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SAN JOAQUIN COUNTY 0 Date F31111 <br /> ENVIRONMENTAL HEALTH DEPARTMENT PR 053o 1161 <br /> y { 600 East Main Street, Stockton, CA 95202 <br /> (209)468-3420 <br /> e `P MEDICAL WASTE INSPECTION FORM <br /> pLtF®Rta <br /> FacilityName �nvcc, n��v t, FacilityAddress q00 N- &A,,,,� <br /> FacilityContact ESA U8.1 f c" Title ItAor of 'cam Phone#(10 333' <br /> INSPECTION TYPE: XRoutine []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 p^ <br /> medical waste. <br /> _2.HSC Section 117903-Permit from the <br /> enforcement agency required to treat medical (,60c'\ } S Ut <br /> waste. <br /> 3.HSC Section 117890-No large LQG shall _TVI'S (kn -1 rArjFkn ti <br /> generate medical waste unless registered with the �„^ r <br /> enforcement agency. «��-u ►®x <br /> 0 o <br /> _4.HSC Section 117895-SQG that treats med ^ V f fV\UJA <br /> waste shall register with enforcement agency. e <br /> _5.HSC Section 117900-Shall not haul med <br /> waste unless registered or obtained LQHE. <br /> _6.HSC Section 117903-Shall not treat med n a <br /> waste without permit from enforcement agency. <br /> _7.HSC Section 117908-Common Storage <br /> facility shall be registered with local enforcement <br /> agency. <br /> Procedures �C1UL C 1 V.� U <br /> _8.HSC Section 117935-SQG MWMP <br /> _9.HSC Section 117943-SQG Shall keep <br /> records for 3 years. — <br /> _10.HSC Section 117945-SQG not required to <br /> register shall keep records for 2 years. 1� ® 5 -� 11 7 I? 0 1 <br /> _11.HSC Section 117960-LQG shall file MWMP `b q ®Ct „ 'a <br /> w h enforcement agency. <br /> 12.HSC Section 117975-LQG shall keep , �,$ 0 <br /> records for 3 years. <br /> Transportation 3 5 ,t?—3 0 - _ t) 6,11 -) d <br /> _13.HSC Section 118030-LQHE application. a lb \,l t <br /> ",1 <br /> Treatment/Storage <br /> _14.HSC Section 118135-Shall obtain a permit t,k S <br /> From the enforcement agency to treat medical <br /> waste prior to treating the waste. C j <br /> _15.HSC Section 118765-All treatment records �S b `J 1 <br /> shall be kept for 3 years. <br /> _16.HSC Section 118215-All medical waste ® l l S 5utrn1 <br /> shall be treated pursuant to this section. 1 <br /> _17.HSC Section 118220-Recognizable human Lb (,S 1 <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, <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. ° I C <br /> _27.HSC Section 118275(g)-Pharm label/store - & Q" <br /> _28.HSC Section 118222-Incineration Required Inspedor Signature Re�cei'vk By Date <br /> 29 Other-Describe in narrative. �L ) <br /> PAa <br />