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Cl <br />El <br />GUIDELINES FOR THE MEDICAL WASTE MANAGEMENT <br />PLAN <br />Small quantity generators that provide Onsite 'rreatinent 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 "ATaste Management Plan shall contain the <br />following information as appropriate -for your facility: <br />Business Name: " <br />Business Address: <br />City <br />Phone Number: <br />State <br />Zip Code <br />Type of Facility or Business: <br />REGISTRATION FOR: <br />small Quantity Generator with Onsite Tivatinent (Generates less than 200lbs/montli). <br />purge Quantity Generator Only (Generates 200 lbs or more/niontli). <br />Ej Large Quantity Generator witli Onsite "Freatment (Generates 200 lbs or morehnontli). <br />Person responsible for implementation of the Medical Waste Management Plan: <br />Name: —Title: <br />'7 <br />Phone: 1'6� Date: - <br />List the types of medical waste generated at your facility, i.e., laboratory wastes, blood or body <br />fluids, sfiarps, contaminated animals, surgical specimens, trace chemo or isolation wastes": <br />E <br />a) Do you generate aj& pharmaceutical waste (exf��Ireq,/Ioutdated, spent, partials)? <br />b) <br />E'"Yes ❑ No <br />If yes, describe the type of pharmaceutical waste (expired, spent, partials, outdated, patient <br />returns, etc):z. <br />And estimate tl-,e monthly arnount of pharmaceutical waste generated at yourID <br />facility:_ `3 <br />