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09/27/2013 07.48 2094655 8 GLC PORT BO PAGE 02/04 <br /> in <br /> IVIAVIR0 <br /> 1MENTAL HEALT n1w SEPARTMENT <br /> SAN JOAQUIN COUNTY <br /> y� 1868 East Hazelton Avenue, Stockton,CA 95205-6232 <br /> Telephone:(209)468-3420 Fax(209)468-3433 <br /> INFORMATION PACKET FOR MEDICAL WASTE GENERATORS <br /> This packet contains the information and forms you will need to help you comply w t the <br /> Medical Waste Management Act, <br /> Instructions <br /> Please return the completed forms prior to medical waste generation or treatment. <br /> Complete the"Pre-Application Questionnaire"on page 2. If your answers Indicate <br /> you are not required to register as a medical waste generator,then complete The <br /> "Certification. Statement"on Page 3 and return both complete forms to the mailing <br /> address below. <br /> 2. If you are required to register as a medical waste generator,as indicated by affirmative <br /> answers to questions 3 &4 on the"Pre-Application Questionnaire",then: <br /> a. Complete the"Registration for Medical Waste"form located on <br /> Page 4. <br /> b. Complete a"Medical Waste Management Plan"following the guidelines <br /> provided on Page 5. <br /> c. Return the completed forms and management plan to the mailing address <br /> below. <br /> Your cooperation in promptly registering and following the specified handling requirements is <br /> greatly appreciated. <br /> If you have any questions regarding registration or handling requirements,please contact(209) <br /> 468-3424 and ask for the Medical Waste Program. <br /> RETURNALL COMPLETED FORMS S TO: <br /> Attn: Medical Waste Program <br /> San Joaquin County Environmental Health Department <br /> 1868 East Hazelton Avenue <br /> Stockton,CA 95205-6232 <br /> F_HD45-03 WEB <br /> 04/18/08 <br />