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Qui SAN JOAQUIN COUNTY Date tl7 aSh3 <br /> ENVIRONMENTAL HEALTH DEPARTMENT PR Q1AS00-3 <br /> 1868 East Hazelton Ave., Stockton, CA 95205 <br /> L (209)468-3420 <br /> Fo't." MEDICAL WASTE INSPECTION FORM <br /> FacilityName FacilityAddress-so0 S- 11M La. <br /> FacilityContact 'rok tn. \ CA\--ru,, Title '4 Oe�cdr p- „k pixt ►- Phone# i��3(p�-�I1� <br /> INSPECTION TYPE: 4toutine ❑Complaint ❑ e-inspection <br /> VIOLATION(S) <br /> Registration THE ITEMS BELOW REPRESENT VIOLATIONS OF THE CALIFORNIA <br /> _1.HSC Section 117955-Large Quantity HEALTH & SAFETY CODE (HSC): <br /> Generator shall register with the enforcement <br /> agency prior to commencement of the generation of <br /> medical waste. ' 'ul �U 1 S e, <br /> _2.HSC Section 117903-Permit from the <br /> enforcement agency required to treat medical e. <br /> was3.HSC Section 117890-No large LQG shallLaw. <br /> generate medical waste unless registered with the <br /> 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 °�• , ��V jq — r?t 1 ! tr0 U" <br /> waste unless registered or obtained LQHE. ( 1 <br /> _6.HSC Section 117903-Shall not treat med rv," CtlA01i�1S. (,i S 0/) <br /> waste without permit from enforcement agency. 1 ,1n 1 '13 >CW Ll7 C. <br /> _7.HSC Section 117908-Common Storage <br /> facility shall be registered with local enforcement P1 <br /> agency. n <br /> Proceduresev() <br /> _8.HSC Section 117935-SQG MWMP -o S� <br /> _9.HSC Section 117943-SQG Shall keep <br /> records for 3 years. <br /> _10.HSC Section 117945-SQG not required to <br /> register shall keep records for 2 years. <br /> _11.HSC Section 117960-LQG shall file MWMP <br /> with enforcement agency. Nb Q S�' '' u 11 0A dfd `, I <br /> _12.HSC Section 117975-LQG shall keep <br /> records for 3 years. , VA-AA�' <br /> Transportation <br /> _13.NSC Section 118030-LQHE application. C -Vr (' J V f c. <br /> Treatment/Storage <br /> _14.HSC Section 118135-Shall obtain a pen-nit <br /> from the enforcement agency to treat medical <br /> waste prior to treating the waste. <br /> _15.HSC Section 118765-All treatment records ( v <br /> shall be kept for 3 years. <br /> 'shall <br /> Section 11 8215-All medical waste <br /> shall be treated pursuant to this section. <br /> _17.HSC Section 118220-Recognizable human <br /> anatomical parts shall be disposed of by interment <br /> unless otherwise hazardous. <br /> _18.HSC Section 118225-Treated sharps shall <br /> be destroyed or somehow prevent public access. <br /> _19.HSC Section 118275-MW red bags,path, <br /> chemo shall be labeled properly. <br /> �O.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 118307-Interim storage labeled <br /> 24.HSC Section 118310-Enclosure labeled. <br /> 25.HSC Section 118305-Cannot reuse drums <br /> _26.HSC Section 117630-Approved biohazard <br /> bag used. <br /> 27.HSC Section I I8275(g)-Pharm label/store <br /> _28.HSC Section 118222-Incineration Required Inspe r Signature R ceived By D to <br /> 29 Other-Describe in narrative. <br />