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GUIDELINES FORTHE MEDICAL WASTE MANAGEMENT <br /> PLAN <br /> Small quantity generators that provide onsite Treatment and all large quantity generators <br /> shall have a Medical Waste Management plan on file with the San Joaquin County <br /> Environmental Health Department. The Medical Waste Management Plan shall contain the <br /> following information as appropriate for yotir facility. <br /> Business Name: <br /> .Business Address: <br /> City State <br /> Zip Code <br /> Phone Number: <br /> Type Of facility or Business:_:D_i_ _t_," <br /> REGISTRATION FOR: <br /> Small Quantity Generator with onsite'rreatinent(Generates less than 200lbs/month), <br /> targe Quantity Generator Only(Generates 200 lbs or snore/month). <br /> Large Quantity Generator with onsite Treatment(Generates 200 lbs or more/month). <br /> Person responsible for implementation of the Medical Waste Management Plan. <br /> Name: <br /> Phonc: <br /> Date: <br /> 1, List the types of inedical waste genet ated.at your facility, i.e., laboratory wastes,blood or body <br /> fluids,sharps, contaminated animals, surgical specimens, trace cherno or isolation wastes": <br /> a) Do You generate gqy pharmaceutical waste(expired/outdated, spent,partials,)? <br /> b) Y yes D No <br /> IFYes, describe the type of pharmaceutical waste(expired, spent, partials,outdated,patient <br /> returns, etc): <br /> And estimate the monthly anjoun of pharmaceutical waste generated at your <br /> facility: <br /> FAT)45-03 <br /> 10/6/2006 5 <br />