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L91S 'ON AVS61 61H [Z 'unr ;W#Alanal <br /> -UIN <br /> SANJOA0 <br /> Environmental Health Department <br /> ---COUNTY <br /> t?5 i y r')W% t,P I <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 /> 1. Complete the "Pre-Application Questionnaire" on Page 2. If your answers indicate you <br /> are not required to register as a medical waste generator,then complete the"Certification <br /> Statement" an Page 3.and return both complete forms to the mailing 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"Modical Waste Management Plan" following the guidelines starting <br /> on Page 5, <br /> c. Return the completed forms and management plan to the mailing address below. <br /> Your cooperation in promptly registering and following the specified handling requirements <br /> is greatly appreciated. <br /> If you have any questions regarding registration or handling requirements, please contact us <br /> at(209) 468-3420 and ask for assistance in the Medical Waste Program. <br /> RETURN ALL COMPLETED FORMS TO: <br /> San Joaquin County Environmental Health Department <br /> 1868 E. Hazelton Ave. <br /> Stockton, CA 95205 <br /> Attn: Medical Waste Program <br /> 1968 E. Hazelton Avenue I Stockton, California 962051 T 209 468.3420 1 F 209.464-0138 1 www.sjcehd.com <br />