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GUIDELINES FOR THE MEDICAL WASTE MANAGEMENT <br /> PLAN <br /> Small quantity generators that provide Onsite Treatment and all large quantity generators <br /> shall have a Medical Waste Management plan on file with the San Joaquin. County <br /> Environmental Health Department. The Medical Waste Management Plan shall contain the <br /> following information as appropriate for your facility: <br /> Business Name: � �L� t (� <br /> Business Address: 7'/0 E -• <br /> t_ Ca <br /> City State Zip Code <br /> Phone Number: (,` e22 ) 416 "" " <br /> Type of Facility or Business: &4V 142-91110 3 .E/r 4e, <br /> REGISTRATION FOR: <br /> ❑ Small Quantity Generator with Onsite Treatment(Generates less than 200lbs/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 /> = 4 r <br /> Name-%1,4 V tom_5 Title: / ty DIy <br /> Phone: e°;?o Date: d <br /> 1. List the types of medical waste generated at your facility, i.e.,laboratory wastes,blood or body <br /> fluids, sharps contaminated ani als,surgical specimens,trace chemo or isolation wastes": <br /> G5 C <br /> Iz-42 <br /> a) ou generate Mpharmaceutical waste(expired/outdated,spent,partials,)? <br /> Do <br /> b) Yes ❑No <br /> If yes,describe the type of pharmaceutical waste(expired,spent,partials,outdated,patient <br /> returns,etc): <br /> And estimate the monthly amount of pharmaceutical waste generated at your <br /> facility: 0 <br /> EHD 45-03 5 <br /> 10f6/2006 <br />