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GUIDELINES FOR THE MEDICAL WASTE MANAGEMENT <br /> PLAN <br /> Small quantity generators that provide Onsite Treatment and all large quantity generators <br /> shall have a Medical Waste Management plan on file with the San Joaquin County <br /> Environmental Health Department. The Medical Waste Management Plan shall contain the <br /> following information as appropriate for your facility: <br /> Business Name: RiVurw oork 1Aeg+ ccvye C2vt�rt�' <br /> Business Address: 63y1p CGry°iv�g y� C i✓. <br /> J�pc�Gn C? A: 9Sa 10 <br /> City State Zip Code <br /> Phone Number: a.ocj 7 3 34®y <br /> Type of Facility or Business: 5 t ltot arSen q c;to <br /> REGISTRATION FOR: <br /> ❑ Small Quantity Generator with Onsite Treatment(Generates less than 200lbs/month). <br /> [" Large Quantity Generator Only(Generates 200 lbs or more/mouth). <br /> ❑ Large Quantity Generator with Onsite Treatment(Generates 200 lbs or more/month). <br /> Person responsible for implementation of the Medical Waste Management Plan: <br /> Name: I v) M`C a r"A Title: KI 1.4 1'54ro, r <br /> Phone: 009- y 7 3-3®®%l Date:7/ y <br /> 1. List the types of medical waste generated at your facility,i.e.,laboratory wastes,blood or body <br /> fluids,sharps,contaminated alumals,surgical specimens,trace chemo or isolation wastes": <br /> $�md� aN.dt�®f' �t�i,•l �tv►:d-' �kow n�S � i So f®.�'►n re w[r�S�'rs <br /> a) Do you generate a�pharmaceutical waste(expired/outdated, spent,partials,)? <br /> b) �fl Yes ❑No <br /> If yes, describe the type of pharmaceutical waste(expired,spent,partials,outdated,patient <br /> returns,etc): <br /> Ad o�n .06cm, <br /> And estimate the monthly amount of pharmaceutical waste generated at your <br /> facility: <br /> EHD 45-03 5 <br /> 10/6/2006 <br />