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MEDICAL WASTERSPECTION REPORT ��1311 b Date: San Joaquin County Environmental Health Department Program r 1868 E. Hazelton Ave., Stockton, CA 95205 Record: E'�eSZ� 6E P (209)468-3420 Program S 3b www.siogv.org/ehd Element: Facility Name Address City Zip Code RAI-West March-Brookside 3115 w. march In. Stockton 95219 Facility Contact Title Phone Number Email Inspection Type Antonio Galang Jr. BSN, RN Charge Nurse (209)955-7527 ext. antonio.galang@f Routine 14 mc-na.com The above facility is inspected for compliance with Division 104,Part 14 of California Health and Safety Code(HSC). Registration Treatment HSC 117890-No LOG shall generate medical waste unless HSC 118130-All onsite medical waste treatment facilities shall F-11 registered with the EA. El 17 be permitted by the EA. ❑ HSC 117950-LQG shall register with the EA prior to 2' E:118. HSC 118165-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. El 19. 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 approved alternative. HSC 117928-Common Storage Facility shall have permit HSC 118225-Sharps waste shall be treated pursuant to this ❑ 6. issured by the EA. El 22 section. ❑ HSC 117890-LQG shall notify EA 72 hours prior to 7. Containment[Storage` participating in temporary event. HSC 117895-SQG shall notify EA 72 hours prior to HSC 117630-Biohazard bag shall meet the standards set forth E] 8' participating in tempora event. ❑ 23' in this section. HSC 118275-Medical, biohazardous,sharps,trace chemo, Records/Documentation ❑ 24 pathology,or pharmaceutical waste shall be segregated and contained pursuant to this section. The container shall be properly labeled. ❑ 9. HSC 117935-Registered SQG shall file MWMP with the EA. ❑ 25 HSC 118280- Biohazard bags shall be containerized and stored pursuant to this section. HSC 117943-SQG required to register shall maintain HSC 118285-Sharps waste shall be containerized and stored El 10. treatment and shipping and tracking records for 3 years. E] 26' pursuant to this section. HSC 117945-SQG not required to register shall maintain HSC 118295-Containers shall be washed and decontaminated El information document and transportation records for 3 years. El 27' pursuant to this section. HSC 118305- Reuseable drums or conainters used for medical ❑ 12. HSC 117960-LQG shall file MWMP with the EA. El 28. waste shall not be used for other storage. HSC 117975-LQG shall maintain treatment and shipping and HSC 118307- Intermediate storage area shall be secured and El 13. 29 tracking documents for 2 years. ❑ . marked with proper signage. Transportation ❑ 30 HSC 118310-Designated accumulation area shall be secured and marked with proper signage. ❑ 14. HSC 117946-MOT exemption requirements for SQG. Other ❑ 15. HSC 117976-MOT exemption requirements for LQG. ❑ 31. ❑ 16. HSC 118032-Pharmaceutical waste hauling exemption. ❑ 32. Received by: Print: Antonio Galang Jr. BSN RN Signature: _k Phone:(209)955-7527 ext. 14 Phone:(209)468-3284 Specialist: Print: Harprit Mattu,Sr REHS Signature: Reinspecion on/about: A reinspection fee of$130 per hour may be charged. Page 1 of 2 EH-08/2015