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opa�!N. • SAN JOAQUIN COUNTY Date <br /> ENVIRONMENTAL HEALTH DEPARTMENT PR -r36 LSI <br /> Q tia 600 East Main Street, Stockton, CA 95202 <br /> (209)468-3420 <br /> cgtiFOR�'`P MEDICAL WASTE INSPECTION FORM <br /> FacilityName N_AA �� cry" <A�FacilityAddress dram Z_C.4' <br /> FacilityContact TitleAuvt 1 1?A�_ 4z%— Phone# 33 q—38 <br /> INSPECTION TYPE: Moutine ❑Complaint ❑Re-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 <br /> e—nforcement agency required to treat medical <br /> waste. <br /> _3.HSC Section 117890-No large LOG shall <br /> generate medical waste unless registered with the , I <br /> enforcement agency. f— <br /> _4.HSC Section 117895-SQG that treats med fA � <br /> waste shall register with enforcement agency. r'°`/t'}�_{�� <br /> _5.HSC Section 117900-Shall not haul med �t p j f. 16f <br /> waste unless registered or obtained LQHE. j y1 <br /> _6.HSC Section 117903-Shall not treat med <br /> waste without permit from enforcement agency. <br /> _7.HSC Section 117908-Common Storage 71. <br /> facility shall be registered with local enforcement <br /> agency. <br /> Procedures <br /> _8.HSC Section 117935-SQG MWMP IrAo <br /> _9.HSC Section 117943-SQG Shall keep <br /> records for 3 years. b <br /> _10.HSC Section 117945-SQG not required to <br /> T1register shall keep records for 2 years. <br /> 1.HSC Section 117960-LQG shall file MWMP <br /> with enforcement agency. ' <br /> X92.HSC Section 117975-LQG shall keep <br /> records for 3 years. <br /> Transportation <br /> _13.HSC Section 118030-LQHE application. <br /> Treatment/Storage <br /> _14.HSC Section 118135-Shall obtain a permit , r <br /> from the enforcement agency to treat medical <br /> waste prior to treating the waste. <br /> _15.HSC Section 118765-All treatment records (� <br /> shall be kept for 3 years. TNA-n <br /> _16.HSC Section 118215-All medical waste <br /> Uyj <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, t <br /> chemo shall be labeled properly. <br /> _420.HSC Section 118280-MW label&contain i y 7`' ✓� <br /> 21.HSC Section 118285-Sharps Iabeucontain <br /> .HSC Section 118295-Proper decon used. <br /> B2.HSC <br /> 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. z <br /> 27.HSC Section 118275(g)-Pharm label/store <br /> 28.HSC Section 118222-Incineration Required In Signature Received ate <br /> 29 Other-Describe in narrative. <br />