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ENVIRONAWINTAL HEALTH ]*PARTMENT <br /> SAN JOAQUIN COUNTY <br /> oAr{urN a Unit Supervisors <br /> Donna K.Heran R.E.H.S. <br /> Director 304 East Weber Avenue, Third Floor Carl Borgman,R.E.H.S. <br /> Ni =� Al Olsen,R.E.H.S. Stockton, California 95202 Mike Huggins,R.E.H.S.,R.D.I. <br /> Douglas W.Wilson,R.E.H.S. <br /> Program Manager Telephone: (209) 468-3420 Margaret Lagorio,R.E.H.S. <br /> .. P Laurie A.Cotulla,R.E.H.S. <br /> Program Manager <br /> Fax: (209) 468-3433 Robert McClellon,R.E.H.S. <br /> Mark Barcellos,R.E.H.S. <br /> INFORMATION PACKET FOR MEDICAL WASTE GENERATORS <br /> This packet contains the information and forms you will need to help you comply with the <br /> Medical Waste Management Act. <br /> Instructions <br /> Please return the completed forms prior to medical waste generation or treatment. <br /> 1. Complete the "Pre-Application Questionnaire" on Page 2. If your answers indicate <br /> you are not required to register as a medical waste generator, then complete the <br /> "Certification Statement" on Page 3 and return both complete forms to the mailing <br /> address below. <br /> 2. If you are required to register as a medical waste generator, as indicated by affirmative <br /> answers to questions 3&4 on the "Pre-Application Questionnaire", then: <br /> a. Complete the "Registration for Medical Waste" form located on <br /> Page 4. <br /> b. Complete a"Medical Waste Management Plan" following the guidelines <br /> provided on Page 5. <br /> c. Return the completed forms and management plan to Kasey Foley at the <br /> mailing address below. <br /> Your cooperation in promptly registering and following the specified handling requirements is <br /> greatly appreciated. <br /> If you have any questions regarding registration or handling requirements,please contact <br /> Kasey Foley at (209)468-3451. <br /> TURN ALL COMPLETED FORMS TO: <br /> Kasey Foley, R.E.H.S., Medical Waste Program <br /> San Joaquin County Environmental Health Department <br /> 304 East Weber Avenue, 3rd Floor, Stockton, CA 95202 <br /> EHD 45-02-003 Page 1 of 7 <br /> 10/6/2003 <br />