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SAN JOAQUIN COUNTY I* Date -7`a6-13 <br />ENVIRONMENTAL HEALTH DEPARTMENT PR 5Z6 -t-70 <br />600 East Main Street, Stockton, CA 95202 <br />(209) 468-3420 <br />MEDICAL WASTE INSPECTION FORM <br />FacilityName 4,m 6my_ Cif FacilityAddress 1L-(2_ _ rL, Z �"I ._ <br />FacilityContact AkZA;r„e Title -P -VS Phone# C46G --0-t5 i <br />INSPECTION TYPE: t4ftutine <br />❑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 />_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 />&7 fA <br />waste shall register with enforcement agency. <br />7 A aZa Yi7!'JZ"�. I L� _ _ PK t C fid 1 Y/VIra.Vw1%� <br />_5. HSC Section 117900 -Shall not haul medtxice <br />-0 A <br />waste unless registered or obtained LQHE. <br />C; <br />_6.HSC Section 117903 -Shall not treat med <br />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 />Procedures <br />_8.HSC Section 117935-SQG MWMP <br />1 a� <br />C`�� �r� 7_1A <br />_9.HSC Section 117943-SQG Shall keep <br />e j/-,- <br />records for 3 years. <br />_10.HSC Section 117945-SQG not required to <br />register shall keep records for 2 years. <br />- <br />11.HSC Section 117960-LQG shall file MWMP <br />with enforcement agency. <br />'f A- LSL V <br />_12.HSC Section 117975-LQG shall keep <br />records for 3 years. <br />Transportation <br />_13. HSC Section 118030-LQHE application. <br />Treatment/Storage <br />_14.HSC Section 118135 -Shall obtain a permit <br />from the enforcement agency to treat medical <br />O 1 <br />) <br />waste prior to treating the waste. <br />0 1a O <br />Section 118765 -All treatment records <br />_15.HSC <br />shall be kept for 3 years. <br />t Z <br />t_4 <br />_16.HSC Section 118215 -All medical wasteIn <br />y L <br />"L� 15 <br />shall be treated pursuant to this section. <br />'14 <br />_17.HSC Section 118220 -Recognizable human <br />�- <br />anatomical parts shall be disposed of by interment <br />unless otherwise hazardous. <br />ti <br />_18.HSC Section 118225 -Treated sharps shall <br />be destroyed or somehow prevent public access. <br />_X19.HSC Section 118275 -MW red bags, path, <br />crgmo shall be labeled properly. <br />_&20.HSC Section 118280 -MW label & contain <br />_21.HSC Section 118285 -Sharps label/contain <br />Section 118295 -Proper decon used. <br />_22.HSC <br />_23.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 />% <br />`C6 -761 / _ / <br />AV <br />27.HSC Section 118275(g)-Pharm label/store <br />_28.HSC Section 118222 -Incineration Required <br />I r ignature eceive y Date <br />29 Other -Describe in narrative. <br />