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PUBLIC HEALTH SERVICES <br />SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DIVISION <br />Karen Furst, M.D., M.P.H., Health Officer <br />304 East Weber Avenue, Third Floor • Stockton, CA 95202 <br />209/468-3420 <br />August 6, 1998 <br />Donna McCauley O <br />Lodi Memorial Hospital <br />PO Box 3004 <br />Lodi CA 95241-1908 <br />Donna, <br />aAg�l'� c <br />Ct•.. 'P <br />���FOttN� <br />Thank you for sending your Medical Waste Management Plan (MWMP) and responding to my concerns so <br />promptly. I have the following questions and/or comments on your MWMP: <br />• Page 2 of 6 under "COLLECTION PROCESSES" #5 states that the medical waste will be labeled as <br />"infectious waste" or "biohazardous waste". Section 118280 of the California Health and Safety Code <br />does not allow for labeling of medical waste as "infectious waste" that terminology was only allowed in <br />the old Title 22 which no longer applies. All medical waste containers "...shall be labeled with the words <br />Biohazardous Waste or with the international biohazard symbol and the word BIOHAZARD..." <br />Also on page 2 of 6 under "SPILL CONTAINMENT AND CLEANUP" it states that the cleaning agent <br />used will be the "appropriate germicidal solution". As we discussed during my inspection that needs to <br />be very specific. Please see section 118295 of the California Health and Safety Code regarding what <br />specific germicidal solutions are acceptable. Please also mention what is done with the waste solution <br />once any reusable medical waste containers are cleaned. Specifically, I mean does the solution go <br />down a storm drain or sewer drain and where is that located at the facility? For example, are the <br />reusable medical waste containers cleaned on the patio outside and allowed to drain into a sewer clean <br />out, storm drain, collected and disposed of inside, or what? <br />• Page 3 of 6 under "DISPOSAL" states that the pathology waste is removed from the hospital Laboratory <br />for disposal under a contract agreement with Delta Pathology. I need this clarified. I understand this to <br />mean that you do generate pathology waste and that Delta Pathology disposes of it for you. Is this <br />correct? Or did you mean you send all of your pathology samples to Delta Pathology for analysis and <br />disposal? Please include a copy of your contract agreement with Delta Pathology. <br />• Page 6 of 6 under "REMOVAL OF STERILIZED WASTE FOR COMPACTION AND DISPOSAL" #6 <br />discusses the process to be followed when removing the bags from the sterilizer. This process should <br />include the requirement that the staff visually inspect each bag to ensure adequate sterilization has <br />been achieved as evidenced by the proper color change of the strip on the bags. That is the purpose of <br />the color change strips on the bags. <br />Should you have any questions regarding this letter, please call me at (209) 468-3451. <br />Thank you, <br />Kasey L. Foley, REHS <br />Medical Waste Management Program <br />A Division of San Joaquin County Hcalth Care Scrvices <br />