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SAN JOAQUIN COUNTY Date h. <br /> ENVIRONMENTAL HEALTH DEPARTME T PR e153(o'9Y, <br /> N. 1868 East Hazelton Ave., Stockton, CA 95205 <br /> (209)468-3420 <br /> P MEDICAL WASTE INSPECTION FORM <br /> q�rF®R�e <br /> FacilityName Sc� ��U�e, �ig�us;S FacilityAddress <br /> FacilityContact Lxe N 0.jtk.S t Title i ' Tec -S Phone#CaaJ qLA-L 1a� <br /> INSPECTION TYPE: [Routine ❑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. 1 Q1 e. GBS [1(1 Ue 01\r tbnS f100 11i0(1. <br /> A dk'i>1� Yl,5 15 <br /> _2.HSC Section 117903-Permit from the L <br /> enforcement agency required to treat medical <br /> waste. l- <br /> _3.HSC Section 117890-No large LQG shall 5'- t- ` ,>C �S �Ttli� i JTe`�L C+� i r <br /> generate medical waste unless registered with the m WUSiC, <br /> enforcement agency. <br /> _4.HSC Section 117895-SQG that treats med <br /> waste shall register with enforcement agency. 1 <br /> _5.HSC Section 117900-Shall not haul med a f (11' O &k , I f(-W) S yyac, <br /> waste unless registered or obtained LQHE. t <br /> _6.HSC Section 117903-Shall not treat med 01 1 IC t S <br /> waste without permit from enforcement agency. <br /> _7.HSC Section 117908-Common Storage iJ\ f C-Ck 1AJiA ' 1,h,I LA)CA� <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 V� <br /> records for 3 years. h COJ tt'l Ll J P "UA) <br /> _10.HSC Section 117945-SQG not required to <br /> register shall keep records for 2 years. <br /> _11.HSC Section 117960-LQG shall file MWMP <br /> with enforcement agency. <br /> _12.HSC Section 117975-LQG shall keep <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 /> Tom the enforcement agency to treat medical <br /> waste prior to treating the waste. <br /> _15.HSC Section 118765-All treatment records <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 /> _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 /> s21.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 /> ba-g used. Ll �� 12 <br /> _27.HSC Section 118275(g)-Pharm label/store "IHT k1f\1 S)::4 <br /> _28.HSC Section 118222-Incineration Required Insp6itor Signature R Ceive Date <br /> 29 Other-Describe in narrative. <br />