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0 <br /> 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: <br /> Business Address: ® �� <br /> .r'-`o CPQ ram s <br /> City State Zip Code <br /> Phone Number: 4 L e <br /> Type of Facility or Business: fACi,-1r/ <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 /> Name: Title: R� ®no® <br /> Phone: �-�7- </�i° �� Date: <br /> 1. List the types of medical waste generated at your facility, i.e., laboratory wastes, blood or body <br /> fluids,sh s,contaminated animals,sur 'cal s ecimens,trace chemo or isolation wastes": <br /> oil <br /> LD <br /> a) Do you generate My pharmaceutical waste(expired/outdated,spent, partials,)? <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 If yes,describe the type of pharmaceutical waste(expired,spent,partials,outdated, patient 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 monthIX amount of pharmaceutical waste generated at your <br /> facility: ... <br /> EEID 45-03 5 <br /> 10/6/2006 <br />