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0 <br />SAN JOAQUIN COUNTY 0 <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />600 East Main Street, Stockton, CA 95202 <br />(209) 468-3420 <br />MEDICAL WASTE INSPECTION FORM <br />'►N1J'A&, 1,64; CACX FacilityAddress Mo . . <br />by <br />Title ;a -# kCA)n1A t.. <br />Registration <br />THE ITEMS BELOW REPRESENT VIOLATIONS OF THE CALIFORNIA <br />_ 1. HSC Section 117955 -Large Quantity <br />HEALTH & SAFETY CODE (HSC): <br />Generator shall register with the enforcement <br />agency prior to commencement of the generation of <br />®® _T <br />a 2 U d5 <br />medical waste. <br />HSC Section 117903 -Permit from the <br />_2. <br />enforcement agency required to treat medical <br />(�{� j (� pt (c WUg Mt1�i �� dt <br />—t l <br />4 _ 1 VV_ W91a',not d} L <br />waste. <br />_3. NSC Section 117890 -No large LQG shall <br />13 <br />generate medical waste unless registered with the <br />Se <br />®117 <br />enforcement agency. <br />_4. HSC Section 117895-SQG that treats med <br />waste shall register with enforcement agency. <br />HSC Section 117900 -Shall not haul med <br />_5. <br />waste unless registered or obtained LQHE. <br />Section 117903 -Shall not treat med <br />i. `, 1> O <br />isgo �tiwe 1 ; loncx� <br />_6.HSC <br />waste without permit from enforcement agency. <br />in f <br />1� <br />�Gt11 LLG o <br />Section 117908 -Common Storage <br />�� �; <br />_7.HSC <br />Tshall be registered with local enforcement <br />\ <br />ska l` An <br />)� to s U) oU 6('4r" <br />('SIL <br />agency. <br />Procedures <br />bf k� io a ' <br />wo) I ;® h <br />_8.HSC Section 117935-SQG MWMP <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 />3 lit`bd r .i (\ �� ; <br />s one <br />r <br />11.HSC Section 117960-LQG shall file MWMP <br />with enforcement agency. <br />t m ( <br />i <br />_12.HSC Section 117975-LQG shall keep <br />n <br />records for 3 years. <br />Transportation <br />W+ �n ca i a r l; <br />1 <br />('311Q_e mcRer�li L <br />_13. HSC Section 118030-LQHE application.' <br />Treatment/Stora a <br />_14.HSC Section 118135 -Shall obtain a permit <br />From the enforcement agency to treat medical <br />= C <br />S�t <br />waste prior to treating the waste. <br />ti ��1 <br />t <br />_15.HSC Section 118765 -All treatment records <br />, <br />S <br />shall be kept for 3 years. <br />Section 118215 -All medical waste <br />_16.HSC <br />shall be treated pursuant to this section. <br />_17.HSC Section 118220 -Recognizable human <br />anatomical parts shall be disposed of by interment <br />i <br />1�uSSC <br />Q Q <br />unless otherwise hazardous. <br />18.HSC Section 118225 -Treated sharps shall <br />i lws <br />be_destroyed or somehow prevent public access. <br />_19.HSC Section 118275 -MW red bags, path, <br />�}.1 <br />l&t �`\ �v c`ytitiu <br />Ca <br />GI <br />1A i v�R nab' afitA A�I <br />chemo shall be labeled properly. <br />Section 118280 -MW label &contain <br />`` <br />(VLklrm-3 �a kt_�, (� W rn� Cc <br />t <br />ami Sc t� U k'R 1 ]Wit <br />, _�ty <br />�Q.t. <br />_21.HSC Section 118285 -Sharps label/contain <br />_22.HSC Section 118295 -Proper decon used. <br />la9R Chi n <br />_23.HSC Section 118307 -Interim storage labeled <br />-X24.HSC Section 118310 -Enclosure labeled. <br />_25.HSC Section 118305 -Cannot reuse drums <br />_26.HSC Section 117630 -Approved biohazard <br />bag used. <br />27.HSC Section 118275(g)-Pharm label/store <br />Insp for Signature Received By Date <br />28.HSC Section 118222 -Incineration Required <br />29 Other -Describe in narrative. <br />M <br />