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GUIDELINES FOR THE 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:J�or--6�r tM4 c c-Qr <br /> p <br /> }} Cr1 <br /> Business Address: d A v ��c �e,nr` <br /> S CJCJQ��,, CA S <br /> City State f Zip Code <br /> Phone Number: ( a ei ) <br /> VIA <br /> t c <br /> Type of Facility or Business: k c r L L-*— <br /> REGISTRATION FOR: <br /> ❑ Small Quantity Generator with Onsite Treatment(Generates less than 2001bs/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:Sn r-i 16- ��C TSN- �cA Title:_0 ' `C t- QU'l 90 <br /> Phone: r)S.' 'S�) LQ 6 01(P lD Date: S1 A -III I <br /> 1. List the types of medical waste generated at your facility,i.e.,laboratory wastes,blood or body <br /> fluids sharps,contaminated mal urgical specimen trace c�yiemo or isolatio wastes": <br /> t r ar <br /> a) Do you generate M pharmaceutical waste(expired/outdated,spent,partials,)? <br /> b) ®Yes ❑No <br /> If yes,describe the type of pharmaceutical waste(expired,spent,partials,outdated,patient <br /> returns,etc): <br /> And estimate the monthly amount of pharmaceutical waste generated at your <br /> facility: <br /> EHD 45-03 5 <br /> 10/6/2006 <br />