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DI L S CTI ® his, � 1 / G� San Joaquin County Environmental at Date:apartment Program 1868 E. Hazelton Ave.,Stockton,CA 95205 Record_ J (209)468-3420 Program www.siocv.orn/and g Element_ Facility Name Address City zip Code G.incoln Square Post Acute Rehab 1032 n.lincoln st. Stockton 85203 Facility Contact Title Phone Number Email Inspection Type Monaliza Botello Director of Staff 209-446-5341 x240 mboteilo@linooln Routine Development sq uarerehab.corn The above facility is inspected for compliance with Division 104,Part 14 of California Health and Safety Code(HSG). Registration Treatment ❑ 1 HSC 117890-No LQG shall generate medical waste unless ❑ 17 HSC 118130-All onsite medical waste treatment facilities shall registered with the EA. be permitted by the EA. HSC 117950-LOG shall register with the EA prior to ❑ 2. ❑ 18. HSC 118166-All treatment records shall be kept for 3 years. generating medical waste. HSC 117903-Permit from the EA is required prior to treating HSC 118215-All medical waste shall be treated pursuant to ® 3' medical waste. F-1 i9' this section- HSC 117925-SQG that treats medical waste onsite shall HSC 118220-Pathology waste of a human nature shall be ❑ 4' register with the EA. ❑ 20- disposed of by interment,incineration,or an approved alternative. HSC 117900-Shall not haul medical waste unless registered, HSC 118222-Contaminated pathology waste,trace chemo ❑ 5- common carrier,trauma scene practitioner,or exempted ® 21, waste,or pharm waste from health care settings shall be treated under the MOT exemption- by incineration or an a2proved alternative. HSC 117928-Common Storage Facility shall have permit HSC 118225-Sharps waste shall be treated pursuant to this ® s" issured by the EA- ® 22. section- HSC 117890-LOG shall notify EA 72 hours prior to Containment/Storag® participating in temporary event. HSC 117895-SQG shall notify EA 72 hours prior to® HSC 117630-Biohazard bag shall meet the standards set forth®' participating in temporary event. 23. in this section. HSC 118275-Medical,biohazardous,sharps,trace chemo, Records/Documentation ED 24 pathology,or phannaceutical waste shall be segregated and contained pursuant to this section, The container shall be properlylabeled" ❑ 9. HSC 117935-Registered SQG shall file MWMP with the EA. ❑ 25 HSC 118280- Biohazard bags shall be contalnerized and stored pursuant to this section. ❑ 10 HSC 117943-SQG required to register shall maintain HSC 118285-Sharps waste shall be containerized and stored treatment and shipping and tracking records for 3 years. El 26 pursuant to this section. ❑ 11 HSC 117945-SQG not required to register shall maintain HSC 118295-Containers shall be washed and decontaminated 27 information document and transportation records for 3 years. ® ' pursuant to this section. HSC 118305- Reuseable drums or consinters used for medical 12. HSC 117960-LQG shall file MWMP with the EA. ® 28. waste shall not be used for other storage. HSC 117975-LQG shall maintain treatment and shipping and ® 29HSC 118307- Intermediate storage area shall be secured and ® 13. tracking documents for 2 years- . marked with proper signage- Transportation ® 3o HSC 118310-Designated accumulation area shall be secured and marked with proper si nage" E] 14. HSC 117946-MOT exemption requirements for SQG. Other El 15. HSC 117976-MOT exemption requirements for LOG. FEI 31. ❑ 16, HSC 118032-Pharmaceutical waste hauling exemption. 32. Received by: Print: Signature: . Phone: Specialist: Print: J"Easter Signature: ,� Phone: 209-953-7310 Reinspecion on/about A reinspection fee of$152 per hour may be charged- Page 1.of 2 EH-11/17 60 A 'd 6S�l "N Wd�ti : � 61N '0l 'add