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SAN JOAQUIN COUNTY Date '7--;,5.,t Z <br /> E RONMENTAL HEALTH DEPARTME PR 53t,266 <br /> { 600 East Main Street, Stockton, CA 95202 <br /> (209)468-3420 <br /> P MEDICAL WASTE INSPECTION FORM <br /> FacilityName�c4eo.t�—_ .w�-_ O xA " ,3 -' FacilityAddress <br /> FacilityContact Title rr - t 4rPhone# 2- <br /> INSPECTION TYPE: ®Routine []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 �1 r i <br /> agency prior to commencement of the generation of d-1 t �= ���f�w�-� 1 �t t� tZ.z:�Lu�a V1Ltr� <br /> medical waste. <br /> 2.HSC Section 117903-Permit from the to^Y YN1C� �2t�� wr�J h' Y`to YYl.nlz'c a'Vl <br /> ^A_ <br /> enforcement agency required to treat medical .�, 3,Y1� _ c1.t?!Siy'� !3(- <br /> waste. ` - <br /> _3.HSC Section 117890 No large LQG shall 1[, j rt.V�[,►�� A:�e_p s _4A - t -4,__ Qty _ S� 20/ � <br /> generate medical waste unless registered with the <br /> enforcement agency. 1�1� hl - 1 L� lux L,tz" ✓ <S '���� �� <br /> _4.HSC Section 117895-SQG that treats med <br /> waste shall register with enforcement agency. ''"�r"t-1 1N1Ct A',.W- 1r,e-JI' <br /> _5.HSC Section 117900-Shall not haul med a Ci`.7r L ii',a.S W CYY1 <br /> waste unless registered or obtained LQHE. <br /> _6.HSC Section 117903-Shall not treat med - v <br /> waste without permit from enforcement agency. <br /> _7.HSC Section 117908-Common Storage `` - ff ii ' <br /> facility shall be registered with local enforcement v�c�'t7 r1 YT'(.�t 1 V1 6e� <br /> agency. r <br /> Procedures 1 <br /> _8.HSC Section 117935-SQG MWMP <br /> _9.HSC Section 117943-SQG Shall keep <br /> records for 3 years. - _ <br /> _10.HSC Section 117945-SQG not required to <br /> register shall keep records for 2 years. <br /> 11.HSC Section 117960-LQG shall file MWMP <br /> with enforcement agency. *" <br /> _12.HSC Section 117975-LQG shall keep <br /> records for 3 years. <br /> Transportation =2yZ =L <br /> _13.HSC Section 118030-LQHE application. 1 <br /> Treatment/Storage <br /> _14.HSC Section 118135 Shall obtain a permit �y�-�� - p_ �E, `U1Y� �,`[l ��t (��✓L b-A ,Ll <br /> from the enforcement agency to treat medical <br /> waste prior to treating the waste. CJ'Y TNl`'' h: V141 '7LA,V Z�"'-j 1)_) �-�SYy�.✓la <br /> _15.HSC Section 118765-All treatment records / t ] - <br /> shall be kept for 3 years. �J ,,N�-- j2�`�- ��� ( -���� -7 <br /> a7r r,to-is /7►'�SLl� <br /> _16.HSC Section 118215-All medical waste lt�c'tti�Yl�i'\ 'fr-r YNLJ�'� ��t[,ri ! r�C� ty <br /> shall be treated pursuant to this section. <br /> _17.HSC Section 118220-Recognizable human <br /> anatomical parts shall be disposed of by interment <br /> unless otherwise hazardous. IRA A y\t t lu- -4 <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, <br /> �. <br /> chemo shall be labeled properly. <br /> _20.HSC Section 118280-MW label&contain /YLS I s <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 <br /> bag used. ( ff rlG7� <br /> _27.HSC Section 118275(8)-Pharm label/store <br /> 28.HSC Section 118222-Incineration Required n c r SignatureeceiV By Da e <br /> :Z29 Other-Describe in narrative. <br />