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ENVIANMENTAL HEAA?H DEPARTMENT <br /> SAN JOAQUIN COUNTY <br /> Donna K Heran,R.E.H.S. Unit Supervisors <br /> Director 600 East Main Street Carl Borgman,R.E.H-S. <br /> Laurie A.Cotulla,R.E.R.S. Stockton, Califorztia 95202 Mike Huggins,R-E.H.S.,R.D.I. <br /> Assistant Director Margaret Lagorio,R.B11S, <br /> Telephone- (209) 468-3420 Robert McClellon,R-E.H.S, <br /> Fax: (209) 468-3433 leff Carraosco,R-17_14.S. <br /> Kasey Foley,RX.H.S. <br /> ESTFORMATION PACKET FOR MEDICAL WASTE GENERATORS <br /> This packet contains the inform ition and forms you will need to help you comply with the <br /> Medical Waste Management Act_ <br /> Instructions <br /> Please return the completed forms prior to medical waste generation or treatment- <br /> 1- Complete the "Pre-Application Questionnaire" on Page 2. If your answers indicate <br /> you are not required to register as a medical waste generator, then complete the <br /> "Cerfification Statement" on Page 3 and return both complete forms to the inailing <br /> address below. <br /> 2. If you are required to register as a medical waste generator, as indicated by affirmative <br /> answers to questions 3 & 4 on the "Pre-Application Questionnaire", then: <br /> a. Complete the "Registration for Medical Waste" form located on <br /> Page 4. <br /> b. Complete a"Medical Waste Management Plan" following the guidelines <br /> provided on Page 5. <br /> C, Return the completed forms and management plan to the mailing address <br /> below_ <br /> Yourcooperation in promptly registering and following the specified handling requirements is <br /> greatly appreciated_ <br /> Ifyou have any questions regarding registration or handling requirements,please contact(209) <br /> 468-3420 and ask for the Medical Waste Program. <br /> RETURN ALL COMPLETED FORMS TO: <br /> Attri- Medical Waste Program <br /> San Joaquin County Environmental Health Department <br /> 600 East Main Street <br /> Stockton, CA 95202-3029 <br /> 4S-C- <br /> 6001 NdSti : � 6lHt 'add <br />