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6 <br />SAN JOAQUIN COUNTY Date 101 1) <br />ENVIRONMENTAL HEALTH DEPARTMENT PR 053L 1'73 <br />600 East Main Street, Stockton, CA 95202 <br />(209) 468-3420 <br />MEDICAL WASTE INSPECTION FORM <br />FacilityName k(i , <br />FacilityContact Ian <br />1r.• nUmni <br />-i <br />Title .,cnciP)gnvgF <br />Mone# a3'�-u14 <br />Ph <br />INSPECTION TYPE: <br />PgRoultine <br />❑Complaint <br />❑Re -inspection <br />Ii�IL�I���[�7►fE.l <br />Registration <br />THE ITEMS BELOW REPRESENT VIOLATIONS OF THE CALIFORNIA <br />_ 1. HSC Section 117955 -Large Quantity <br />Generator shall register with the enforcement <br />HEALTH & SAFETY CODE (HSC): <br />agency prior to commencement of the -generation of <br />medical waste. <br />2. HSC Section 117903 -Permit from the <br />e—nforcement agency required to treat medical <br />waste. <br />_3. HSC Section 117890 -No large LQG shall <br />S — u ,} 5 M9 5S�'� ! q <br />S'A (. An c 0 1 V -h -'%C4 cke*e-s'. <br />a5Q'nA -0A fit <br />generate medical waste unless registered with the <br />enforcement agency. <br />_4. HSC Section 117895-SQG that treats med <br />i <br />'� t`rn3 '1 l7, s y- A t`t1t <br />j <br />waste shall register with enforcement agency. <br />_5. HSC Section 117900 -Shall not haul med <br />waste unless registered or obtained LQHE. <br />_6.HSC Section 117903 -Shall not treat med <br />�1®� mLLt1N Glf1 <br />W <br />w ing t ott'.. 1u t i <br />waste without permit from enforcement agency. <br />_7.HSC Section 117908 -Common Storage <br />1 i O <br />facility shall be registered with local enforcement® <br />agency. <br />Procedures <br />A 4�m° 1 041 nLa <br />a <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 />register shall keep records for 2 years. <br />,.L%VIAUl ; r , C <br />_11.HSC Section 117960-LQG shall file MWMP <br />.th enforcement agency. <br />_12.HSC Section 117975-LQG shall keep <br />' 1 <br />records for 3 years. <br />Transportation <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 />LO] _j 1 , ' �G 0 <br />v� 1 <br />_15.HSC Section 118765 -All treatment records <br />_rA <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 <br />anatomical parts shall be disposed of by interment <br />unless otherwise hazardous. <br />I 1 <br />C- i�S ,� ,l` 11�(t' '1 �-G �`ov <br />t <br />G e, P (, <br />®� <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 />/ <br />(/s �6 <br />_27.HSC Section 118275(g)-Pharm label/store <br />Inspecor Signature C@I d Da e <br />_28.HSC Section 118222 -Incineration Required <br />29 Other -Describe in narrative. <br />