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SAN JOAQUIN COUNTY Date 6-1,i a' <br />ARONMENTAL HEALTH DEPARTM PR 4� f, l'Zl2 <br />600 East Main Street, Stockton, CA 95202 <br />(209) 468-3420 <br />MEDICAL WASTE INSPECTION FORM <br />FacilityName +},�n C,_L�_ elzFacilityAddress c-k-A.wj2bx. 4,z - . <br />FacilityContact '�:e r ✓t tom- Title L.VS Phone# y-JLL <br />INSPECTION TYPE: XRoutine ❑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 />< �. <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 <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 />waste unless registered or obtained LQHE. <br />_6.HSC Section 117903 -Shall not treat med <br />waste without permit from enforcement agency. <br />_7.HSC Section 117908 -Common Storage <br />facility shall be registered with local enforcement <br />agency. <br />Procedures <br />r <br />c - _ +Z_ er <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 />v <br />register shall keep records for 2 years. <br />_11.HSC Section 117960-LQG shall file MWMP <br />w, h enforcement agency. <br />" ��, lam; 17w: Yir'.✓b71I" <br />' <br />12.1-11SC Section 117975-LQG shall keep <br />records for 3 years. <br />R <br />Transportation <br />- <br />_13. HSC Section 118030-LQHE application. <br />Treatment/Storage <br />_14.HSC Section 118135 -Shall obtain a permitfrom <br />the enforcement agency to treat medical <br />waste prior to treating the waste. <br />'' INA. <br />' ti ! 3 <br />_15.HSC Section 118765 -All treatment records <br />shall be kept for 3 years. <br />_16.HSC Section 118215 -All medical waste <br />shall be treated pursuant to this section. <br />_17.HSC Section 118220 -Recognizable human <br />anatomical parts shall be disposed of by interment <br />unless otherwise hazardous. <br />7 } ��•L-, �'t�, )3�%G.7Gt ►' <br />r� <br />✓h i / V7 e) •+�IfJ <br />_18.HSC Section 118225 -Treated sharps shall <br />qe destroyed or somehow prevent public access. <br />X19.HSC Section 118275 -MW red bags, path, <br />chemo shall be labeled properly. <br />_20.HSC Section 118280 -MW label & contain <br />-�-- \ <br />tA eL, ZCV et <br />_21.HSC Section 118285 -Sharps label/contain <br />_22.HSC Section 118295 -Proper decon used. <br />,:23.HSC Section 118307 -Interim storage labeled <br />Section 118310 -Enclosure labeled. <br />_24.HSC <br />_25.HSC Section 118305 -Cannot reuse drums <br />_26.HSC Section 117630 -Approved biohazard <br />bag used. <br />27.HSC Section 118275(8)-Pharm label/store4- <br />gag,- � <br />I for Signature Rec Ved Date <br />_28.HSC Section 118222 -Incineration Required <br />29 Other -Describe in narrative. <br />hrl <br />M 'CZ) <br />