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GUIDELINES A THE MEDICAL WASTE IIYL&GEMENT PLAIN <br /> (Please Type or Print) <br /> Small quantity generators that provide onsite treatment and all large quantity generators shall have a medical waste <br /> management plan on file with the local enforcement agency. minimum required information: <br /> Business Name: integrated Pathology Services Corporation <br /> Business Address- 2291 West March Lane #179E Stockton CA 95207 <br /> Business Phone: -20% 4777-432 <br /> Type of Facility/Business: C1 i ni cal Pathol <br /> o Laboratory <br /> Registered As: (Check One) <br /> Small Quantity Generator With Onsit,e. Treatment- (Generates <200 lbsJmo.) <br /> Large Quantity Generator.(Generates 200-lbsor more/mo.) <br /> 0 Large Quantity Generator With Onsite Treatment.(Generates 200 tbs.or morelmo.) <br /> O Common Storage Facility(Small Quantity Generators only.) <br /> Person Responsible For Implementation Of The Plan: Safety and Manager <br /> Name: David R Daniel Title:Environmental Compl i a ehone: ( 2091 477-4432 <br /> ATTACH THE FOLLOWING ADDITIONAL INFORMATION <br /> I. List the types of regulated medical waste generated at your facility(refer to list on page 2). <br /> 2. Estimate the monthly amount, in pounds,of medical waste generated at your facility. <br /> 3. Describe the medical waste handling procedures utilized by and applicable to your facility: <br /> a. Onsite location and method for segregation.containment, packaging, labelling and collection. <br /> b. Storage area description with storage methods utilized, including duration and temperature <br /> controls, if applicable. <br /> c. Onsite treatment facility description, including type of treatment utilized.maximum capacity, time <br /> and temperature necessary, alternate contingency plan in case of equipment failure,etc. <br /> d. Name, address, registration number, and phone number, of the registered hazardous waste hauler <br /> employed by your facility. <br /> e. Name, address, and phone number of offsite treatment facility where medical waste is transported <br /> for treatment, if different than the hauler. <br /> f. Do you have a Limited Quantity Hauling Exemption? Who on your staff is authorized to transport <br /> your medical waste? <br /> z. Do you have tracking documents for all medical wastes handled at your facility? All medical <br /> waste generators are required to keep accurate records regarding containment, storage, hauling, <br /> treatment and disposal. All medical waste records are to be maintained and available for 3) years. <br /> h. Describe your medical waste emergency action plan, including procedures for handling spills, <br /> exposures,equipment failures,etc. <br /> I hereby certify that to the best of\rny knowledge and belief that the statements made herein are correct and true. <br /> �� Safety And Enviromental ,Compliance <br /> SIGNATURE: David R Daniel TITLE.Manager DATE: Aug. 8, 2000 <br />