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SAN JOAQUIN COUNTY Date 4111131 <br /> A ENVIRONMENTAL HEALTH DEPARTMENT PR svftf <br /> 1868 East Hazelton Ave., Stockton, CA 95205 <br /> (209)468-3420 <br /> 0 MEDICAL WASTE INSPECTION FORM <br /> FacilityName <br /> FacilityAddress Avg Mr-C)n 1,01. <br /> FacilityContact IQefr', Title 0. Phone# Lw)413'-('0ub <br /> INSPECTION TYPE: -6Routine oComplaint EiRe-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. J) 9uht"n <br /> 2.HSC Section 117903-Permit from the V 4�) <br /> -e-n—forcement agency required to treat medical <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 wusl-!e, vql-nvi <br /> waste unless registered or obtained LQHE. <br /> —6.HSC Section 117903-Shall not treat med W (A:jC4AMjjL JA <br /> waste without permit from enforcement agency. <br /> THSC Section 117908-Common Storage <br /> facilityfacilityshall be registered with local enforcement 5A - ccr"A I <br /> agency. <br /> Procedures <br /> 8.HSC Section 117935-SQG MWMP <br /> —9.HSG Section 117943-SQG Shall keep �ja(jVu feWA e. �Qvd <br /> records for 3 years. Au <br /> —10.HSG Section 117945-SQG not required to 4H <br /> register shall keep records for 2 years. +0 <br /> I IMSC Section 117960-LQG shall file MWMP <br /> �ith enforcement agency. c0i EL&PIDAA <br /> —12.HSC Section 117975-LQG shall keep k <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 pen-nit <br /> from 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 /> ITHSC Section 118220-Recognizable human <br /> 'a-n—atomlcal 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 /> —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 /> —27.HSC Section 118275(g)-Pharm label/store A, <br /> —28.HSC Section 118222-Incineration Required InspUtor signature Received By Date <br /> 1/1/ <br /> 29 Other-Describe in narrative. <br />