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®Pain^!. oo 0 SAN JOAQUIN COUNTY Date-7-3.0-)3 <br /> c ENVIRONMENTAL HEALTH DEPARTME PR 536J-114 <br /> 600 East Main Street, Stockton, CA 95202 <br /> (209)468-3420 <br /> FOR�`P MEDICAL WASTE INSPECTION FORM <br /> FacilityName ca Wcrwl -FacilityAddress S8 A,v► <br /> FacilityContact Al 1 2h11e � Title t Phone# _ <br /> INSPECTION TYPE: outine ❑Complaint []Re-inspection <br /> VIOLATION(S) <br /> Registration THE ITEMS BELOW REPRESENT VIOLATIONS OF THE CALIFORNIA <br /> _1.HSC Section 117955-Large Quantity 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 17 g 1111Q 44 <br /> waste. <br /> _3.HSC Section 117890-No large LQG shall QW t –e <br /> generate medical waste unless registered with the <br /> enforcement agency. <br /> _4.HSC Section 117895-SQG that treats med <br /> waste shall register with enforcement agency. a sic. _ <br /> _5.HSC Section 117900-Shall not haul med IvAija2, JUL r.®rte- �5 <br /> waste unless registered or obtained LQHE. <br /> _6.HSC Section 117903-Shall not treat med <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 1 r <br /> _8.HSC Section 117935-SQG MWMP <br /> _9.HSC Section 117943-SQG Shall keep <br /> records for 3 years. <br /> Al" Ali jirzk Yn)nj4 <br /> _10.HSC Section 117945-SQG not required to <br /> register shall keep records for 2 years. '\ <br /> _11.HSC Section 117960-LQG shall file MWMP <br /> with enforcement agency. <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 --Irk n h <br /> _14.HSC Section 118135-Shall obtain a permit <br /> from the enforcement agency to treat medical <br /> waste prior to treating the waste. <br /> _15.HSC Section 118765-All treatment records <br /> shall be kept for 3 years. Ll "in <br /> _16.HSC Section 118215-All medical waste <br /> shall be treated pursuant to this section. � <br /> _17.HSC Section 118220-Recognizable human ,i n,i a A-1A ®,� ,ti AA a C <br /> anatomical parts shall be disposed of by interment <br /> unless otherwise hazardous. � <br /> _18.HSC Section 118225-Treated sharps shall <br /> be destroyed or somehow prevent public access. 'C� �-- <br /> _19.HSC Section 118275-MW red bags, path, <br /> chemo shall be labeled properly. <br /> _20.HSC Section 118280-MW label&contain <br /> _21.HSC Section 118285-Sharps label/contain <br /> 22.HSC Section 118295-Proper decon used. <br /> 3.HSC Section 118307-Interim storage labeled <br /> 24.HSC Section 118310-Enclosure labeled. <br /> —25.HSC Section 118305-Cannot reuse drums <br /> _26.HSC Section 117630-Approved biohazard <br /> bag used. <br /> 27.HSC Section 118275(g)-Pharm label/store <br /> 28.HSC Section 118222-Incineration RequiredI pet Signature ReCLt::� oate? <br /> 29 Other-Describe in narrative. <br />