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oaq"f" SAN JOAQUIN COUNTY Date 3.-/O`l`d <br /> EM 1RONMENTAL HEALTH DEPARTMER"i' PR -)1.� L� <br /> { 600 East Main Street, Stockton, CA 95202 <br /> (209)468-3420 <br /> o <br /> q`rFOR��P MEDICAL WASTE INSPECTION FORM <br /> FacilityName—'+Zehtnn- 04z) �b-yv- l Cn?-�, FacilityAddress r2Lgo,to-4,a2rno) <br /> FacilityContactt,1v(v� C,. yIL ►0AC n <br /> kka, � Title i :'t�. Phone# -/17,3 &&T& <br /> INSPECTION TYPE: #(&outine []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 - — <br /> enforcement agency required to treat medical <br /> waste. <br /> _3.HSC Section 117890-No large LQG shall ci S <br /> generate medical waste unless registered with the C <br /> enforcement agency. e <br /> _4.HSC Section 117895-SQG that treats med ' <br /> waste shall register with enforcement agency. 11 <br /> _5.HSC Section 117900-Shall not haul med f74'eI)c- 44 kb <br /> waste unless registered or obtained LQHE. II ] <br /> _6.HSC Section 117903-Shall not treat med 3'k t-,) 140 <br /> waste without permit from enforcement agency. q� <br /> _7.HSC Section 117908-Common Storage <br /> facility shall be registered with local enforcement <br /> agency. —�1 <br /> Procedures <br /> _8.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 evn,P+fr� OS LeiraAl— Mie,-- 1412v <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 <br /> records for 3 years. <br /> Transportation -, <br /> _13.HSC Section 118030-LQHE application. <br /> Treatment/Storage - <br /> _14.HSC Section 118135-Shall obtain a permit -y,x �'N 7C✓44/-A <br /> from the enforcement agency to treat medical N <br /> waste prior to treating the waste. <br /> _15.HSC Section 118765-All treatment records <br /> shall be kept for 3 years. <br /> _16.HSC Section 118216-All medical waste <br /> shall be treated pursuant to this section. <br /> _17.HSC Section 118220-Recognizable human <br /> anatomical parts shall be disposed of by interment f <br /> unless otherwise hazardous. i C�X --t+ <br /> _18.HSC Section 118225-Treated sharps shall / <br /> be destroyed or somehow prevent public access. YLl%,i-� L ��:61«�C�I SCJ <br /> _19.HSC Section 118275-MW red bags,path, <br /> -hemo 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. <br /> _27.HSC Section 118275(g)-Pharm label/store <br /> _28.HSC Section 118222-Incineration Required `I SJ e r ignature Received By Date <br /> 29 Other-Describe in narrative. f <br />