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ANNA& <br /> W I 1 0 <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> SAN JOAQUIN COUNTY <br /> fiG Donna K_Hiran.R.E.H.S. Unit Supervisors <br /> Director 600 1✓ast Main Street carl.13orTne.n.R.E.H.S. <br /> XMike Huggins.R.E.H.S..R.D.I. <br /> Laurie A.Cotulla,R.E.H.S. <br /> Stockton,California 95202 <br /> Avistant Director Margaret Laprio,R.E.H.S. <br /> Telephone.: (209)468-3-420 Robert McClellon,R.B.H,S, <br /> 'pho <br /> Fax: (209)468-3431 JcffCameico,P,.E-.H,S. <br /> (Casey 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 /> I. Complete the "Pre-Application Questionnaire" on Page 2. If your answers indicate <br /> you are not required to tegistcr 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 /> answere.to questions 3 & 4 on the"Pre-Application Questionnaire",then: <br /> a. Complete the"Registraidon for Medical Waste" form located on <br /> Page 4, <br /> b. Complete,a"Medical Waste Management Pine 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 95202-3029 <br /> F,1-1 D 4 S-()3 <br /> 0411 PAIR <br /> Received Tirre Jun- 21. 2019 10 : 55AM No. 5187 <br />