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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 information as appropriate for your facility: <br /> Business Name• t Av`fA <br /> Business Address: <br /> -cam til 3`LA t� <br /> City State Zip Code <br /> Phone Number: (:2, 0) <br /> Type of Facility or Business:`���s S kA N J <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 /> [✓al Large Quantity Generator with Onsite Treatment(Generates 200 lbs or more/month). <br /> Person responsible for implementation of the Medical Waste Management Plan: <br /> Name: fir s - d�," Title: T7.'111g!4 mz61,,jmq 1 <br /> Phone: ' `�?L _ ffi Date: <br /> 1. List the types of medical waste generated at your facility, i.e., laboratory wastes,blood or body <br /> fluids,sharps,contaminated animals, surgical specimens,trace chemo or isolation wastes": <br /> S. "�- e � QC y F <br /> a) Do you generate M pharmaceutical waste(expired/outdated, spent,partials,)? <br /> b) 0 Yes ❑No <br /> If yes, describe the type of pharmaceutical waste(expired,spent,partials,outdated,patient <br /> returns, etc): <br /> e, g.- <br /> And estimate the monthly amount of pharmaceutical waste generated at your <br /> facility: 1 <br /> EHD 45-03 5 <br /> 10/6/2006 <br />