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®PqUl <br /> SAN JOAQUIN COUNTY Date <br /> ENVIRONMENTAL HEALTH DEPARTMENT PR C2 1cl <br /> 600 East Main Street, Stockton, CA 95202 <br /> (209)468-3420 <br /> ;i ®R MEDICAL WASTE INSPECTION FORM <br /> FacilityName Ee_ktA- -jm6,�J -FacilityAddress )110 0- 9Cj41ewAQ'h <br /> FacilityContact -V% kiaow-ey\ Title 66S Phone# o6V-1- 91 <br /> INSPECTION TYPE: Aoutine []Complaint EiRe-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 =1iM/xU C4., 'A47 <br /> enforcement agency required to treat medical Ctky� YICY+- PYIN11 4-`& - <br /> waste. ir <br /> 3.HSC Section 117890-No large LOG shall 12 e-)1y <br /> i - -(.Al r-YA� <br /> generate medical waste unless registered with the <br /> enforcement agency. i ±=LjL <br /> AA e��J I <br /> —4.HSC Section I I 7895-SQG that treats med MfA Ag"A 1-'AOO <br /> waste shall register with enforcement agency. <br /> —5.HSC Section 117900-Shall not haul med U-n 41 L ickac-L <br /> waste unless registered or obtained LQHE. <br /> —6.HSC Section 117903-Shall not treat med <br /> waste without permit from enforcement agency. r9 <br /> THSC Section 117908-Common Storag <br /> Ta-cility shall be registered with local enforcement <br /> fA rt <br /> agency. <br /> Air ayd:r'9 <br /> Procedures /A AA 1--4 1 J �a L6123 2 1= LMC1Lre7 <br /> HSC Section 117935-SQG MWMP I <br /> 9.HSC Section 117943-SQG Shall keep <br /> 't'V1'C;4 Lyl- a® 2'ra <br /> records for 3 years. Q <br /> -10.HSC Section 117945-SQG not required to 13 <br /> register shall keep records for 2 years. L LzL -t�Ai;2 221=1 I a::! <br /> 11.HSC Section 117960-LQG shall file MWMP <br /> �ith enforcement agency. <br /> —12.HSC Section 117975-LQG shall keep <br /> records for 3 years. <br /> Transportation <br /> —13.HSC Section 11 8030-LQHE application. 'Z�" 6- 43 L <br /> Treatment/Storage L <br /> 14.HSC Section 118135-Shall obtain a permit ®j-:C, LjjCjk'j h: jj= VIA <br /> From the enforcement agency to treat medical <br /> waste prior to treating the waste. <br /> 15.HSC Section 118765-All treatment records t -1\ <br /> shall be kept for 3 years. �Uak - w f.M' I'n g�� �= 4 ie'z: za::A <br /> 6.HSC Section 118215-All medical waste L <br /> shall be treated pursuant to this section. <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 <br /> b-e­destroyed 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 lei <br /> bag used. <br /> —27.HSC Section 118275(g)-Pharm label/store <br /> —28.HSC Section 118222-Incineration Required I6%sqctQ/5Anature Received By Date <br /> 29 Other-Describe in narrative. <br />