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op4U!N, • SAN JOAQUIN COUNTY Date (', --I <br /> zA'' °c ENVIRONMENTAL HEALTH DEPARTMER PR ,S <br /> Q• a 600 East Main Street, Stockton, CA 95202 <br /> (209)468-3420 <br /> c9�,FOR `P MEDICAL WASTE INSPECTION FORM <br /> FacilityName �j6�,4yt>c4a. <br /> _etj:►n � r1:,rt .6e FacilityAddress /,­!!.-�- ccs. ',,NQ „ <br /> FacilityContact f j-jn?x In- « Title r- Phone# <br /> INSPECTION TYPE: []Routine ❑Complaint fie-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 <br /> _2.HSC Section 117903-Permit from the �—�ISnL� StY1r�e'lY:'fCr CYI 47 17, <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 q <br /> waste shall register with enforcement agency. <br /> _5.HSC Section 117900-Shall not haul med V , <br /> waste unless registered or obtained LQHE. <br /> _6.HSC Section 117903-Shall not treat med <br /> waste without permit from enforcement agency. <br /> 7.HSC Section 117908-Common Storage ' <br /> fa_cility shall be registered with local enforcement <br /> agency. <br /> Procedures __ <br /> _8.HSC Section 117935-SQG MWMP <br /> _9.HSC Section 117943-SQG Shall keep <br /> records for 3 years. VVL Ell le— - ` ); <br /> _10.HSC Section 117945-SQG not required to <br /> register shall keep records for 2 years. <br /> 11.HSC Section 117960-LQG shall file MWMP <br /> with enforcement agency. ,,Ll � �J r) <br /> _12.HSC Section 117975-LQG shall keep <br /> records for 3 years. <br /> Transportation I , <br /> _13.HSC Section 118030-LQHE application. <br /> Treatment/Storage <br /> _14.HSC Section 118135-Shall obtain a permit <br /> from the enforcement agency to treat medical <br /> waste prior to treating the waste. <br /> _15.HSC Section 11 8765-All treatment records <br /> shall be kept for 3 years. <br /> _16.HSC Section 118215-All medical waste , <br /> shall be treated pursuant to this section. � � <br /> _17.HSC Section 118220-Recognizable human �A� _ VA �')� W L _ :A/\j, (_oAjj <br /> anatomical parts shall be disposed of by interment I ( [ f f 'h -) <br /> \ <br /> unless otherwise hazardous. 1'fiY�:rG ,A"YA 4- STtlY`e Y1►77AA C.LZZa. U� r <br /> _18.HSC Section 118225-Treated sharps shall S <br /> be destroyed or somehow prevent public access. <br /> _19.HSC Section 118275-MV red bags,path, <br /> hemo shall be labeled properly. la 14 <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. IMA944 <br /> 27.HSC Section 118275(g)-Pharm label/store , 7.5 ` <br /> _28.HSC Section 118222-Incineration Required r Signature 10.1ceived By Date <br /> 29 Other-Describe in narrative. <br /> L_ i <br />