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aPaU1!v, ° 0 SAN JOAQUIN COUNTY 0 Date a-,.2-6 -13 <br /> ENVIRONMENTAL HEALTH DEPARTMENT PR �3�Is3 <br /> { 600 East Main Street, Stockton, CA 95202 <br /> (209)468-3420 <br /> 4GrFpR��P MEDICAL WASTE INSPECTION FORM <br /> FacilityNamegn'-, dy_,- , k.( c4 L.' FacilityAddress 94/o s_ Fr, v��,4- A,� s lr_ �7__ <br /> FacilityContact Title Ot Phone# 334 - 76aS <br /> INSPECTION TYPE: PtRoutine []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. r } t y <br /> _2.HSC Section 117903-Permit from the 3(7� cex ar ja D a ��'Z Irl ial Il.i i `�-Y&_C_4� <br /> enforcement agency required to treat medical ,L� 1� M.,)� r],�-� C, z cA,r e7 c) U� <br /> waste. \ <br /> _3.HSC Section 117890-No large LQG shall n iA �_li.�� } <br /> JL_ (A)i-2� d c:,)+ <br /> generate medical waste unless registered with the p Q✓ �\ <br /> �� <br /> enforcement agency. <br /> _4.HSC Section 117895-SQG that treats med <br /> waste shall register with enforcement agency. <br /> _5.HSC Section 117900-Shall not haul med > > , <br /> waste unless registered or obtained LQHE. <br /> _6.HSC Section 117903-Shall not treat med �1 - 02irp 07 I z, <br /> waste without permit from enforcement agency. - �r <br /> _7.HSC Section 117908-Common Storage <br /> facility shall be registered with local enforcement Jer+S?7v, A ) <br /> agency. <br /> Procedures 1)P.iacx_nv tn�_,� finnG �v�1Ja/w�%A ir�i�Y 1 <br /> _8.HSC Section 117935-SQG MWMP \ Q w J , n -� 4-1( <br /> _9.HSC Section 117943-SQG Shall keep i � 1 i'r'n,�n1 o rc,.�YLu <br /> records for 3 years. <br /> _10.HSC Section 117945-SQG not required to <br /> register shall keep records for 2 years. S <br /> _11.HSC Section 117960-LQG shall file MWMP <br /> with enforcement agency. S <br /> _12.HSC Section 117975-LQG shall keep y�, <br /> records for 3 years. ''� y'A C� -)—s��ro' 'M <\^,A iAr2+ <br /> Transportation s}n,��_ �;�, Inc_-7�, r7�r�z�� o,r �- <br /> _13.HSC Section 118030-LQHE application. © _ T <br /> Treatment/Storage <br /> _14.HSC Section 118135-Shall obtain a permit Ck� a 7T <br /> ✓l- C � j pCr�, /tih' � <br /> Torn the enforcement agency to treat medical <br /> waste prior to treating the waste. AA/i C •,i w <br /> _15.HSC Section 118765-All treatment records <br /> shall be kept for 3 years. <br /> _16.HSC Section 118215-All medical waste )� 4 G <br /> shall be treated pursuant to this section. ` <br /> _17.HSC Section 118220-Recognizable human J Gj <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. �=rl�> > ���" •v, 3 r7o�.i\. <br /> —19.HSC Section 118275-MW red bags, path, <br /> chemo shall be labeled properly. <br /> 420.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. _ <br /> 27.HSC Section 118275(g)-Pharm label/store <br /> 28.HSC Section 118222-Incineration Required 14 t0 Signature Receive68y ate <br /> 29 Other-Describe in narrative. <br />