9.HSC Section 117943-SQG Shall keep <br />records for 3 years. <br />Section 117945-SQG not required to <br />- <br />Z© Z(7(j S <br />_10.HSC <br />regi ter shall keep records for 2 years. <br />Section 117960-LQG shall file <br />�1. with <br />MWMP with enforcement agency. <br />_12.HSC Section 117975-LQG shall keep <br />t _ t �Q L QaS �� C 1 t,. n � r L A d f _ <br />I"1r`0.�t f�J �o— <br />A 1 d �16— L <br />records for 3 years. <br />Transportation <br />_13. HSC Section 118030-LQHE application. <br />7"-)n- <br />Treatment/Storage <br />Section 118135 -Shall obtain a <br />E <br />- <br />\\ <br />_14.HSC <br />permit from the enforcement agency to treat <br />medical waste prior to treating the waste. <br />Section 11 8765 -All treatment <br />�'� UZCt:-e U�l d �� <br />_15.HSC <br />records shall be kept for 3 years. <br />Section 118215 -All medical waste <br />/� _ _� //I� <br />I �_ �� -1 tri/ � 1y M� CG�a <br />br _� <br />_16.HSC <br />shall be treated pursuant to this section. <br />Section 118220 -Recognizable <br />_17.HSC <br />human anatomical parts shall be disposed of by <br />interment unless otherwise hazardous. <br />Section 118225 -Treated sharps shall <br />_18.HSC <br />be destroyed or somehow prevent public access. <br />Section 118275 -MW red bags, path, <br />_19.HSC <br />ch7mo 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 118310 -Enclosure labeled. <br />HSC Section 118305 -Cannot reuse drums <br />—24. <br />_25.HSC Section 117630 -Approved biohazard <br />bag used. <br />4n�s <br />26. Other -Describe in narrative. <br />— er- <br />t r Signa re lqeceived By <br />