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GUIDELINES FOR THE MEDICAL WASTE MANAGEMENT <br />PLAN <br />Shall quantity generators that provide Onsite Treatment and all large quantity generators <br />shall have a Medical Waste Management plan on file with the San Joaquin County <br />Environmental Health Department. The Medical Waste Management Plan shall contain the <br />following information as approprriQat'(e� for your <br />facility:®, Q <br />Business Name: J 1 �M' h ' S <br />Business Address: <br />Stv do'D r� CSA - <br />City State 1 Zip Code <br />Phone Number: (� 1 ) 4 V 7 "(0 4 3-1 <br />Type of Facility or Business: t eA F!'Vl CjX re, <br />❑ Small Quantity Generator with Onsite Treatment (Generates less than 200lbs/month). <br />❑ Large Quantity Generator Only (Generates 200 lbs or more/month). <br />Large Quantity Generator with Onsite Treatment (Generates 200 lbs or snore/month). <br />Person responsible for implementation of the Medical Waste Management Plan: <br />Name: 3-6' r1 Y'erj I -e, Title: SZyltdr CVC' " 6C -RAA -0r <br />Phone: 601) AUT " U4 -+-I Date: ( a- j a h q <br />List the types of medical waste generated at your facility, i.e., laboratory wastes, blood or body <br />fluids, sharps, contaminated animals, surgical specimens, trace chemo or isolation astes": <br />Tr U e'er. phGt(m a-c�:C' V �, C �j S RQ _19& <br />19 S W �- c a > pac, wctm . <br />a) Do u generate M pharmaceutical waste (expired/outdated, spent, partials,)? <br />b) [Yes ❑ No <br />If yes, describe the type of pharmaceutical waste (expired, spent, partials, outdated, patient <br />returns, etc): <br />And estimate the monthly amount of pharmaceutical waste generated at your <br />facility: 3., 4 9® l b S M oYt+h <br />EHD 45-03 <br />10/6/2006 <br />