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SAN JOAQUIN COUNTY Date A,-)�S-- )I <br />E IRONMENTAL HEALTH DEPARTME9 PR 5,36 i'Z[L <br />600 East Main Street, Stockton, CA 95202 <br />(209) 468-3420 <br />MEDICAL WASTE INSPECTION FORM <br />FacilityName ,ofz� 6r.w e— �°A FacilityAddress 4411- E. 4rLW <br />FacilityContact A v A -Z, c-. Title &V_�, s; aA_* av' Phone# X16 --DLA <br />INSPECTION TYPE: A8outine []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 />r7�'l T'►�l ,.�-y <br />_2. HSC Section 117903 -Permit from the <br />enforcement agency required to treat medical <br />waste. <br />HSC Section 117890 -No large LQG shall <br />"" i <br />_3. <br />generate medical waste unless registered with the <br />enforcement agency. <br />- <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 />_6.HSC Section 117903 -Shall not treat med <br />07,7- c <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 />, <br />- <br />Procedures <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 <br />register shall keep records for 2 years. <br />11.HSC Section 117960-LQG shall file MWMP <br />with enforcement agency. <br />— KAvt ( <br />�-t <br />43 ` f � �Y }� �hon <br />_&12.HSC Section 117975-LQG shall keep <br />records for 3 years. <br />Transportation <br />r «,<. <br />_13. HSC Section 118030-LQHE application. <br />Treatment/Storage <br />_14.HSC Section 118135 -Shall obtain a permit <br />ace. Ue-,j6AY 6nie re, <br />from the enforcement agency to treat medical <br />waste prior to treating the waste. <br />l <br />\ <br />_15.HSC Section 118765 -All treatment records <br />shall be kept for 3 years. <br />_16.HSC Section 118215 -All medical waste 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 />✓l <br />_18.HSC Section 118225 -Treated sharps shall <br />be destroyed or somehow prevent public access. <br />_A-19.HSC Section 118275 -MW red bags, path, <br />chemo shall be labeled properly. <br />_20.HSC Section 118280 -MW label & contain <br />}/)� `�,Y.p l� M r'w►n Ce,i'7'�e `Kl/�/� L Z t'�t`TVl l`' ✓ <br />21.HSC Section 118285 -Sharps label/contain <br />22.HSC Section 118295 -Proper decon used. <br />Y�' <br />�423.HSC Section 118307 -Interim storage labeled <br />_24.HSC Section 118310 -Enclosure labeled. <br />25.HSC Section 118305 -Cannot reuse drums <br />Section 117630 -Approved biohazard <br />_26.HSC <br />bag used. <br />_27.HSC Section 118275(g)-Pharm label/store <br />° <br />or Signature eive By Date <br />_28.HSC Section 118222 -Incineration Required <br />29 Other -Describe in narrative. <br />