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U9 if ° SAN JOAQUIN COUNTY Date S11,011A <br /> ENVIRONMENTAL HEALTH DEPARTMENT PR OS <br /> y < 600 East Main Street, Stockton, CA 95202 <br /> (209)468-3420 <br /> MEDICAL WASTE INSPECTION FORM <br /> A��FOR� <br /> FacilityName Se,, ��6_ N'CJjASA S FacilityAddress ly)l C_ tuc)u , dol- A <br /> FacilityContact N) Nc�Wu,tlr- Title F 'l` - '� - Phone#Lio�)qtq-I <br /> NSPECTION TYPE: 4Routine []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. _ C, S rt1 (a S <br /> _2.HSC Section 117903-Permit from the <br /> enforcement agency required to treat medical 1 <br /> waste. t. 1 <br /> _3.HSC Section 117890-No large LQG shall S 1� �titA <br /> generate medical waste unless registered with the s �1 <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 - 4 J <br /> waste unless registered or obtained LQHE. <br /> _6.HSC Section 117903-Shall not treat med LA_ t <br /> waste without permit from enforcement agency. _ <br /> _7.HSC Section 117908-Common Storage <br /> facility shall be registered with local enforcement f o ! <br /> agency. <br /> Procedures c, - <br /> _8.HSC Section 117935-SQG MWMP53 t <br /> _9.HSC Section 117943-SQG Shall keep <br /> fVj- <br /> records for 3 years. d on U 1 nttO <br /> _10.HSC Section 117945-SQG not required to <br /> register shall keep records for 2 years. a{ W 'S <br /> _11.HSC Section 117960-LQG shall file MWMP –{ r <br /> with enforcement agency. \r t lmtjV eel . 1�r s \,V,1►Q l AXA�, Ch I(cA' (Jn an e <br /> _12.HSC Section 117975-LQG shall keep <br /> records for 3 years. <br /> Transportation T <br /> _13.HSC Section 118030-LQHE application. <br /> Treatment/Storage T 2' <br /> _14.HSC Section 118135-Shall obtain a permitALP 1)n <br /> from the enforcement agency to treat medical <br /> waste prior to treating the waste. 1 P. <br /> _15.HSC Section 118765-All treatment records <br /> shall be kept for 3 years. <br /> _16.HSC Section 118215-All medical waste o5 0 <br /> shall be treated pursuant to this section. 1 i <br /> _17.HSC Section 118220-Recognizable human S, a0s is-au/iS <br /> anatomical parts shall be disposed of by interment <br /> unless otherwise hazardous. Lh S ICS(. n Vl'ke, <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 /> '3t20.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. ; `Ip it <br /> k 27.HSC Section 118275(g)-Pharm label/store <br /> _28.HSC Section 118222-Incineration Required Inspe or Signature R Date <br /> 29 Other-Describe in narrative. <br /> 1 PA6, 2 <br />