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?-- Z3- Jz AA <br /> oaq`H... ° SAN JOAQUIN COUNTY Date <br /> EN IRONMENTAL HEALTH DEPARTME0 PR <br /> y { 600 East Main Street, Stockton, CA 95202 <br /> (209)468-3420 <br /> q�/FOR�`P MEDICAL WASTE INSPECTION FORM <br /> 1Fac11ityName_0e'1.,) _, FacilityAddress i�SaZ E_ i'_6yzi, /in # _OnD <br /> FacilityContact L.:. ,,jn., kr� Title vL* h.4 A,�x,hjjhe.A ,Phone# <br /> INSPECTION TYPE: tgRoutine ❑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. <br /> _2.HSC Section 117903-Permit from the <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 /> _4.HSC Section 117895-SQG that treats med <br /> waste shall register with enforcement agency. <br /> _5.HSC Section 117900-Shall not haul med ,�� z ,(� /L, 1� # e,--� i-?-A 1 L^V'_\I?- <br /> waste unless registered or obtained LQHE. \\ <br /> _6.HSC Section 117903-Shall not treat med l`PVJu cam. <br /> waste without permit from enforcement agency. <br /> _7.HSC Section 117908-Common Storage C - <br /> facility shall be registered with local enforcement ,r) <br /> agency. <br /> Procedures <br /> _8.HSC Section 117935-SQG MWMP <br /> _9.HSC Section 117943-SQG Shall keep � 'Cr`'�,^++-fit^.j1�["l4 <br /> records for 3 years. �,r P�n� 0./"'42f,,�lt �� h ,( cy� ,,7ft, "-11�P <br /> _10.HSC Section 117945-SQG not required to •'r�-�-`-�— I I <br /> register shall keep records for 2 years. d T,v 1�,�/c. c s/l �i.1 t �� �C_. ny� - -2_ L.7 e-\) <br /> _11.HSC Section 117960-LQG shall file MWMP <br /> with enforcement agency. rn✓i/ <br /> _12.HSC Section 117975-LQG shall keep <br /> records for 3 years. <br /> Transportation r <br /> _13.HSC Section 118030-LQHE application. <br /> Treatment/Storage t' <br /> From- <br /> Section 118135-Shall obtain a permit 7- = <br /> from the enforcement agency to treat medical <br /> waste prior to treating the waste. <br /> _15.HSC Section 118765-All treatment records LT .. <br /> shall be kept for 3 years. �7`^ CG <br /> _16.HSC Section 118215-All medical waste <br /> shall be treated pursuant to this section. <br /> _17.HSC Section 118220-Recognizable human L <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. <br /> 27.HSC Section 118275(8)-Pharm label/store <br /> 28.HSC Section 118222-Incineration Required I S r Ignature Received By Date <br /> 29 Other-Describe in narrative. <br />