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I <br />SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMEN i <br />600 East Main Street, Stockton, CA 95202 <br />(209) 468-3420 <br />MEDICAL WASTE INSPECTION FORM <br />DateyA 6- /3 <br />PR 045ooco Z <br />FacilityName "eron l�v6 FacilityAddress X25 tJ. <br />INSPECTION TYPE: rgRoutine <br />[]Complaint ❑Re -inspection <br />VIOLATION(S) <br />Registration <br />THE ITEMS BELOW REPRESENT VIOLATIONS OF THE CALIFORNIA <br />_ 1. HSC Section 117955 -Large Quantity <br />Generator shall register with the enforcement <br />HEALTH & SAFETY CODE (HSC): <br />agency prior to commencement of the generation of <br />medical waste. <br />HSC Section 117903 -Permit from the <br />1 g <br />9-4 <br />(V' 0 elf (` r <br />_2. <br />enforcement agency required to treat medical <br />waste. <br />_3. HSC Section 117890 No large LQG shall <br />[ ",4_7.i ,1 G 1 .1 1 Y1 <br />-S� rd ✓� t �eJ21 <br />generate medical waste unless registered with the <br />enforcement agency. <br />_ ��ti1r.. , <br />k/,7ga glr7r1' 'VL-kr" I -r- � <br />I <br />_4. HSC Section 117895-SQG that treats med <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 <br />M Gk.- YP J"?-) k CwV_71 ci r 6Yl1,2 I+G /D✓J <br />f — L I <br />�(a.1!� �Yr ) ,t»,i7� S �� /� ?, L/ -' Ln�?.l�ay� <br />waste without permit from enforcement agency. <br />_7. HSC Section 117908 -Common Storage <br />1% <br />ct%��Ale _ o -Y (A) 1, —ILu M. -iZ ✓✓1�. bYl�, <br />facility shall be registered with local enforcement <br />1 <br />agency. <br />Procedures <br />I <br />_8.HSC Section 117935-SQG MWMP <br />_9.HSC Section 117943-SQG Shall keep <br />,! <br />records for 3 years. <br />_10.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. <br />,rn I <br />/1 <br />_12.HSC Section 117975-LQG shall keep <br />records for 3 years. <br />Transportation <br />cz7h <br />_13. HSC Section 118030-LQHE application. <br />Treatment/Storage <br />_14.HSC Section 118135 -Shall obtain a permit <br />from the enforcement agency to treat medical <br />waste prior to treating the waste. <br />_15.HSC Section 11 8765 -All treatment records <br />shall be kept for 3 years. <br />_16.HSC Section 11 8215 -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 <br />unless otherwise hazardous. <br />_18.HSC Section 118225 -Treated sharps shall <br />be destroyed or somehow prevent public access. <br />,n lo.>f�rVr�� nr` _ �1n�,✓x/11 Govt. Iz�,61�1rr _ <br />\ <br />319.HSC Section 118275 -MW red bags, path, <br />chemo shall be labeled properly. <br />_20.HSC Section 118280 -MW label & contain <br />//�� <br />ArAtw ea r... A >rA Ile M.i.b'f_ 'L7-" Gr 1 <br />_21.HSC Section 118285 -Sharps label/contain <br />r <br />_22.HSC Section 118295 -Proper decon used. <br />c-� <br />eC� hii7Yl tit7ct./UCVS 1_118✓l, -]ri <br />�� N�n� ✓1�T7 D✓1 fit I - 1v� ��� �.n C� <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 />-k 7� I 13 <br />_28.HSC Section 118222 -Incineration Required <br />29 Other -Describe in narrative. <br />I S e t Signature -,,Received By Date <br />