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SAN JOAQUIN COUNTY 0 Date jn-/6-/3 <br />ENVIRONMENTAL HEALTH DEPARTMENT PR <br />600 East Main Street, Stockton, CA 95202 <br />(209) 468-3420 <br />MEDICAL WASTE INSPECTION FORM <br />FacilityName 4)me- ((�� - FacilityAddress 3e2t T,,�,r� <br />FacilityContact P6L � (2<-s Title Phone# 331-1- u-7Ar <br />INSPECTION TYPE: ❑Routine <br />❑Complaint ❑Re -inspection <br />VIOLATION(S) <br />Registration <br />THE ITEMS BELOW REPRESENT VIOLATIONS OF THE CALIFORNIA <br />_ 1. HSC Section 117955 -Large Quantity <br />Generator shall register with the enforcement <br />HEALTH & SAFETY CODE (HSC): <br />agency prior to commencement of the generation of <br />medical waste. <br />\ / <br />14-2p 14 -r 1n ir. A --tkW <br />_2. HSC Section 117903 -Permit from the <br />Al 0 6L -y x O'A Z - 1 C' - A <br />enforcement agency required to treat medical%r!�']1sY► <br />waste. <br />' <br />_3. HSC Section 117890 -No large LOG shall <br />generate medical waste unless registered with the <br />enforcement agency. <br />a,.r�� 3P <br />_4. HSC Section 117895-SQG that treats med <br />�� ' AAr�`� O L �� L�. M d4 <br />waste shall register with enforcement agency. <br />_5. HSC Section 117900 -Shall not haul medJlO,r <br />/rYlr -/S-IZ <br />waste unless registered or obtained LQHE. <br />_6.HSC Section 117903 -Shall not treat med <br />/D- /6 -/ ncn c) Yin 0 1W At HU [ne <br />waste without permit from enforcement agency. <br />_7.HSC Section 117908 -Common Storage <br />✓t <br />facility shall be registered with local enforcement <br />agency. <br />Procedures <br />�fr�,'>" '0 c� <br />_8.HSC Section 117935-SQG MWMP <br />_9.HSC Section 117943-SQG Shall keep <br />e-�'t. 19 4gym i <br />records for 3 years. <br />Section 117945-SQG not required to <br />_10.HSC <br />register shall keep records for 2 years. <br />_11.HSC Section 117960-LQG shall file MWMP <br />with enforcement agency. <br />M l,n� <br />VYt ►2>tr1iV>`c��l'V1Oirj i�vr�! <br />�✓1' <br />_12.HSC Section 117975-LQG shall keep <br />records for 3 years. <br />Transportation <br />k-Pj-0 (9-1� ��J�, ��c Vie,— r�c✓L <br />I <br />_13. HSC Section 118030-LQHE application. <br />Treatment/Storage <br />Il-1��' '''" �r�ti�G r""'k c ✓>c✓c., <br />_14.HSC Section 118135 -Shall obtain a permit <br />rz:An&,Lk yyi wAm &A e ✓VlL ✓G / nr <br />from the enforcement agency to treat medical <br />waste prior to treating the waste. <br />v ir <br />_15.HSC Section 11 8765 -All treatment records <br />shall be kept for 3 years. <br />_16.HSC Section 118215 -All medical waste <br />- (Y -r LJvvt9'✓t- <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 />--destroyed <br />be or somehow prevent public access. <br />_19.HSC Section 118275 -MW red bags, path, <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. <br />IS1 <br />di <br />_27.HSC Section 118275(g)-Pharm label/store <br />8,�1 �r6 �6� V t <br />_28.HSC Section 118222 -Incineration Required <br />29 Other -Describe in narrative. <br />Irt6#e09i Signature Received By Dat <br />