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0 SAN JOAQUIN COUNTY 0 Date <br /> ENVIRONMENTAL HEALTH DEPARTMENT PR <br /> 600 East Main Street, Stockton, CA 95202 <br /> (209)468-3420 <br /> MEDICAL WASTE INSPECTION FORM <br /> FacilityNarne" Sr le. &W,6"ioa—FaCIIityAddress M- --) E, Fi,1-h2r, A- <br /> FacilityContact Liz— :Te-mac;ros— Title Phone# L1 ; 1b <br /> INSPECTION TYPE: 7dRoutine ElComplaint EiRe-inspection <br /> VIOLATION(S) <br /> Registration THE ITEMS BELOW REPRESENT VIOLATIONS OF THE CALIFORNIA <br /> —1.HSC Section 117955-Large Quantity 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 /> waste. <br /> —3.HSC Section 117890-No large LQG shall 2 1QC-Q <br /> generate medical waste unless registered with the <br /> enforcement agency. <br /> —4.HSC Section 117895-SQG that treats med cA <br /> waste shall register with enforcement agency. <br /> —5.HSC Section 117900-Shall not haul med W e'Llx'c <br /> waste unless registered or obtained LQHE. <br /> —6.HSC Section 117903-Shall not treat med S& Arlr--4- <br /> waste without permit from enforcement agency. <br /> THSC Section 117908-Common Storage '12 1) <br /> Tac7flity shall be registered with local enforcement Z2 �a-Z4 <br /> agency. 11 la k2lz <br /> Procedures <br /> —8.1-11SC Section 117935-SQG MWMP <br /> —9.1-11SC Section 117943-SQG Shall keep <br /> records for 3 years. <br /> —10.HSC Section 117945-SQG not required to <br /> register shall keep records for 2 years. <br /> 1111.1-11SC Section 117960-LQG shall file MWMP <br /> with enforcement agency. <br /> —12.HSC Section 117975-LQG shall keep <br /> records for 3 years. <br /> Transportation (A) <br /> —13.HSC Section 118030-LQHE application. <br /> Treatment/Storage <br /> —114.1-11SC Section 118135-Shall obtain a permit <br /> from the enforcement agency to treat medical <br /> waste prior to treating the waste. <br /> 15.HSC Section 118765-All treatment records <br /> ;hall be kept for 3 years. <br /> 16.HSC Section 118215-All medical waste <br /> shall be treated pursuant to this section. <br /> --117.1-11SC Section 118220-Recognizable human <br /> anatomical parts shall be disposed of by interment <br /> unless otherwise hazardous. <br /> -118.1-11SC Section 118225-Treated sharps shall L <br /> be destroyed or somehow prevent public access. 11-A V\P, <br /> l 9.HSC Section 118275-MW red bags,path, /f <br /> 1,A) I-ijn <br /> chemo shall be labeled properly. I�L <br /> rVkAr rn-6 <br /> —20.HSC Section 118280-MW label&contain 1)�n CA Lyy),:::A LWL, 92 /L S4 <br /> —21.HSC Section 118285-Sharps label/contain <br /> —22.HSC Section 118295-Proper decon used. 1�2 <br /> —23.1-11SC Section 118307-Interim storage labeled <br /> —24.1-11SC Section 118310-Enclosure labeled. <br /> —25.1-11SC Section 118305-Cannot reuse drums <br /> --26.1-11SC Section 117630-Approved biohazard <br /> -bag used. <br /> —27.HSC Section 118275(g)-Pharm label/store —j;L.�/ - Z5 <br /> —28.HSC Section 118222-incineration Requiredgnature d By Date <br /> 29 Other-Describe in narrative. cl�x <br />