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Facility Name <br />Dameron Hospital <br />Address <br />525 w. acacia st. <br />City Zip Code <br />Stockton 95203 <br />Facility Contact Title Phone Number Email Inspection Type <br />Steven Manning Director of EVS 209-461-3116 steven.manning Routine <br />@crothall.com <br />The above facility is inspected for compliance with Division 104, Part 14 of California Health and Safety Code (HSC). <br />MEDICAL WAST&SPECTION REPORT <br />• <br />1116 IS <br />Treatment <br />F1 <br />Date: <br />/ <br />^ » <br />AJ <br />San Joaquin County Environmental Health Department <br />1868 E. Hazelton Ave., Stockton, CA 95205 <br />Program <br />?112 <br />@ P: <br />(209) 468-3420 <br />Record: <br />Program <br />2 <br />www.siogv.org/ehd <br />Element: <br />2' <br />Facility Name <br />Dameron Hospital <br />Address <br />525 w. acacia st. <br />City Zip Code <br />Stockton 95203 <br />Facility Contact Title Phone Number Email Inspection Type <br />Steven Manning Director of EVS 209-461-3116 steven.manning Routine <br />@crothall.com <br />The above facility is inspected for compliance with Division 104, Part 14 of California Health and Safety Code (HSC). <br />Received <br />Print: Harorit Mattu, Sr REHS <br />Reinspecion on/about: A reinspection fee of $130 per hour may be charged. <br />EH -08/2015 <br />Phone: (209) 461-3116 <br />Phone: (209) 468-3284 <br />Page 1 of 2 <br />Registration <br />Treatment <br />F1 <br />1' <br />HSC 117890 - No LOG shall generate medical waste unless <br />E] <br />17' <br />HSC 118130 - All onsite medical waste treatment facilities shall <br />registered with the EA. <br />be permitted by the EA. <br />❑ <br />2' <br />HSC 117950 - LOG shall register with the EA prior to <br />El <br />18. <br />HSC 118165 -All treatment records shall be kept for 3 years. <br />generating medical waste. <br />El <br />3' <br />HSC 117903 - Permit from the EA is required prior to treating <br />EI <br />19. <br />HSC 118215 - All medical waste shall be treated pursuant to <br />medical waste. <br />this section. <br />HSC 117925 - SQG that treats medical waste onsite shall <br />❑ <br />HSC 118220 - Pathology waste of a human nature shall be <br />interment, incineration, <br />❑ <br />4' <br />20. <br />disposed of by or an approved <br />register with the EA. <br />alternative. <br />HSC 117900 - Shall not haul medical waste unless registered, <br />HSC 118222 - Contaminated pathology waste, trace chemo <br />❑ <br />5. <br />common carrier, trauma scene practitioner, or exempted <br />❑ <br />21. <br />waste, or pharm waste from health care settings shall be treated <br />under the MOT exemption. <br />by incineration or an approved alternative. <br />❑ <br />6' <br />HSC 117928 - Common Storage Facility shall have permit <br />El <br />22. <br />HSC 118225 - Sharps waste shall be treated pursuant to this <br />issured by the EA. <br />section. <br />❑ <br />7 <br />HSC 117890 - LOG shall notify EA 72 hours prior to <br />Containment/Storage <br />participating in temporary event. <br />❑ <br />8' <br />HSC 117895 - SQG shall notify EA 72 hours prior to <br />® <br />23' <br />HSC 117630 - Biohazard bag shall meet the standards set forth <br />participating in temporary event. <br />in this section. <br />HSC 118275 - Medical, biohazardous, sharps, trace chemo, <br />Records/Documentation <br />® <br />24 <br />pathology, or pharmaceutical waste shall be segregated and <br />contained pursuant to this section. The container shall be <br />properlylabeled. <br />❑ <br />9. <br />HSC 117935 - Registered SQG shall file MWMP with the EA. <br />❑ <br />25 <br />HSC 118280 - Biohazard bags shall be containerized and <br />stored pursuant to this section. <br />❑ <br />10. <br />HSC 117943 - SQG required to register shall maintain <br />❑ <br />26 <br />HSC 118285 - Sharps waste shall be containerized and stored <br />treatment and shipping and tracking records for 3 years. <br />' <br />pursuant to this section. <br />El11. <br />HSC 117945 - SQG not required to register shall maintainHSC <br />El27' <br />118295 - Containers shall be washed and decontaminated <br />information document and transportation records for 3 years. <br />pursuant to this section. <br />® <br />12. <br />HSC 117960 - LOG shall file MWMP with the EA. <br />❑ <br />28 <br />HSC 118305 - Reuseable drums or conainters used for medical <br />waste shall not be used for other storage. <br />® <br />13. <br />HSC 117975 - LOG shall maintain treatment and shipping and <br />® <br />29. <br />HSC 118307- Intermediate storage area shall be secured and <br />tracking documents for 2 years. <br />marked with proper signage. <br />❑ <br />30' <br />HSC 118310 - Designated accumulation area shall be secured <br />Transportation <br />and marked with proper signage. <br />❑ <br />14. <br />HSC 117946 - MOT exemption requirements for SQG. <br />Other <br />❑ <br />15. <br />HSC 117976 - MOT exemption requirements for LOG. <br />❑ <br />31. <br />❑ <br />16. <br />HSC 118032 - Pharmaceutical waste hauling exemption. <br />❑ <br />32. <br />Received <br />Print: Harorit Mattu, Sr REHS <br />Reinspecion on/about: A reinspection fee of $130 per hour may be charged. <br />EH -08/2015 <br />Phone: (209) 461-3116 <br />Phone: (209) 468-3284 <br />Page 1 of 2 <br />