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GUIDELINES FOR THE MEDICAL WASTE MANAGEMENT <br /> PLAN <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 s appropriate for your facility: <br /> Business Name: �. <br /> Business Address: <br /> City Statte, 1 n Zip Code <br /> Phone Number: <br /> Type of Facility or Business: <br /> REGISTRATION FOR: <br /> ❑ Small Quantity Generator with Onsite Treatment(Generates less than 2001bs/month). <br /> ��lll Large Quantity Generator Only(Generates 200 lbs or more/month). <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: — Title: C4jPj <br /> JW-fj� <br /> Phone: `y—p�p JO(Ao Date: <br /> 1. List the types of medical waste generated at your facility,i.e., laboratory wastes,blood or body <br /> fluids,sharps,contaminated animals,surgical s ecimens,tracp chemo or isolatfon wastes": <br /> a) Do you generate a�pharmaceutical waste(expired/outdated,spent,partials,)? <br /> b) M Yes ❑No <br /> If yes, describe the type of pharmaceutical waste(expired,spent,partials, outdated,patient <br /> returns, etc): <br /> And estimate tl ion amount of pharmaceutical waste generated at your <br /> facility: �^ <br /> EHD 45-03 5 <br /> 10/6/2006 <br />