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ENVIRONMENTAL HEALTH DEPARTMENT <br /> SAN JOAQUIN COUNTY <br /> 1868 E. Hazelton Avenue <br /> Stockton, California 95205 <br /> Telephone: (209) 468-3420 <br /> Fax: (209) 468-8392 <br /> 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: 16 (® ( in e _ �i_1 tie- D <br /> tbct OA yz <br /> City State Zip Code <br /> Phone Number: ( 9 J 3 -q 8 <br /> bb <br /> Type of Facility or Business: <br /> REGISTRATION FOR: <br /> ❑ Small Quantity Generator with Onsite Treatment(Generates less than 200 lbs/month). <br /> NJ 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: h e e� cty Title: Fa-(2,1 ,1 tW AA'S <br /> Phone: �01- 5 3q—qbbb Date: <br /> 1. List the types of medical waste generated at your facility (i.e. laboratory wastes, blood or body <br /> fluids sharps, cont inated animal , surgical specimens, trace chemo or i olation wastes): <br /> k <br /> a) Do you generate aM pharmaceutical waste (expired, spent,partials, patient returns)? X Yes ❑ No <br /> If yes, describe the type of pharmaceutical waste (expired, spent,partials,patient returns): <br /> ALk c � �ILL l <br /> And estimate the monthly amount of pharmaceutical waste generated at your facility: 56 <br /> EHD 45-03 5 <br /> 2015 <br />