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INFORMATION PACKET FOR MEDICAL WASTE GENERATORS <br />This packet contains the information and forms you will need to help you comply with the <br />Medical Waste Management Act. RECEIVED <br />OEM <br />Please return the completed forms prior to medical waste generation or treatme"'VWRONMENTALWALTH <br />PERMITISERVICES <br />1. Complete the "Pre -Application Questionnaire" on Page 2. If your answers indicate <br />you are not required to register as a medical waste generator, then complete the <br />"Certification Statement" on Page 3 and return both complete forms to the rnailing <br />address below. <br />2. If you are required to register as a medical waste generator, as indicated by affirmative <br />answers to questions 3 ) & 4 on. the "Pre -Application Questionnaire", then: <br />a. Complete the "Registration for Medical Waste" form located on <br />Page 4. <br />b. Complete, a "Medical Waste Management Plan" following the guidelines <br />provided on Page 5. <br />c. Return the completed 'forms and management plan to the mailing address <br />below. <br />Your cooperation in promptly registering and following the specified handling requirements is <br />greatly appreciated. <br />If you have any questions regarding registration or handling requirements. <br />, please contact (209) <br />468-3420 and ask for the Medical Waste Program. <br />RETURN ALL COMPLETED FORMS TO: <br />Alin: Medical Waste Program <br />San Joaquin County Environmental Health Department <br />600 East Main Street <br />Stockton, CA 95202 <br />F14T),B-0" WFFi <br />SAN JOAQUIN COUNTY <br />Donna K. Heran, R.E.H.S1 <br />Vidt Supenlson <br />Director <br />600 East Main Street <br />Carl Bo man. IU"A.S. <br />Laurie A. Cotulla, RXM.S� <br />Stockton, California 95202 <br />Mike Huggins. R.E.H.S., RDA, <br />Margaret Lagorio, R.F.A.S. <br />Assisfaia Dit vetor <br />Telephone: (209) 468-3420 <br />Robert MeClelloii', RJ".11S. <br />Fax: (209) 468-3433 <br />- <br />Jeff Canuesco, R.EATS. <br />Kasey Foley, fU-JI.S. <br />INFORMATION PACKET FOR MEDICAL WASTE GENERATORS <br />This packet contains the information and forms you will need to help you comply with the <br />Medical Waste Management Act. RECEIVED <br />OEM <br />Please return the completed forms prior to medical waste generation or treatme"'VWRONMENTALWALTH <br />PERMITISERVICES <br />1. Complete the "Pre -Application Questionnaire" on Page 2. If your answers indicate <br />you are not required to register as a medical waste generator, then complete the <br />"Certification Statement" on Page 3 and return both complete forms to the rnailing <br />address below. <br />2. If you are required to register as a medical waste generator, as indicated by affirmative <br />answers to questions 3 ) & 4 on. the "Pre -Application Questionnaire", then: <br />a. Complete the "Registration for Medical Waste" form located on <br />Page 4. <br />b. Complete, a "Medical Waste Management Plan" following the guidelines <br />provided on Page 5. <br />c. Return the completed 'forms and management plan to the mailing address <br />below. <br />Your cooperation in promptly registering and following the specified handling requirements is <br />greatly appreciated. <br />If you have any questions regarding registration or handling requirements. <br />, please contact (209) <br />468-3420 and ask for the Medical Waste Program. <br />RETURN ALL COMPLETED FORMS TO: <br />Alin: Medical Waste Program <br />San Joaquin County Environmental Health Department <br />600 East Main Street <br />Stockton, CA 95202 <br />F14T),B-0" WFFi <br />