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MEDICAL WASTE INSPECTION REPORT ,2•• ilate: March 9,2023 N. San Joaquin County Environmental Health Department 'rogram Z. 1868 E.Hazelton Ave.,Stockton,CA 95205 Record: PR0526720 (209)468-3420 grogram 4�iF OOF -i www.siogy.org/ehd =lement: 4530 Facility Name Address City Zip Code Davita Tokay Dialysis Center 312 S Fairmont Ave#A Lodi 95240 Facility Contact Title Phone Number Email Inspection Type Courtney Vela Facility Administrator 209-369-5418 Routine The above facility is inspected for compliance with Division 104,Part 14 of California Health and Safety Code(HSC). Registration Treatment 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. HSC 117950-LQG shall register with the EA prior to ❑ 2. generating medical waste. El18. 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 El 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 6. issured by the EA. ❑ 22' section. ❑ HSC 117890-LQG shall notify EA 72 hours prior to 7. Containment/Storage participating in temporary event. HSC 117895-SQG shall notify EA 72 hours prior to HSC 117630-Biohazard bag shall meet the standards set forth El 8. participating in temporary event. El 23' in this section. HSC 118275-Medical,biohazardous,sharps,trace chemo, Records/Documentation ® 24 pathology,or pharmaceutical waste shall be segregated and contained pursuant to this section. The container shall be 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. HSC 117943-SQG required to register shall maintain HSC 118285-Sharps waste shall be containerized and stored ❑ 10. 26 treatment and tracking records for 3 years. ❑ . pursuant to this section. HSC 117945-SQG not required to register shall maintain HSC 118295-Containers shall be washed and decontaminated El 11. 27 information document and USPS records for 3 years. ❑ ' pursuant to this section. HSC 118305-Reuseatle drums or conainters used for medical El 12. HSC 117960-LQG shall file MWMP with the EA. ® 28. waste shall not be used for other storage. ® HSC 117975-LQG shall maintain treatment and tracking 29HSC 118307-Intermediate storage area shall be secured and 13. documents for 2 years. ❑ . marked with proper signage. Transportation ❑ 30. HSC 118310-Designated accumulation area shall be secured and marked with proper signage. ❑ 14. HSC 117946-MOT exemption requirements for SQG. Other ❑ 15. HSC 117976-MOT exemption requirements for LQG. ® 31. HSC 117630—Secondary Container ❑ 16. HSC 118032-Pharmaceutical waste hauling exemption. ❑ 32. Received by: Print: Courtney Vela Signature: EMAILED Phone:209-369-5418 Specialist: Print: Sandip Singh Signature: Sa+ _1fLF £ Phone:209-468-3526 Reinspecion on/about: A reinspection fee of$156 per hour may be charged. Page 1 of 3 EH-2/2023