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® 5 <br /> F <br /> pC <br /> p <br /> ENVIRONMENTAL HE,ALT EPA T HENT <br /> SAN JOAQUIN COUNTY <br /> 1868 E.]Hazelton Avenue <br /> Stockton, California 95205 <br /> Telephone: (209)468-3420 <br /> Fax: (209)468-8392 <br /> F <br /> E <br /> F. <br /> GUIDELINES FOR THE MEDICAL WASTE MANAGEMENT PLAIT <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 I <br /> facility: <br /> ti <br /> Business Name: American Medical Response <br /> Business Address: 400 South Fresno Ave <br /> CA. 95203 <br /> Stockton � <br /> city State Zip Code <br /> Phone Number: (209 ) 405-0622 <br /> i <br /> Type of Facility or Business: Ambulance Provider <br /> REGISTRATI[OrMFOR.:-- <br /> ❑ Small Quantity Generator with Onsite Treatment(Generates less than 200 lbs/month). <br /> 5 <br /> ® Large Quantity Generator Only(Generates 200 lbs or more/month). <br /> ❑ Large Quantity Generator with Onsite Treatment(Generates 200 lbs or more/month). i <br /> Person responsible for implementation of the Medical Waste Management Plan: <br /> E <br /> E <br /> Name: Shawn Gosgen Title:Deployment Coordinator <br /> Phone: (209) 405-0622 Date: 9/14/2015 <br /> 1. List the types of medical waste generated at your facility(i.e. laboratory wastes,blood,or body <br /> fluids, shaips,contaminated animals, surgical specimens,trace cherno or isolation wastes): <br /> Bloody and/or Body fluids, Pharmaceutical Waste, Isolation Waste <br /> z <br /> a)Do you generate aM pharmaceutical waste(expired, spent,partials,patient returns)? [�;Yes ❑No <br /> If yes, describe the type of pharmaceutical waste expired,spent,partials,patient returns): <br /> Expired, Partials <br /> i <br /> And estimate the monthly amount of pharmaceutical waste generated at your facility: 5 LBS. <br /> k, <br /> MM 45-03 5 t <br /> 2015 <br /> 3 <br />