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�o qurH co • SAN JOAQUIN COUNTY Date 0-1S- 12- <br /> ENVIRONMENTAL <br /> ZENVIRONMENTAL HEALTH DEPARTMENT PR 53b L-11-f <br /> N 600 East Main Street, Stockton, CA 95202 <br /> (209)468-3420 <br /> MEDICAL WASTE INSPECTION FORM <br /> FacilityName Xk z�p e V-, FacilityAddress G }ln;anc .nn A-� <br /> fx�,�n�tsn,w.•cwk�1 <br /> FacilityContact ,A IRTitle Phone# -- -1 <br /> INSPECTION TYPE: $Boutine []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 l (. L <br /> waste. <br /> _3.HSC Section 117890-No large LQG shall 11 7-e,—-r l° Tri J'yj Zf ✓ M <br /> generate medical waste unless registered with the 1�� <br /> enforcement agency. 1 <br /> _4.HSC Section 117895-SQG that treats meda L • r <br /> waste shall register with enforcement agency. <br /> _5.HSC Section 117900-Shall not haul medL')c. y? <br /> waste unless registered or obtained LQHE. <br /> _6.HSC Section 117903-Shall not treat med WV <br /> waste without permit from enforcement agency. <br /> _7.HSC Section 117908-Common Storage /� L� <br /> facility shall be registered with local enforcement -� r lm le- ima y z-c-- PV\G1YYV1Cs C�tl"t�ZL'a <br /> agency. <br /> Procedures <br /> _8.HSC Section 117935-SQG MWMP <br /> _9.HSC Section 117943-SQG Shall keep y <br /> records for 3 years. <br /> _10.HSC Section 117945-SQG not required to �. rI� <br /> register shall keep records for 2 years. SJ oy <br /> v . .lte-- <br /> DC11.HSC Section 117960-LQG shall file MWMP r 9 <br /> with enforcement agency. _ �-Y G� hLL✓YVLC��G'Ce�Z� ( GJCs`l I'f Ccr'l <br /> records forC3 years. 117975-LQG shall keep \ <br /> I G(prt+C& L4 r- -r,ZCef i'►2 Nye C_'Tjq <br /> Transportation � oge✓ <br /> _13.HSC Section 118030-LQHE application. <br /> Treatment/Storage mr�sl- cz ��c-� ►-\c; 1c� 1-�c�lr fc.,Ytr'r�7'i <br /> _14.HSC Section 118135-Shall obtain a permit O� !NL p I i a Ilii' <br /> from the enforcement agency to treat medical `` ( <br /> waste prior to treating the waste. 7tt� _ L')--x 1 h! !—Ylyyx Gt_P1 <br /> _15.HSC Section 118765-All treatment records Ij <br /> shall be kept for 3 years. r�`egf—n L'77 <br /> _16.HSC Section 118215-All medical waste <br /> shall be treated pursuant to this section. <br /> _17.HSC Section 118220-Recognizable human <br /> anatomical parts shall be disposed of by interment <br /> unless otherwise hazardous. 1 <br /> _18.HSC Section 118225-Treated sharps shall <br /> be destroyed or somehow prevent public access. p " <br /> _19.HSC Section 118275-MW red bags, path, 1[1VC? 10-41r 1Nl�NtC�i ttr/` CfTLI`tom tV1L✓1ze h4l' l <br /> chemo shall be labeled properly. - <br /> -X_20.HSC Section 118280-MW label&contain ©i— D�Ir_t.VYYIt, C r'eJ�>�_ �7 l .5.� '►/L L� `� <br /> _21.HSC Section 118285-Sharps label/contain _T <br /> _22.HSC Section 118295-Proper decon used. 421 �q I V1 �7 .> <br /> _23.HSC Section 118307-Interim storage labeled <br /> �24.HSC Section 118310-Enclosure labeled. <br /> _25.HSC Section 118305-Cannot reuse drums gie� <br /> _26.HSC Section 117630-Approved biohazard n <br /> bag used. " / /� <br /> 6L27.HSC Section 118275(8)-Pharm label/store 6 <br /> _28.HSC Section 118222-Incineration Required I Signature Re eived y ate <br /> 29 Other-Describe in narrative. <br /> P�( ' 3 <br />