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04QZ MEDICAL WASTIISPECTION REPORT • Date:ppj Z, San Joaquin County Environmental Health Department Program p p i Zsr :.,. L:. 1868 E. Hazelton Ave.,Stockton,CA 952051 Record: r � '1 `1 (209)468-3420 Program ✓FORS% www.siogv.org/ehd Element: Facility Name Address City Zip Code Manteca Dialysis 1620 w.yosemite avenue Manteca 95337 Facility Contact Title Phone Number Email Inspection Type Jennifer Mount Facility Administrator 209-825-3905 jennifer.mount@d Routine avita.com The above facility is inspected for compliance with Division 104,Part 14 of California Health and Safety Code(HSC). Registration Treatment ❑ 1 HSC 117890-No LQG shall generate medical waste unless ❑ 17 HSC 118130-All onsite medical waste treatment facilities shall registered with the EA. be permitted by the EA. ❑ 2 HSC 117950-LQG shall register with the EA prior to generating medical waste. ❑ 18. HSC 118165-All treatment records shall be kept for 3 years. ❑ 3 HSC 117903-Permit from the EA is required prior to treating ❑ 19. HSC 118215-All medical waste shall be treated pursuant to medical waste. this section. HSC 117925-SQG that treats medical waste onsite shall HSC 118220-Pathology waste of a human nature shall be ❑ 4. register with the EA. ❑ 20. disposed of by interment,incineration,or an approved alternative. HSC 117900-Shall not haul medical waste unless registered, HSC 118222-Contaminated pathology waste,trace chemo ❑ 5. common carrier,trauma scene practitioner,or exempted ❑ 21. waste,or pharm waste from health care settings shall be treated under the MOT exemption. by incineration or an approved alternative. ❑ HSC 117928-Common Storage Facility shall have permit HSC 118225-Sharps waste shall be treated pursuant to this 6. issured by the EA. ❑ 22' section. HSC 117890-LQG shall notify EA 72 hours prior to El 7. Containment/Storage participating in temporary event. El 8 HSC 117895-SQG shall notify EA 72 hours prior to [j 23 HSC 117630-Biohazard bag shall meet the standards set forth participating in temporary event. in this section. HSC 118275-Medical,biohazardous,sharps,trace chemo, Records/Documentation ❑ 24 pathology,or pharmaceutical waste shall be segregated and contained pursuant to this section. The container shall be properly labeled. ❑ 9. HSC 117935-Registered SQG shall file MWMP with the EA. ® 25 HSC 118280- Biohazard bags shall be containerized and stored pursuant to this section. ❑ 10. HSC 117943-SQG required to register shall maintain ❑ 26 HSC 118285-Sharps waste shall be containerized and stored treatment and shipping and tracking records for 3 years. pursuant to this section. ❑ 11. HSC 117945-SQG not required to register shall maintain ❑ 27 HSC 118295-Containers shall be washed and decontaminated information document and transportation records for 3 years. pursuant to this section. ❑ HSC 118305- Reuseable drums or conainters used for medical 12. HSC 117960-LQG shall file MWMP with the EA. ❑ 28. waste shall not be used for other storage. E] 13. HSC 117975-LQG shall maintain'treatment and shipping and ❑ 29 HSC 118307- Intermediate storage area shall be secured and tracking documents for 2 years. marked with proper signage. Transportation ❑ HSC 118310-Designated accumulation area shall be secured 30. and marked with proper signage. ❑ 14. HSC 117946-MOT exemption requirements for SQG. Other ❑ 15. HSC 117976-MOT exemption requirements for LQG. ❑ 31. ❑ 16. HSC 118032-Pharmaceutical waste hauling exemption. ❑ 32. Received by: Print: Jennifer Mount ' ature• hone:209-825-3905 Specialist: Print: J.Easter 6sio/ure: Phone: 209-953-7310 Reinspecion ontabout: A reinspection fee of$152 per hour may be charged. Page 1 of 2 EH-11/17 �^