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- ----- ---------------i 1 - - <br /> i <br /> SAN JOAQUIN COUNTY <br /> Environmental Health Department DIRECTOR <br /> ���'�• Linda Turkatte,RENS i <br /> 1868 E. Hazelton Avenue <br /> GM <br /> q Stockton, California 95205 PRORobbed McCCleel oDn,REHS s <br /> y. <br /> o - . Jeff Carruesco,REHS,RD[ <br /> Website:www.sjcohd.com Kasey Foley,REHS <br /> c��ipoN�p Phone; (209)468-3420 Adrienne Ellsaesser,REHS <br /> r Fax:(209)468-8392 Rodney Estrada,REHS <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. j <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 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 /> i <br /> If you have any questions regarding registration or handling requirements,please contact us at ' <br /> (209)4683420 and ask for assistance in the Medical Waste Program, <br /> RETURN ALL COMPLETED FORMS TO: <br /> i <br /> San Joaquin County Environmental Health Department <br /> 1868 E. Hazelton Ave. j <br /> Stockton, CA 95205 <br /> Attn: Medical Waste Program ' <br /> EM X15-03 <br /> 2015 1 <br />