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GUIDELINES FOR THE E 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 your facility: <br /> Business Name: 3 WLLi(l� <br /> Business Address: J M t - Lh p Itt,1+ LAA-10 <br /> j'( UT0hl CA- ��;zI0 <br /> City State Zip Code <br /> Phone Number: ( 7,0 q ) q T3• �,d1 O <br /> Type of Facility or Business: a 1 hL° S 15 CLI i�- <br /> REGISTRATION FOR: <br /> ❑ Small Quantity Generator with Onsite Treatment(Generates less than 200lbs/month). <br /> Large Quantity Generator Only(Generates 200 lbs or more/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: JA,M ClR IL I A' Title: F11 C�-kED t L- T-e QJ Nl C <br /> Phone: 204 '7-7i� 10 X55 Date: I 'f ®��( <br /> 1. List the types of medical waste generated at your facility,i.e., laboratory wastes,blood or body <br /> fluids,sharps,contaminated animals, surgical specimens,trace chemo or isolation wastes": <br /> �Dplo u) 1D3, � !jRAgPC, - <br /> a) Do ou generate Mpharmaceutical waste(expired/outdated,spent,partials,)? <br /> b) Do <br /> ❑No <br /> If yes, describe the type of pharmaceutical waste(expired, spent,partials,outdated,patient <br /> returns, etc): 0 <br /> C-XP 1ttfl) P�9T( 't WNrL McC�5. gV $ ,Ct <br /> And estimate the monthly amount of pharmaceutical waste generated at your <br /> facility: 19 �?Csd�iOSf <br /> EHD 45-03 5 <br /> 10/6/2006 <br />