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Date C Z <br />Record I -?(,' SO(s�l�Z <br />Prog Elernzf; , 30 <br />SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />304 E. Weber Ave., Third Floor, Stockton, CA 95202 <br />(209) 468-3420 <br />MEDICAL WASTE INSPECTION FORM <br />Facility Name .r)qFacility Address <br />Facility Contact ��! I �C e� Title k,.mac{. Phone # �iS � �(`f1 ;Ic <br />INSPECTION TYPE: Aoutine ❑Complaint ❑Reinspection <br />VIOLATION(S) <br />Registration <br />1. HSC Section 117955 -Large Quantity <br />THE ITEMS BELOW REPRESENT VIOLATIONS OF THE CALIFORNIA <br />HEALTH & SAFETY CODE (HSC): <br />_ <br />Generator shall register with the enforcement <br />agency prior to commencement of the generation <br />of medical waste. <br />_2. HSC Section 117903 -Permit from the <br />enforcement agency required to treat medical <br />��GC �'Ci `�, (��{� f-) cf f {` �F' i <br />r <br />waste. <br />HSC Section 117890 -No large LQG shall <br />Tr <br />_3. <br />generate medical waste unless registered with <br />the enforcement agency. <br />HSC Section 117895-SQG that treats med <br />_4. <br />waste shall register with enforcement agency. <br />HSC Section 117900 -Shall not haul med <br />_5. <br />waste unless registered or obtained LQHE. <br />Section 117903 -Shall not treat med <br />_6.HSC <br />waste without permit from enforcement agency. <br />HSC Section 117908 -Common Storage <br />facility shall be registered with local enforcement <br />agency. <br />Procedures <br />Section 117935-SQG MWMP <br />_8.HSC <br />_9.HSC Section 117943-SQG Shall keep <br />records for 3 years. <br />Section 117945-SQG not required to <br />_10.HSC <br />Yre 'ster shall keep records for 2 years. <br />Y1ter <br />Section 117960-LQG shall file <br />MWMP 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 <br />Section 118135 -Shall obtain a <br />_14.HSC <br />permit from the enforcement agency to treat <br />medical waste prior to treating the waste. <br />-- <br />Section 11 8765 -All treatment <br />_15.HSC <br />records shall be kept for 3 years. <br />Section 118215 -All medical waste <br />_16.HSC <br />shall be treated pursuant to this section. <br />Section 118220 -Recognizable <br />_17.HSC <br />human anatomical parts shall be disposed of by <br />interment unless otherwise hazardous. <br />Section 118225 -Treated sharps shall <br />_18.HSC <br />be destroyed or somehow prevent public access. <br />Section 118275 -MW red bags, path, <br />_19.HSC <br />chemo shall be labeled properly. <br />20.HSC Section 118280 -MW label & contain <br />21.HSC Section 118285 -Sharps label/contain <br />HSC Section 118295 -Proper decon used. <br />—22. <br />23.HSC Section 118310 -Enclosure labeled. <br />_24.HSC Section 118305 -Cannot reuse drums <br />Section 117630 -Approved biohazard <br />—25.HSC <br />bag used. <br />— 26. Other -Describe in narrative. <br />ns ect r ignature Received By <br />