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COMPLIANCE INFO
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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PORTER
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4500 - Medical Waste Program
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PR0537018
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COMPLIANCE INFO
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Last modified
12/17/2024 3:52:51 PM
Creation date
7/3/2020 10:22:14 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4500 - Medical Waste Program
File Section
COMPLIANCE INFO
RECORD_ID
PR0537018
PE
4532
FACILITY_ID
FA0021254
FACILITY_NAME
INNOVATION DENTAL
STREET_NUMBER
702
STREET_NAME
PORTER
STREET_TYPE
AVE
City
STOCKTON
Zip
95207
APN
09771019
CURRENT_STATUS
01
SITE_LOCATION
702 PORTER AVE STE F
P_LOCATION
01
P_DISTRICT
002
QC Status
Approved
Scanner
SJGOV\cfield
Supplemental fields
FilePath
\MIGRATIONS\MW\MW_4532_PR0537018_702 PORTER_.tif
Tags
EHD - Public
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r <br /> 0 w0 <br /> Certification Statement <br /> FOR NON-MEDICAL WASTE GENERATORS AND MEDICAL WASTE GENERATORS NOT REQUIRED TO REGISTER <br /> Business Name: <br /> Business Address: <br /> City State Zip Code <br /> Phone Number: ) <br /> Contact Person: <br /> I am not required to register as a Medical Waste Generator because: <br /> Please check the appropriate statement(s) <br /> ❑ I do not generate any medical waste. <br /> ❑ I generate less than 200 pounds of medical waste per month. <br /> ❑ I do not treat any medical waste at my facility by means of autoclaving, incinerating or <br /> microwaving. <br /> ❑ Other: <br /> Please indicate the appropriate statement(s): <br /> ❑ I declare under penalty of law that to the best of my knowledge and belief, I do not generate or <br /> store any of the wastes specified on the"Pre-Application Questionnaire"as regulated medical <br /> wastes in an amount that equals or exceeds 200 pounds per month. <br /> ❑ I declare under penalty of law that I will not be treating any amount of regulated medical wastes <br /> at my facility by way of autoclaving, incinerating or microwaving. <br /> Signature: Title: Date: <br /> EHD 45-03 3 <br /> 10/6/2003 <br />
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