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o�aUi!v. o SAN JOAQUIN COUNTY Date Ll I/11A <br /> ENVIRONMENTAL HEALTH DEPARTMENT PR 6S3(,3.0* <br /> 1868 East Hazelton Ave., Stockton, CA 95205 <br /> (209)468-3420 <br /> ca�tF0R `4 MEDICAL WASTE INSPECTION FORM <br /> FacilityName 5kocl2jo---' miylor;,nC):,wlr,�� _FacilityAddress�-tDal _Cul'�vm11� Sfi. . S��fiP B <br /> FacilityContact Title otiy mss. Phone##(2 <br /> INSPECTION TYPE: JAoutine ❑Complaint ❑Re-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. ` 1� rOnS 0 <br /> _2.NSC Section 117903-Permit from the <br /> enforcement 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. tea N QS ' . 1 r ,b 1 1 Vlt A S (All <br /> 4.HSC Section 117895-SQG that treats med 01noT4,C)(A(f&913[, mdkk�°�ri q� (`(�tA S1 be" & o <br /> waste shall register with enforcement agency. <br /> S.HSC Section 117900-Shall not haul med ), n S <br /> waste unless registered or obtained LQHE. Ll \ <br /> _6.HSC Section 117903-Shall not treat med , Mi ,L' ®�U�Mtt[�cA (�� U S Q- tcIn 1pir \. <br /> waste without permit from enforcement agency. 1,� 11- 1 <br /> 7.HSCSection 117908-Common Storage V�ttisCOCA t'Q,J�1'ify� �OrIOSl�Ilul� +ti� (��e Qcxe{��_ <br /> facility shall be registered with local enforcement 1 &k 130,11101 <br /> 1\ <br /> agency. <br /> Procedures l7 <br /> _8.HSCSection 117935-SQG MWMP GD tnk� y�'lec1. <br /> _9.HSC Section 117943-SQG Shall keep r <br /> records for 3 years. <br /> _10.HSC Section 117945-SQG not required to l <br /> register shall keep records for 2years. 714 (- ,l)te()G <br /> _11.HSC Section 117960-LQG shall file MWMP <br /> with enforcement agency. <br /> _12.HSC Section 117975-LQG shall keep ` 1 <br /> records for 3 years. <br /> Transportation Wu y vJ rG�,PA-0- <br /> _13.NSC Section 118030-LQHE application. <br /> Treatmenustorage (� <br /> _14.HSC Section 118135-Shall obtain a permit . F C�i ' ' L 'J A 1 a � 'r <br /> from the enforcement agency to treat medical { <br /> waste prior to treating the waste. <br /> _15.HSC Section 11 8765-All treatment records <br /> shall be kept for 3 years. 1 <br /> _16.HSC Section 118215-All medical waster1s- <br /> shall be treated pursuant to this section. <br /> _17.HSC Section 11.8220-Recognizable human ,p J rC1A S <br /> anatomical parts shall be disposed of by interment 1 Qs <br /> UL otherwise hazardous. 11' J <br /> _ U <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, ' s , <br /> 1 1 <br /> chemo shall be labeled properly. <br /> 20.HSC Section 118280-MW label&contain (9 t C;A �a <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 o 4— <br /> used. <br /> _27.HSC Section 118275(g)-Pharm label/store rnjlArrfV��A qj <br /> _28.HSC Section 118222-Incineration Required InspEator Signature 'Received—By Date <br /> 29 Other-Describe in narrative. <br />