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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: Com. �. <br /> Business Address: �- '�--- <br /> SE���"" <br /> Cityrr�� State n Zip Code <br /> XPhone Number: f Cl <br /> Type of Facility or Business: <br /> REGISTRATION FOR: <br /> ❑ Small Quantity Generator with Onsite Treatment(Generates less than 200ibs/month). <br /> Large Quantity Generator Only(Generates 200 lbs or more/month). <br /> �i� ❑ Large Quantity Generator with Onsite Treatment(Generates 200 lbs or mor month). <br /> (y Person responsible for implementation of the Medical Waste Management Plan: <br /> e. Title• J.�6� 0 A4 <br /> -LO Phone: 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 secimens,tra chemo or isola on wastes": <br /> ;E( <br /> a) Do you generate any pharmaceutical waste(expired/outdated, spent,partials,)? <br /> b) Yes ❑No <br /> If yes,describe the type of pharmaceutical waste(expired,spent,partials,outdated, patient <br /> returns, etc): <br /> And estimate tl i onthly amount of pbarariaceutical waste generated at your <br /> facility: <br /> EHD 45-03 5 <br /> ![/6/2006 <br />