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U!N'Qo ` SAN JOAQUIN COUNTY Date , v7 <br /> z; cy ENVIRONMENTAL HEALTH DEPARTMENT PR 5-TAi, <br /> Q. -+ 600 East Main Street, Stockton, CA 95202 <br /> (209)468-3420 <br /> cgt�FOR�`P MEDICAL WASTE INSPECTION FORM <br /> FacilityName f)o-16- -Acl �Cei -e:% FacilityAddress 1�2:/S <br /> ' <br /> FacilityContact v Dng::= Lj ftC,. Title 6vec_-E� �� 1�� � Phone# <br /> INSPECTION TYPE: ❑Routine ❑Complaint fie-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. <br /> _2.HSC Section 117903-Permit from the ✓U! C` r'M__ 711.1 S <br /> enforcement agency required to treat medical <br /> waste. <br /> _3.HSC Section 117890-No large LQG shall <br /> generate medical waste unless registered with the <br /> enforcement agency. <br /> _4.HSC Section 117895-SQG that treats med _1l�L 1` <br /> waste shall register with enforcement agency. L <br /> _5.HSC Section 117900-Shall not haul med <br /> waste unless registered or obtained LQHE. <br /> _6.HSC Section 117903-Shall not treat med <br /> waste without permit from enforcement agency. <br /> _7.HSC Section 117908-Common Storage <br /> facility shall be registered with local enforcement <br /> agency. Le� <br /> Procedures L <br /> _8.HSC Section 117935-SQG MWMP _ <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. `' <br /> _12.HSC Section 117975-LQG shall keep <br /> records for 3 years. <br /> Transportation & r ` ' <br /> _13.HSC Section 118030-LQHE application. - <br /> Treatment/Storage <br /> _14.HSC Section 118135-Shall obtain a permit <br /> from the enforcement agency to treat medicalr <br /> waste prior to treating the waste. <br /> _15.HSC Section 118765-All treatment records <br /> shall be kept for 3 years. <br /> _16.HSC Section 118215-All medical waste c <br /> shall be treated pursuant to this section. <br /> _17.HSC Section 118220-Recognizable human no I rt <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. AiLs^ <br /> _19.HSC Section 118275-MW red bags,path, `f / j 7 <br /> chemo 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 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. 7 <br /> _27.HSC Section 118275(g)-Pharm label/store ,c <br /> 28.HSC Section 118222-Incineration Required IO Signature Received By Date <br /> 29 Other-Describe in narrative. 64 <br />