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GUIDELINES FOR THE MEDICAL WASTE MANAGEMENT PLAN <br /> Small quantity generators that provide Onsite Treatment and all large quantity generators shall have a <br /> Medical Waste Management plan on file with the San Joaquin County Environmental Health Department. <br /> The Medical Waste Management Plan shall contain the following information as appropriate for your <br /> facility: <br /> Business Name: <br /> Business Address: <br /> City State Zip Code <br /> Phone Number: ) <br /> Type of Facility or Business: <br /> REGISTRATION FOR: <br /> ❑ Small Quantity Generator with Onsite Treatment(Generates less than 2001bs/month). <br /> 19/ Large Quantity Generator Only(Generates 200 lbs or more/month). <br /> ❑ Large Quantity Generator with Onsite Treatment(Generates 200 lbs or more/month). <br /> Person responsible for implementation of the Medical Waste Management Plan: <br /> Name: re <br /> n Q& \k Title: Y Date: <br /> 1. List the types of medical waste generated at your facility, i.e., laboratory wastes,blood or body <br /> fluids, sharps, contaminated animals, surgical specimens or isolation wastes: (See "Regulated <br /> Medical Wastes" listed on Page 2). 0>- 10 c.Ai CA <br /> 2. Estimate the monthly amount of medical waste generated at your facility: 1 <br /> 3. Describe the medical waste handling procedures utilized by and applicable to your facility, including, <br /> but not limited to the following: <br /> a. Onsite location and method for segregation, containment,packaging, labeling and collection: <br /> c\ id c v <br /> c CA t\ <br /> EHD 45-02-003 Page 5 of 7 <br /> 10/6/2003 <br />