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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: <br /> Business Name: ��fl C>A-1 V vl 2 LW1 <br /> Business Address: 1 ?4 6WITZA-L— 'rL <br /> kTXr- <br /> (j- g52jcq <br /> 1t' State Zip Code <br /> Phone Number: (2j�fl ) i Fj 155- <br /> Type of Facility or Business: Com mym l CU L �,Q e- <br /> REGISTRATION=FOR:.. <br /> ❑ Small Quantity Generator with Onsite Treatment(Generates less than 2001bs/month). <br /> urge 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: VA 0 a G Title:�G G '2 <br /> � � �i.Y1YU�. Y�ut►�n►�w�a� <br /> Phone: �`1 ���?JS Date: ((�—2--7 <br /> 1. List the types of medical waste <br /> f ►wr SGV" <br /> generated at your facility(i.e. laboratory wastes, blood or body <br /> fluids, harps, contaminated animals, surgical specimens, trace cherno or isolation wastes): <br /> AM <br /> a) Do you generate 4ny pharmaceutical waste (expired, spent,partials,patient returns)? ❑ Yes 5 No <br /> If yes, describe the type of pharmaceutical waste (expired, spent,partials,patient returns): <br /> And estimate the monthly amount of pharmaceutical waste generated at your facility: <br /> HD 45-03 <br /> X15 5 <br />