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oPa..... ° SAN JOAQUIN COUNTY Date 5-17 <br /> ERONMENTAL RHEALTH DEPARTME0 PR 36L-74i <br /> Q a 600 East Main Street, Stockton, CA 95202 <br /> rn: <br /> (209)468-3420 <br /> P MEDICAL WASTE INSPECTION FORM <br /> �<r F ORS <br /> FacilityName /V:'w 4ne., Ctkrc, CW_ FacilityAddress ;z�sv &L." VVL-'ylrt l�vr- <br /> eA_tro-,rete ui,, <br /> FacilityContact A[ v�1. -� w� Title_ ; Ltz✓ Phone# X_;r�Z -,22 <br /> INSPECTION TYPE: WHoutine []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 /> S / /� <br /> _2.HSC Section 117903-Permit from the �' , , � I <br /> enforcement agency required to treat medical LrM} �t.v G h r ��Yr'c-\ �'�t✓lel Lr"\- r^.it L' 'N <br /> waste. ` r <br /> _3.HSC Section 117890-No large LQG shall m r—yY -qtr. VA �cw <br /> generate medical waste unless registered with the c <br /> enforcement agency. YrTSVy� /�]r 1�l . .21. _ 3Gl l f r-) Aj yl ';2 f <br /> _4.HSC Section 117895-SQG that treats med <br /> waste shall register with enforcement agency. <br /> _5.HSC Section 117900-Shall not haul med rJc�v� G <br /> waste unless registered or obtained LQHE. <br /> _6.HSC Section 117903-Shall not treat med - Z U y <br /> waste without permit from enforcement agency. <br /> _7.HSC Section 117908-Common Storage ✓Y7 r",*�� 4 --t lf' %G� 'J��'�.� l 72r� { CcsL4 <br /> n' <br /> facility shall be registered with local enforcement <br /> agency. \ <br /> i7/ b`fizn- _ 2 Vt Z ice_ e. -Csi:J C,v I�/c ✓,�S <br /> Procedures <br /> _8.HSC Section 117935-SQG MWMP <br /> _9.HSC Section 117943-SQG Shall keep Yl <br /> records for 3 years. ire L4 <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 S <br /> records for 3 years. <br /> Transportation Oyl <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 /> waste prior to treating the waste. r ey P LJ.-.ems <br /> _15.HSC Section 118765-All treatment records <br /> shall be kept for 3 years. <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. <br /> _18.HSC Section 118225-Treated sharps shall <br /> be destroyed or somehow prevent public access. <br /> _19.HSC Section 118275-MW red bags,path, <br /> chemo shall be labeled properly. <br /> _�LO.HSC Section 118280-MW label&contain <br /> _21.HSC Section 118285-Sharps label/contain <br /> _22.HSC Section 118295-Proper decon used. <br /> 23.HSC Section 118307-Interim storage labeled <br /> a24.HSC Section 118310-Enclosure labeled. <br /> _25.HSC Section 118305-Cannot reuse drums <br /> _26.HSC Section 117630-Approved biohazard <br /> ba used. <br /> 7.HSC Section 118275(g)-Pharm label/store <br /> _28.HSC Section 118222-Incineration Required I ' ec Signature Recei ed By D to <br /> 29 Other-Describe in narrative. <br /> PFJ �' <br />