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ENVIRONMENTAL HEALTH DEPARTMENT <br /> SAN JOAQUIN COUNTY <br /> 1868 E. Hazelton Avenue <br /> Stockton, California 95205 <br /> Telephone: (209)468-3420 <br /> Fax: (209)468-8392 <br /> GUIDELINES FOR THE MEDICAL WASTE MANAGEMENT PLAN <br /> Small quantity generators that provide onsite treatment and all large quantity generators shall have a <br /> Medical Waste Management plan on file with the San Joaquin County Environmental Health Department. <br /> The Medical Waste Management Plan shall contain the following information as appropriate for your <br /> facility: l <br /> Business Name:E? t 1'T Pa r <br /> Business Address: r� �(,�r A I Il C4 —I't)Co'% <br /> �Cza 952.47 <br /> City State Zip Code <br /> Phone Number: ( 2k�) 1 j (4 5 200 <br /> Type of Facility or Business: km D Ct I CLI�d 5 i -S <br /> REGISTRATION FOR: <br /> ❑ Small Quantity Generator with Onsite Treatment(Generates less than 200 lbs/month). <br /> TK 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: �P 'r^I 6rr (1 Z Title: & MdjPr-111°�I t..ri14 <br /> Phone: 2-()�A - --7 7 q— ,5!3 Ca(7 Date: <br /> 1. 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 /> 5 <br /> a)Do you generate Iy pharmaceutical waste (expired, spent,partials,patient returns)?g Yes ❑No <br /> If yes, describe the type of pharmaceutical waste(expired, spent,partials,patient returns): <br /> emp t ce--a ay---A 6 , <br /> And estimate the monthly amount of pharmaceutical waste generated at your facility: <br /> EI-ID 45-03 5 <br /> &r 4- <br /> 2015 <br />