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pa !IV • SAN JOAQUIN COUNTY Date 7-,� -,tZ <br /> 'o. ENVIRONMENTAL HEALTH DEPARTME10 PR <br /> y tij 600 East Main Street, Stockton, CA 95202 <br /> (209)468-3420 <br /> gc�FOMEDICAL WASTE INSPECTION FORM <br /> FacilityName xA.� P,-) ", n a!?!,,FacilityAddress -5,;? ' _�tt <br /> FacilityContactt*,r tv\yn C'. tl,;tl%'ACvV\C Title A-b_ . , Phone# LI W-T S <br /> INSPECTION TYPE: gRoutine []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. CLI <br /> _2.HSC Section 117903-Permit from the <br /> enforcement agency required to treat medical 14 C,L <br /> waste. <br /> _3.HSC Section 117890-No large LQG shall i - <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. ('�S�n�'��'� r AVU-4 VneC�'C?,C j �' },�..��t' <br /> _5.HSC Section 117900-Shall not haul med �— _CL. L <br /> waste unless registered or obtained LQHE. <br /> _6.HSC Section 117903-Shall not treat med vie <br /> waste without permit from enforcement agency. <br /> _7.HSC Section 117908-Common Storage <br /> facility shall be registered with local enforcement eJCC&Alr i V1 -g:4 rz VLC\ 11".­4 fVl.'rTnA-VN OYL <br /> agency. <br /> Procedures AIA ,yk „nm:.;471 Lh-\ A (')i,t n��r�✓l �— :v� l <br /> _8.HSC Section 117935-SQG MWMP �'l tlt�lk VK?C' S rv►� ('ems rr�,✓r h 1�7Mc ✓G..�Z/Y <br /> _9.HSC Section 117943-SQG Shall keep l _ <br /> records for 3 years. f'1�� crAA f� <br /> W0.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. jnwy I }tj •iVuZ y—A iv <br /> _12.HSC Section 117975-LQG shall keep rr { <br /> records for 3 years. <br /> Transportation r,1—AA.,—J1 <br /> _13.HSC Section 118030-LQHE application. <br /> Treatment/Storage <br /> _14.HSC Section 118135-Shall obtain a permit <br /> C1. j/� 7 I � - ti � <br /> p <br /> from the enforcement agency to treat medical -` <br /> waste prior to treating the waste. - <br /> _15.HSC Section 118765-All treatment records �3 \�` <br /> shall be kept for 3 years. <br /> _16.HSC Section 11 8215-All medical waste1 \ 1 <br /> shall be treated pursuant to this section. C�Y1D:L�J�'� 1;l ca (� t'7c�(Y J r.7;7V1 <br /> _17.HSC Section 118220-Recognizable human <br /> anatomical parts shall be disposed of by interment ,t - _ <br /> unless otherwise hazardous. i.r;.` 'ham fVL`,Gv 4(kA-,Z Y1eAj .N. i'l 1,Z4.V 14 iQ Ire l <br /> _18.HSC Section 118225-Treated sharps shall <br /> be destroyed or somehow prevent public access. n,H, _ i,[ 1[`TJ2'� cam; b�r..��.,✓c <br /> -j�-19.HSC Section 118275-MW red bags,path, <br /> chemo shall be labeled properly. <br /> -420.HSC Section 118280-MW label&contain •- ; - <br /> _21.HSC Section 118285-Sharps label/contain <br /> _22.HSC Section 118295-Proper decon used. - A L1 <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 C� <br /> �ba used. Z"', <br /> 27.HSC Section 118275(8)-Pharm label/store <br /> IF <br /> —28.HSC Section 118222-Incineration Required + I e r Signature Recel d y Date <br /> 29 Other-Describe in narrative. <br /> (1(,� 1___ <br />