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�oPqU!"!..oo SAN JOAQUIN COUNTY Date <br /> c ENVIRONMENTAL HEALTH DEPARTMENT PR 053IM <br /> ?� 600 East Main Street, Stockton, CA 95202 <br /> (209)468-3420 <br /> MEDICAL WASTE INSPECTION FORM <br /> A<<F O RCS <br /> FacilityName �•,.j% �)el�, Col6c FacilityAddress Si51 Pau�'ii <br /> FacilityContact Tato \ nn�tP. Title fnV, �tot,,r,k M f Phone# qS 3 <br /> INSPECTION TYPE: XRoutine ❑Complaint ❑Re-inspection <br /> VIOLATION(S) <br /> Registration THE ITEMS BELOW REPRESENT VIOLATIONS OF THE CALIFORNIA <br /> _1.HSC Section 117955-Large Quantity HEALTH & SAFETY CODE (HSC): <br /> Generator shall register with the enforcement <br /> agency prior to commencement of the generation of + <br /> medical waste. �� .1 ] dto 6 — I C 01'jWl fec,, J ,U ff/1 % <br /> 2.HSC Section 117903-Permit from the <br /> en_forcement agency required to treat medical 04S k IIMXA-A <br /> waste. 1�� t) a Q �l ) <br /> _3.HSC Section 117890-No large LQG shall 1 <br /> generate medical waste unless registered with the In hu 1' <br /> enforcement agency. <br /> _4.HSC Section 117895-SQG that treats med } SQ,� +v� G. + I'f-) CU u) <br /> waste shall register with enforcement agency. / <br /> _5.HSC Section 117900-Shall not haul med 6L &1 "R <br /> waste unless registered or obtained LQHE. 1 1^ ! /1 _.1 <br /> _6.HSC Section 117903-Shall not treat med U 0.1 S wC t vl l '1 <br /> waste without permit from enforcement agency. (�(��S fid i h �� i <br /> _7.HSC Section 117908-Common Storageik 3 <br /> facility shall be registered with local enforcement �U e►`QfS �1>1Q�S �� <br /> agency. 1 I �� <br /> Procedures ''(�,tJYIuP,e,YAVUL u11ks..gq ,�' 0r"�'' A 1n <br /> _8.HSC Section 117935-SQG MWMP tlt)��� (,t) S�ln+l1�1 " t011- <br /> _9.HSC Section 117943-SQG Shall keep <br /> records for 3 years. <br /> _10.HSC Section 117945-SQG not required to ��11 IIJJ 1 <br /> register shall keep records for 2 years. d+. ' b d -F b J i /Y12n oi <br /> _11.HSC Section 117960-LQG shall file MWMP f u Z t t us f <br /> with enforcement agency. <br /> _12.HSC Section 117975-LQG shall keep ) l� <br /> records for 3 years. <br /> Transportation es 'jySke <br /> -)c9 <br /> _13.HSC Section 118030-LQHE application. Aj <br /> Treatment/Storage fY1 G r MLA3 <br /> _14.HSC Section 118135-Shall obtain a permit C <br /> from the enforcement agency to treat medical , <br /> waste prior to treating the waste. <br /> _15.HSC Section 118766-All treatment records , <br /> shall be kept for 3 years. r <br /> _16.HSC Section 118215-All medical wasteJ <br /> e <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 /> _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 /> -,20.HSC Section 118280-MW label&contain <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 /> _24.HSC Section 118310-Enclosure labeled. <br /> _25.HSC Section 118305-Cannot reuse drums <br /> _26.HSC Section 117630-Approved biohazard <br /> bag used. f�KA 01� <br /> _27.HSC Section 118275(g)-Pharm label/store <br /> _28.HSC Section 118222-Incineration Required Inspec r Signature Receiv By ate <br /> 29 Other-Describe in narrative. <br /> P��c 1 <br />