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2)� 4u k cOGy MEDICAL WASTASPECTION REPORT • Date: -7 7— /Ab I San Joaquin County Environmental Health Department Program �. 1868 E. Hazelton Ave.,Stockton,CA 95205 Record: �IZQ 52.2 6 1 I (209)468-3420 Program �`oRa�a• www.swogy.org/ehd Element: Facility Name Address City Zip Code Davita Manteca Dialysis Center 1156 s.main st. Manteca 95336 Facility Contact Title Phone Number Email Inspection Type (209)823-3078 Routine The above facility is inspected for compliance with Division 104,Part 14 of California Health and Safety Code(HSC). `i� v a Gtl��`iyhi°fl'y'9d$faratlOfi�. £f" :... ........,# E� ., '^`' �n+' vN � t �'" ..,', 'a^^ ( ,kr1 yl INiu4sgG�' 14'r"�",,.; HSC 117890-No LQG shall generate medical waste unless HSC 118130-All onsite medical waste treatment facilities shall ❑ 1' registered with the EA. El 17' be permitted by the EA. ❑ 2 HSC 117950-LQG shall register with the EA prior to generating medical waste. ❑ 18. HSC 118165 All treatment records shall be kept for 3 years. ❑ 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 El 6' issured by the EA. E] 22. section. HSC 117890-LQG shall notify EA 72 hours prior to 3 ❑ 7. ei1 participating in temporary event. ,,.,. ��a, g ,,,. ;4 ❑ 8 HSC 117895-SQG shall notify EA 72 hours prior to ❑ 23. HSC 117630-Biohazard bag shall meet the standards set forth artici atin in temporary event. in this section. HSC 118275-Medical,biohazardous,sharps,trace chemo, �s fir,"Iylipp°II°u "ll { r ';`i pathology,or pharmaceutical waste shall be segregated and ' I��c�rdS/DOCUM � �� _ � ��r"��ud��"��+ ,' ❑ 24. P 9Y P a4F' I'M'u4'nly"i ' '', contained pursuant to this section. The container shall be � irlf IM�tli I'll4h dii rry� r t gK. i a� tp '�r 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. ❑ 10 HSC 117943-SQG required to register shall maintain ❑ 26 HSC 118285-Sharps waste shall be containerized and stored treatment and shipping and tracking records for 3 years. pursuant to this section. ❑ 11 HSC 117945-SQG not required to register shall maintain ❑ 27. HSC 118295-Containers shall be washed and decontaminated information document and transportation records for 3 years. pursuant to this section. HSC 118305- Reuseable drums or conainters used for medical E] 12. HSC 117960-LQG shall file MWMP with the EA. F-128. waste shall not be used for other storage. HSC 117975-LQG shall maintain treatment and shipping andHSC 118307- Intermediate storage area shall be secured and El13. tracking documents for 2 years. El29' marked with proper signage. h HSC 118310-Designated accumulation area shall be secured > OTI rai1lSOrfd�#411 ` ❑ 30. and marked with proper signage. ❑ 14. HSC 117946-MOT exemption requirements for SQG. Ot�1e � ` ❑ 15. HSC 117976-MOT exemption requirements for LQG. ❑ 31. ❑ 16. HSC 118032-Pharmaceutical waste hauling exemption. ❑ 32. Received by: Print: Signature: Phone:(209)823-3078 Specialist: Print: Harprit Mattu,Sr REHS Signature: f"'�L,l� — Phone:(209)468-3284 Reinspecion on/about: A reinspection fee of$130 per hour may be charged. Page 1 of 2 EH-08/2015