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oPQ�f^!. c 0 SAN JOAQUIN COUNTY i Date3a6 <br /> ENVIRONMENTAL HEALTH DEPARTMENT PR(-)3-7nix <br /> Q -+ 600 East Main Street, Stockton, CA 95202 <br /> (209)468-3420 <br /> cgCiFORr'`P MEDICAL WASTE INSPECTION FORM <br /> FacilityName Tin�c;��i Z� �:.� kz. FacilityAddress 7V;2- 4)6,� Ajn,-, <br /> FacilityContact Title, Phone# .�t 7 ' -`�6 <br /> INSPECTION TYPE: t,;Ikoutine []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. <br /> _2.HSC Section 117903-Permit from the r <br /> enforcement agency required to treat medical <br /> waste. � {- �,��_ADriti' MZfc)N2;�.( 11.Y_A )h- <br /> 3.HSC Section 117890-No large LQG shall C.�..��✓L <br /> generate medical waste unless registered with the <br /> enforcement agency. <br /> _4.HSC Section 117895-SQG that treats med t- <br /> waste shall register with enforcement agency. <br /> _5.HSC Section 117900-Shall not haul med <br /> waste unless registered or obtained LQHE. _ <br /> _6.HSC Section 117903 Shall not treat med A.,%,[ ,yyyU'r y1C'a(�w{Y r,,);n K /'V_ w <br /> waste without permit from enforcement agency. 1 vL <br /> _7.HSC Section 117908-Common Storage /=• ' +n16dr.c_� f' OYI. <br /> facility shall be registered with local enforcement <br /> agency. <br /> Procedures L - k <br /> _8.HSC Section 117935-SQG MWMP <br /> _9.HSC Section 117943-SQG Shall keep <br /> records for 3 years. Al )1 JC�.iM�P�r z�C� v�Dl3 GCv� y �r�ytUL'n ✓t.i �� �/�/ <br /> _10.HSC Section 117945-SQG not required to 11 1 7 <br /> register shall keep records for 2 years. 4 J --'k� rpt-l' A C_ l e%' T <br /> _11.HSC Section 117960-LQG shall file MWMP l L <br /> with enforcement agency. (A iGt_� 04-1 l�Z Y C � '}7� "�1^Pc✓T � iJVI���►�t� <br /> _12.HSC Section 117975-LQG shall keep <br /> records for 3 years. <br /> Transportation <br /> _13.HSC Section 118030-LQHE application. <br /> Treatment/Storage )"yV1 <br /> _14.HSC Section 118135-Shall obtain a permit ���� nA- CQ5001[:-' , filt1)4 <br /> from the enforcement agency to treat medical <br /> waste prior to treating the waste. <br /> 15.HSC Section 118765-All treatment records <br /> sh_all be kept for 3 years. rJ <br /> _ 1_%HSC Section 118215-All medical waste /AA i7n,,',I L, V� CA A AA'P'r-_� 47 bY-i I 9� j <br /> shall be treated pursuant to this section. 1l <br /> _17.HSC Section 118220-Recognizable human <br /> anatomical parts shall be disposed of by interment <br /> unless otherwise hazardous. <br /> _18.HSC Section 118225-Treated sharps shall C- <br /> be destroyed or somehow prevent public access. r '✓ ` L <br /> _19.HSC Section 118275-MW red bags,path, " vlY <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. ` ' S ON— r <br /> _23.HSC Section 118307-Interim storage labeled <br /> _24.HSC Section 118310-Enclosure labeled. VIA 1PVfV_\' <br /> _25.HSC Section 118305-Cannot reuse drums <br /> _26.HSC Section 117630-Approved biohazard <br /> bag used. 01_2i,120 <br /> 27.HSC Section 118275(g)-Pharm label/store <br /> _28.HSC Section 118222-Incineration Requireda Signature Received By Y Date <br /> 29 Other-Describe in narrative. <br />