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GUIDELINES FOR ■ MEDICAL MANAGEMENY <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: <br />Business -16-0Address: -16,,� b.y"Qe <br />+ <br />City State Zip Code <br />Phone Number: ( ;7,07 <br />Type of Facility or Business: La,1An car NaM re <br />❑ Small Quantity Generator with Onsite Treatment (Generates less than 200lbs/month). <br />Large Quantity Generator Only (Generates 200 lbs or more/month). <br />❑ 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: ad bL/,f^A Title:_ 61t4i era MO-41log <br />Phone:�Date: <br />List the types of medical waste generated at your facility, i.e., laboratory wastes, blood or body <br />a) Do you generate a� pharmaceutical waste (expired/outdated, spent, partials,)? <br />b) X Yes ❑ No <br />If yes, describe the type of pharmaceutical waste (expired, spent, partials, outdated, patient <br />returns, etc): / g / <br />-eya;r-rj . sp fP444ia�(S . '0 . fa ref <br />And estimate the monthly amount of pharmaceutical waste generated at your <br />facility: <br />EHD 45-03 <br />10.!6/2006 <br />