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ENVIROtMENTAL HEALTH%EPARTMENT <br /> Donna K.Reran,PU.H.S. SAN JOAQUIN COUNTY Unit Supervisors <br /> Director 600 East Main Street Carl Borgman,R.E.H.S. <br /> Mike Huggins,R.E.H.S.,R.D.I. <br /> x Stockton, California 95202 <br /> Laurie A.Cotulla,R.E.H.S. <br /> Assistant Director Margaret Lagorio,R.E.H.S. <br /> Telephone: (209)468-3420 Robert McClellon,R.E.H.S. <br /> Fax: (209)468-3433 JeffCarruesco,R.E.H.S. <br /> Kasey Foley,R.E.H.S. <br /> INFORMATION PACKET FOR MEDICAL WASTE GENERATORS <br /> This packet contains the information and forms you will need to help you comply with the <br /> Medical Waste Management Act. <br /> Instructions <br /> Please return the completed forms prior to medical waste generation or treatment. <br /> 1. Complete the "Pre-Application Questionnaire" on Page 2. If your answers indicate <br /> you are not required to register as a medical waste generator,then complete the <br /> "Certification Statement" on Page 3 and return both complete forms to the mailing <br /> address below. <br /> 2. If you are required to register as a medical waste generator, as indicated by affirmative <br /> answers to questions 3 &4 on the"Pre-Application Questionnaire",then: <br /> a. Complete the "Registration for Medical Waste"form located on <br /> Page 4. <br /> b. Complete a"Medical Waste Management Plan" following the guidelines <br /> provided on Page 5. <br /> c. Return the completed forms and management plan to the mailing address <br /> below. <br /> Your cooperation in promptly registering and following the specified handling requirements is <br /> greatly appreciated. <br /> If you have any questions regarding registration or handling requirements,please contact(209) <br /> 468-3420 and ask for the Medical Waste Program. <br /> RETURN ALL COMPLETED FORMS TO: <br /> Attn: Medical Waste Program <br /> San Joaquin County Environmental Health Department <br /> 600 East Main Street <br /> Stockton, CA 95202 <br /> EHD 45-03 WEB <br /> 04/18/08 <br />