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SAN JOAQUIN COUNTY Date <br />ENVIRONMENTAL HEALTH DEPARTMENT PR ®Sa;"14 <br />1868 East Hazelton Ave., Stockton, CA 95205 <br />(209) 468-3420 <br />MEDICAL WASTE INSPECTION FORM <br />FacilityName Prr.LIj iL, nuAt cat i)c_ FacilityAddress 110D CWis,n,ur �%+y <br />FacilityContact `.oreTitle LA 6wlAlf4or Phone QT1 63 --CIO <br />INSPECTION TYPE: ImRoutine ❑Complaint ❑Re -inspection <br />VIOLATION(S) <br />Registration <br />_ 1. HSC Section 117955 -Large Quantity <br />THE ITEMS BELOW REPRESENT VIOLATIONS OF THE CALIFORNIA <br />HEALTH & SAFETY CODE (HSC): <br />Generator shall register with the enforcement <br />agency prior to commencement of the generation of <br />medical waste. <br />_2. HSC Section 117903 -Permit from the <br />Ny V`Clc�y'y�1S n e�� Aj�ng S 1n5 'Uri_ <br />enforcement agency required to treat medical <br />waste. <br />_3. HSC Section 117890 -No large LQG shall <br />generate medical waste unless registered with the <br />enforcement agency. <br />�e <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 eJa��Ln1 hU, JCI`�l �1 <br />1 U M'L11114 '11, VW <br />1 <br />_6.HSC <br />waste without permit from enforcement agency. <br />_7.HSC Section 117908 -Common Storage <br />facility shall be registered with local enforcement <br />agency. <br />Procedures <br />fNAI <br />_8.HSC Section 117935 SQG MWMP <br />_9.HSC Section 117943-SQG Shall keep <br />h S Ur A -o c i c t� <br />records for 3 years. <br />_10.HSC Section 117945-SQG not required to <br />register shall keep records for 2 years. <br />11.HSC Section 117960-LQG shall file MWMP <br />with enforcement agency. <br />_12.HSC Section 117975-LQG shall keep <br />records for 3 years. <br />Transportation <br />_13. HSC Section 118030-LQHE application. <br />Treatment/Storage <br />_14.HSC Section 118135 -Shall obtain a permit <br />from the enforcement agency to treat medical <br />waste prior to treating the waste. <br />- <br />_15.HSC Section 118765 -All treatment records <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 />unless otherwise hazardous. <br />- <br />_18.HSC Section 118225 -Treated sharps shall <br />be destroyed or somehow prevent public access. <br />_19.HSC Section 118275 -MW red bags, path, <br />chemo shall be labeled properly. <br />Section 118280 -MW label & contain <br />_20.HSC <br />_21.HSC Section 118285 -Sharps label/contain <br />_22.HSC Section 118295 -Proper decon used. <br />_23.HSC Section 118307 -Interim storage labeled <br />Section 118310 -Enclosure labeled. <br />(� <br />_24.HSC <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 />28.HSC Section 118222 -Incineration Required <br />Ins ctor Signature Received By Dat <br />29 Other -Describe in narrative. <br />