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SAN JOAQUIN COUNTY Date , T7 -1 <br />E RONMENTAL HEALTH DEPARTMER PR <br />600 East Main Street, Stockton, CA 95202 <br />(209) 468-3420 <br />MEDICAL WASTE INSPECTION FORM <br />FacilityName (A),\ulll�lnav,;cia5a CZE, FacilityAddress �6 tLLc) Pes <br />FacilityContact)n �C V vl,:t i ti)P 7 _ Title f r' n..,�ivPhone# �I� 7 - �,'l7 <br />INSPECTION TYPE: XfRoutine <br />❑Complaint ❑Re -inspection <br />VIOLATION(S) <br />Registration <br />THE ITEMS BELOW REPRESENT VIOLATIONS OF THE CALIFORNIA <br />_ 1. HSC Section 117955 -Large Quantity <br />HEALTH & SAFETY CODE (HSC): <br />Generator shall register with the enforcement <br />agency prior to commencement of the generation of <br />medical waste. <br />_2. HSC Section 117903 -Permit from the <br />enforcement agency required to treat medical <br />l <br />waste. <br />_3. HSC Section 117890 -No large LQG shall <br />IU- - <br />generate medical waste unless registered with the <br />enforcement agency. <br />_4. HSC Section 117895-SQG that treats med <br />waste shall register with enforcement agency. <br />_5. HSC Section 117900 -Shall not haul med <br />, <br />waste unless registered or obtained LQHE. <br />Section 117903 -Shall not treat med <br />_6.HSC <br />waste without permit from enforcement agency. <br />_7.HSC Section 117908 -Common Storage <br />tiG 6 <br />facility shall be registered with local enforcement <br />agency. <br />Procedures <br />49 — Oyl s <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 />re aster shall keep records for 2 years. <br />T 1.HSC Section 117960-LQG shall file MWMP <br />with enforcement agency. <br />_Al2.11-11SC Section 117975-LQG shall keep <br />, r <br />records for 3 years. <br />Transportation <br />5 Lx e- <br />1>) h c,.Zl� ��r�c�� >_c r <br />-13. HSC Section 118030-LQHE application. <br />Treatment/Storage <br />_14.HSC Section 118135 -Shall obtain a permit <br />P 71/1 'T r llj <br />from the enforcement agency to treat medical <br />waste prior to treating the waste. <br />('�� IY�G i l' (�w <br />lj <br />_15.HSC Section 118765 -All treatment records <br />shall be kept for 3 years. <br />- Z <br />_16.HSC Section 118215 -All medical waste <br />shall be treated pursuant to this section. <br />Section 118220 -Recognizable human <br />r <br />_17.HSC <br />anatomical parts shall be disposed of by interment <br />unless otherwise hazardous. <br />S <br />_18.HSC Section 118225 -Treated sharps shall <br />be destroyed or somehow prevent public access. <br />_X19.HSC Section 118275 -MW red bags, path, <br />chemo shall be labeled properly. <br />J VNLJ <br />_420.HSC Section 118280 -MW label & containy <br />21.HSC Section 118285 -Sharps label/contain <br />]&2.HSC Section 118295 -Proper decon used.CJ <br />Vn <br />tJl <br />_423.HSC Section 118307 -Interim storage labeled <br />24.11-11SC Section 118310 -Enclosure labeled. <br />_25.HSC Section 118305 -Cannot reuse drums <br />_26.HSC Section 117630 -Approved biohazard <br />bag used. <br />_27.HSC Section 118275(g)-Pharm label/store` <br />r� 6� <br />e r Signature c ' ed By Date <br />_28.HSC Section 118222 -Incineration Required <br />29 Other -Describe in narrative. <br />