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SAN JOAQUIN COUNTY Date 5-a 0-1j <br /> E101RONMENTAL HEALTH DEPARTMEIP PR ff2-,36 1-7Q1, <br /> 600 East Main Street, Stockton, CA 95202 <br /> (209)468-3420 <br /> MEDICAL WASTE INSPECTION FORM <br /> FacilityNamefktAwAjhmL f*6,r AAFacilityAddress u) hen ernmj + <br /> 4A--�mA,-Alri6iz, <br /> FacilityContact flax-,. —Tit1eL2R_V(*w Phone# qla-6L2 <br /> INSPECTION TYPE: PQoutine ilComplaint oft-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 fA <br /> waste. <br /> 3.HSC Section 117890-No large LQG shall 12 Li n <br /> J1 eX,)jaCA, La,"i TtC4,18,Ct Cts, VM,-A,� <br /> generate medical waste unless registered with the 31 4.a a--& dLn Lax a m r-ij Itz An n c ..e <br /> enforcement agency. -w L <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 LOUJ—L C= X-46 <br /> waste unless registered or obtained LQHE. <br /> ii <br /> 6.HSC Section 117903-Shall not treat med 6AL) <br /> waste without permit from enforcement agency. <br /> THSC Section 117908-Common Storage <br /> facility 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. <br /> —10.HSC Section 117945-SQG not required to <br /> re ter shall keep records for 2 years. <br /> I.HSC Section 117960-LQG shall file MWMP <br /> wit <br /> enforcement agency. <br /> 212.HSC Section 117975-LQG shall keep <br /> records for 3 years. /L (ICZ <br /> Transportation r <br /> —13.HSC Section 118030-LQHE application. <br /> Treatment/Storage "'j pet V'-- I j <br /> 14.HSC Section 118135-Shall obtain a permit 7-—_, <br /> ti ,-7 <br /> Tr— -LU <br /> from the enforcement agency to treat medicalI <br /> waste prior to treating the waste. V'-0 <br /> —15.HSC Section 118765-All treatment records <br /> shall be kept for 3 years. <br /> 43 <br /> —16.HSC Section 118215-All medical waste <br /> shall be treated pursuant to this section. acla <br /> 17.HSC Section 118220-Recognizable human 62QU2 <br /> anatomical parts shall be disposed of by interment <br /> unless otherwise hazardous. S20 E&rw n-A <br /> 18.HSC Section 118225-Treated sharps shall I <br /> be destroyed or somehow prevent public access. 1-7-010 �jc I all <br /> )K_19.HSC Section 118275-MW red bags,path, <br /> ctemo shall be labeled properly. exApw' (A. <br /> X 20.1-11SC Section 118280-MW label&contain Al IrA t <br /> 211.1-11SC Section 118285-Sharps label/contain <br /> —22.HSC Section 118296-Proper decon used. <br /> V-23.HSC Section 118307-interim storage labeled 00(-,3, <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 S c igna ure Received By Dat <br /> 29 Other-Describe in narrative. <br /> 4,lnul <br /> I P <br />