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oPq"!"' ° • SAN JOAQUIN COUNTY Date <br /> ENVIRONMENTAL HEALTH DEPARTMEP PR 5,766- t tai'I <br /> 600 East Main Street, Stockton, CA 95202 <br /> (209)468-3420 <br /> FOMEDICAL WASTE INSPECTION FORM <br /> FacilityName 0,AW. cA -1ti e Pc cZ-61 FacilityAddress '751 ,f��r) t )c Ac� <br /> FacilityContact A, h Ck&,,:, n -Title-6-r- AL �tk t?crrtT , Phone# a�jE �5 <br /> INSPECTION TYPE: Moutine ❑Complaint ❑Re-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 medicaltC✓ <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 <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 r\ <br /> waste without permit from enforcement agency. <br /> _7.HSC Section 117908-Common Storage <br /> facility shall be registered with local enforcement S i• <br /> agency. <br /> Procedures 4L \ <br /> _8.HSC Section 117935-SQG MWMP <br /> _9.HSC Section 117943-SQG Shall keep <br /> records for 3 years. " Z► <br /> _10.HSC Section 117945-SQG not required to <br /> register shall keep records for 2 years. j�) <br /> 11.HSC Section 117960-LQG shall file MWMP i with enforcement agency. :� l P/ _' j 711 Z �- GYI Gt <br /> _12.HSC Section 117975-LQG shall keep <br /> records for 3 years. <br /> Transportation 1 V.. <br /> _13.HSC Section 118030-LQHE application. nfla on 0-P yly <br /> \ <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. vi 4 <br /> _15.HSC Section 118765-All treatment records <br /> shall be kept for 3 years. <br /> _16.HSC Section 11821 5-All medical waste l J <br /> shall be treated pursuant to this section. <br /> _17.HSC Section 118220-Recognizable human CZe <br /> � <br /> anatomical parts shall be disposed of by interment <br /> unless otherwise hazardous. o <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 j - jZ� {� / ;�L '&-4 JA L-�. <br /> _21.HSC Section 118285-Sharps label/contain <br /> _22.HSC Section 118295-Proper decon used. <br /> _23.HSC Section 118307-Interim storage labeled 14Z <br /> _24.HSC Section 118310-Enclosure labeled. <br /> _25.HSC Section 118305-Cannot reuse drums <br /> _26.HSC Section 117630-Approved biohazard I <br /> bag used. ����Uyt�A <br /> 27.HSC Section 118275(g)-Pharm label/store v?-Lt ., 73 �— <br /> —28.HSC Section 118222-Incineration Requireds,e ty Signature Received By Date <br /> 29 Other-Describe in narrative. <br />