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GUIDELINES FOR THE MEDICAL WASTE MANAGEMENT PLAN <br /> (Please Type or Print) <br /> Small quantity generators that provide onsite treatment and all large quantity generators <br /> shall have a medical waste management plan on file with the local enforcement agency <br /> (PHS-EHD). The medical waste management plan shall contain the following information, <br /> as appropriate for your facility: <br /> Business Name: Delta Health Carewh z <br /> Business Address: 911 Industrial Way Lod; CA ?S-240 <br /> Business Phone: ( 209 ) 369-2704 ;,;�s w.w <br /> Type Of Facility Or Business: Community Clinic <br /> Registered As: (Check One) <br /> (x� Small Quantity Generator With Onsite Treatment. (Generates < 200 lbs./mo.) <br /> ( ) Large Quantity Generator. (Generates 200 lbs. or more/mo.) <br /> ( ) Large Quantity Generator With Onsite Treatment. (Generates 200 lbs. or more/mo.) <br /> Person Responsible For Implementation Of The Plan: <br /> Name: Sara Godwin, N.P. <br /> Title: Director, Clinical Services Phone: ( 2og ) 466--1 45 <br /> ATTACH ADDITIONAL INFORMATION <br /> 1. List the types of medical waste generated at your facility, i.e., Laboratory Wastes, <br /> Blood or Body Fluids, Sharps, Contaminated Animals, Surgical Specimens, or <br /> Isolation Wastes. (See "Regulated Medical Wastes" on Page 3.) <br /> 2. Estimate the monthly amount of medical waste generated at your facility. <br /> 3. Describe the medical waste handling procedures utilized by and applicable to your <br /> facility: <br /> a. Onsite location and method for segregation, containment, packaging, <br /> labelling, and collection. <br /> -CONTINUED ON E- <br /> 7 <br />