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GUIDELINES FOR THE MEDICAL WASTE MANAGEMENT <br /> PLAN <br /> Small quantity generators that provide Onsite Treatment and all large quantity generators <br /> shall have a Medical Waste Management plan on file with the San Joaquin County <br /> Environmental Health Department. The Medical Waste Management Plan shall contain the <br /> following inform as appriate for your facility: <br /> Business Name: ei <br /> Busi ess Address: tit, n Ns— <br /> city State Zip Code <br /> Phone Number: �b3 <br /> Type of Facility or Business: <br /> REGISTRATION FOR: <br /> ❑ Small Quantity Generator with Onsite Treatment(Generates less than 200lbs/month). <br /> ['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-unplementation of the Medical Waste Management Plan: <br /> Name: Title: flM"V1MW6J@J1 <br /> Phone-M I c1 U�� Date: f GYW <br /> 1. List the types of medical waste generated at your facility,i.e.,laboratory wastes,blood or body <br /> uid ,sharps, ontaminated anim ls,su i 1 spe i ens,t ace o or'solation astes": <br /> a) Do you generated pharmaceutical waste(expired/outdated,spent,partials,)? <br /> b) ❑Yes Q�iO <br /> If yes,describe the type of pharmaceutical waste(expired,spent,partials,outdated,patient <br /> returns,etc): <br /> And estimate the monthly amount of pharmaceutical waste generated at your <br /> facility: <br /> EM 45-03 5 <br /> 10/6/2006 <br />