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SAN JOAQUIN COUNTY • Date ® - t <br /> ; oL ENVIRONMENTAL HEALTH DEPARTMENT PR 53 <br /> 600 East Main Street, Stockton, CA 95202 <br /> F <br /> (209)468-3420 <br /> MEDICAL WASTE INSPECTION FORM <br /> FacilityName - ,%n &Mn,I FacilityAddress 70, rr _ r= <br /> FacilityContact Title Phone#y77- -16"18 <br /> INSPECTION TYPE: SiREoutine ❑Complaint ❑Re-inspection <br /> VIOLATION(S) <br /> Registration THE ITEMS BELOW REPRESENT VIOLATIONS OF THE CALIFORNIA <br /> _1.HSC Section 117955-Large Quantity HEALTH & SAFETY CODE (HSC): <br /> Generator shall register with the enforcement <br /> agency prior to commencement of the generation of <br /> medical waste. f <br /> _2. HSC Section 117903-Permit from the <br /> enforcement agency required to treat medical <br /> waste. <br /> _3. HSC Section 117890-No large LQG shall <br /> generate medical waste unless registered with the <br /> enforcement agency. <br /> _4. HSC Section 117895-SQG that treats med , <br /> waste shall register with enforcement agency. <br /> _5.HSC Section 117900-Shall not haul med <br /> waste unless registered or obtained LQHE. rPo <br /> _6.1-11SC Section 117903-Shall not treat med Z ' <br /> waste without permit from enforcement agency. <br /> _7.HSC Section 117908-Common Storage <br /> facility shall be registered with local enforcement <br /> agency. <br /> Procedures <br /> B.HSC Section 117935-SQG MWMP <br /> _9.HSC Section 117943-SQG Shall keep <br /> records for 3 years. <br /> _10.HSC Section 117945-SQG not required to <br /> register shall keep records for 2 years. <br /> _11.HSC Section 117960-LQG shall file MWMP <br /> With enforcement agency. <br /> _12.HSC Section 117975-LQG shall keep 41-1 <br /> records for 3 years. <br /> Transportation 2/1 <br /> _13.HSC Section 118030-LQHE application. <br /> Treatment/Storage <br /> 4 <br /> _14.HSC Section 118135-Shall obtain a permit <br /> from the enforcement agency to treat medical <br /> waste prior to treating the waste. <br /> _15.HSC Section 11 8765-All treatment records <br /> shall be kept for 3 years. 7 il <br /> 16.HSC Section 118215-All medical waste K <br /> shall be treated pursuant to this section. <br /> _17.HSC Section 118220-Recognizable humanl <br /> anatomical parts shall be disposed of by interment <br /> unless otherwise hazardous. <br /> _18.HSC Section 118225-Treated sharps shall <br /> be destroyed or somehow prevent public access. <br /> _19.HSC Section 118275-MW red bags,path, <br /> chemo shall be labeled properly. <br /> 20.HSC Section 118280-MW label&contain <br /> _21.HSC Section 118285-Sharps label/contain <br /> _22.HSC Section 118295-Proper decon used. <br /> _23.HSC Section 118307-Interim storage labeled <br /> 24.HSC Section 118310-Enclosure labeled. <br /> _25.HSC Section 118305-Cannot reuse drums <br /> _26.HSC Section 117630-Approved biohazard <br /> bag used. -7 <br /> ®J <br /> _27.HSC Section 118275(g)-Pharm label/store S/6 I <br /> _28.HSC Section 118222-Incineration Required I r Signature Received y Date <br /> 29 Other-Describe in narrative. <br />