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SAN JOAQUIN COUNTY Date4i-d7-/ <br /> EPRONMENTAL HEALTH DEPARTMEPI PR M21 6(2-5-- <br /> 600 East Main Street, Stockton, CA 95202 <br /> (209)468-3420 <br /> MEDICAL WASTE INSPECTION FORM <br /> FaciIityName_AA'7- CLcLr 60 14A <br /> FacilityAddress 8115- fcS <br /> FacilityContact Nl�� Title avlVcr &wLinc -Phone# <br /> INSPECTION TYPE: *outine []Complaint De-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 /> Z;e-nerator shall register with the enforcement <br /> agency prior to commencement of the generation o <br /> medical waste. <br /> 2.HSC Section 117903-Permit from the �01IL1133E, <br /> enforcement agency required to treat medical <br /> waste. <br /> —3.HSC Section 117890-No large LQG shall <br /> generate medical waste unless registered with the <br /> enforcement agency. <br /> —4.HSC Section I I 7895-SQG that treats med <br /> waste shall register with enforcement agency. <br /> _5.HSC Section 117900-Shall not haul med <br /> waste unless registered or obtained LQHE. 1:2W Cr.nas. • <br /> —6.HSC Section 117903-Shall not treat med <br /> waste without permit from enforcement agency. <br /> THSC Section 117908-Common Storage <br /> facility shall be registered with local enforcement <br /> agency. <br /> Procedures <br /> -8.HSC Section 117936-SQG MWMP P)L_4 &+e-Y-) ;,-,f -1 e-- r <br /> —9.HSC Section 117943-SQG Shall keep <br /> records for 3 years. <br /> —10.HSC Section 117945-SQG not required to <br /> register shall keep records for 2 years. <br /> 1 I.HSC Section 11 7960-LQG shall file MWMP <br /> with enforcement agency. Lvlz I ki I <br /> —1 2.HSC Section 11 7975-LQG shall keep <br /> records for 3 years. <br /> Transportation <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. ry <br /> 16.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 A&2�f)0�6 M ine-"i <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 /> Q� CAN AW?--r CA ci �r, �wls <br /> chemo shall be labeled properly. A'> <br /> —20.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 /> 24.HSC Section 118310-Enclosure labeled. <br /> 26.HSC Section 118305-Cannot reuse drums <br /> 26.HSC Section 117630-Approved biohazard <br /> bag used. <br /> —27.HSC Section 118275(g)-Pharm label/store441 — <br /> —28.HSC Section 118222-incineration Required Ii141Yr Signature C-)Keceived Ty Date <br /> 29 Other-Describe in narrative. <br />