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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: -'-t-Y,+on �e,-ma4 6tic&ov Ke4 Grip <br /> e V <br /> Business Address:_-_01(-Q 2 I + 0/n <br /> CA 9 5 <br /> city state Zip Code <br /> Phone Number: f2-0 <br /> Type of Facility or Business: I <br /> REGISTRATION FOR: <br /> E] Small Quantity Generator with Onsite Treatment(Generates less than 200lbs/month). <br /> XLarge Quantity Generator Only(Generates 200 lbs or more/month). <br /> El 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: b. <br /> Title: ,e <br /> 00O3 — fi4"!LXqV <br /> Phone-2 Date:_ cl 1-111 V� <br /> I. 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 /> a) Do you generate AU pharmaceutical waste(expired/outdated,spent,partials,)? <br /> b) K Yes [:]No <br /> If yes,describe the type of pharmaceutical waste(expired,spent,partials,outdated,patient <br /> And estimate th onthly amount of pharmaceutical waste generated at your <br /> facilitv:_t, <br /> EHD 45-03 5 <br /> 10/6/2006 <br />