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May -13. 2011 9:OOAM S n Joaquin County No,1896 P. 6/9 <br />GUIDELINES FOR THE MEDICAL WASTE MANAGEMENT <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 Warne: <br />Business Address, <br />City <br />State <br />Phone Number: ( } <br />Type of Facility or Business: <br />Zip Code <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: 4 Title: A I IBJ 7— AJ C'e--- J t,) <br />Phone: q— 4.7 7 . 81 7 bate: — / -7— / / <br />1. i,ist the types of medical waste generated at your facility, i.e., laboratory was s d or body <br />flui shay s contaminated animals, surgical specimens, trace chemo o' isolation waste <br />1-0(ow 6E b 4) -CI V+ dS <br />a) bo you generate aM pharmaceutical waste (expired/outdated, spent, partials,)? <br />b) ZLYes ❑ No <br />if <br />retarns esccribe the type of pharmaceutical wast expire spe , arti outda , patient <br />) <br />And estimate the monthly amount of pharmaceutical waste generated at your <br />facility: iGU 5 <br />EHD 45-03 <br />AIAM04 <br />