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EC/21/2015/MON 06:13 PM PAX No, P,001 <br />ENVIRONMENTAL r r <br />SAN JOAQUIN COUNTY <br />1868 E. Hazelton Avenue <br />Stockton, California 95205 <br />Telephone: (209) 468-3420 <br />Fax: (209) 468-8392 <br />Small quantity generators that provide onsite treatment and all large quantity generators shall have a. <br />Medical Waste Management plan on: file with the San Joaquin County Environmental Health Department. <br />The Medical Waste Management plan shall contain the following information as appropriate for your <br />facility: " A n I / J. <br />Business Name: <br />Business A.ddxess: <br />Phone Number: <br />Type of Facility or Business: <br />❑ Small Quantity Generator with Onsite Treatment (Generates less than 200 lbs/month). <br />n -"Large Quantity Generator Only (Generates 200 lbs or more/month). <br />❑ Large Quantity Generator with Onsite Treatment (Generates 200 lbs or more/month), <br />Person responsible for knplementation of the Medical Waste Management Plan: <br />Name:,/(�l !�_ �t�"" Title: <br />Phone: --26ci_ e-C7&'046—Cp Date,, /0-? '?' /— /s- <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 specimens, trace chemo or isolation wastes): <br />a) Do you generate My pharmaceutical waste (expired, spent, partials, patient returns)? <br />If yes, describe thq,t)W of phaMaeeutical waste (expired, spent, partials, patient returns): <br />'Y'es ❑ No <br />— it - _ _v <br />And estimate the monthly amount of pharmaceutical waste generated at your facility: / � ' <br />SM 45-43 <br />Received Time Dec,21. 2015 5:19PM No -1447 <br />