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SAN JOAQUIN COUNTY D; <br /> ENVIRONMENTAL HEALTH DEPARTMENT PR U93 7 4 <br /> 1868 East Hazelton Ave., Stockton, CA 95205 <br /> (209)468-3420 <br /> MEDICAL WASTE INSPECTION FORM <br /> FacilityName c-ikkeWk- 'D�Aj�s;c Gj)c- ill Address S1QE. BAjAj64 (1-0114 <br /> i <br /> cn'�' 11 <br /> FacilityContact Ttf6, (or Title 'T q VVI Phone# oA)n)4-S&O <br /> ISPECTI TYPE: outine []Complaint Eille-inspection <br /> VIOLATION(S) <br /> Registration THE ITEMS BELOW REPRESENT VIOLATIONS OF THE CALIFORNIA <br /> 1.NSC 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. <br /> 2.HSC Section 117903-Permit from the <br /> enforcement agency required to treat medical <br /> waste. <br /> —3.HSC Section 117890-No large LQG shall Nc�ei-A F-%C'1AiA A3',A <br /> generate medical waste unless registered with the <br /> enforcement agency. <br /> —4.HSC Section 117895-SQG that treats med L+J M n1A.-I t614 <br /> waste shall register with enforcement agency. -Ij <br /> —5.HSC Section 117900-Shall not haul med P C)4-k <br /> waste unless registered or obtained LQHE. % <br /> —6.HSC Section 117903-Shall not treat med <br /> waste without permit from enforcement agency. <br /> THSC Section 117908-Common Storage <br /> facility shall be registered with local enforcement <br /> agency. tJ,L& 4 A U-6 S. It <br /> Procedures W1111A <br /> -8.HSC Section 11 7936-SQG MVVMP I jo <br /> —9.HSC Section 117943-SQG Shall keep AULA� FIVA,' Ili 101AA� ln:S'�JW <br /> records for 3 years. <br /> —10.HSC Section 117945-SQG not required to CNAA) f-I 'Pl',C lAr-- <br /> register shall keep records for 2 years. I-V t S <br /> I IMSC Section 117960-LQG shall file MWMP <br /> �ith enforcement agency. <br /> —12.HSC Section 117975-LQG shall keep '<'4 <br /> records for 3 years. e- I DaL Mcji"I �A 9 a.51c- <br /> Transportation <br /> —13.HSC Section 11 8030-LQHE application. <br /> TreatmentiSto rage <br /> 14.HSC Section 118135-Shall obtain a permit LIA a ml <br /> from the enforcement agency to treat medical <br /> waste prior to treating the waste. C S ULt C'vOICA S- <br /> 15.HSC Section 118765-All treatment records (lx� <br /> shall be kept for 3 years. <br /> 16.HSC Section 118215-All medical waste Loll :: <br /> shall be treated pursuant to this section. 1)2iq2)-I ��\ i <br /> 17.HSC Section 118220-Recognizable human rt- )A <br /> anatomical parts shall be disposed of by interment <br /> unless otherwise hazardous. <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, fevt <br /> _jh-'emo shall be labeled properly. <br /> 20.HSC Section 118280-MW label&contain <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 /> E-a-9 used. <br /> 27.HSC Section 118275(g)-Pharm label/store I.,-- A <br /> —28.HSC Section 118222-Incineration Required - - Date <br /> 29 Other-Describe in narrative. nspEat6r Signature Received By <br /> I i <br />