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• <br />• SAN JOAQUIN COUNTY Date z4 III / )L`� <br />ENVIRONMENTAL HEALTH DEPARTME T PR e450-)6 <br />600 East Main Street, Stockton, CA 95202 <br />(209) 468-3420 <br />MEDICAL WASTE INSPECTION FORM <br />FacilityName Gi ,a11� 1 r��5nT%,1. FacilityAddress r'K C '1 �-(t'j?� s <br />FacilityContact jl�PyxL� Title EI)j r Phone# 416-7- 6 -ft ll <br />INSPECTION TYPE: Moutine <br />❑Complaint ❑Re -inspection <br />VIOLATION(S) <br />Registration <br />_ 1. HSC Section 117955 -Large Quantity <br />THE ITEMS BELOW REPRESENT VIOLATIONS OF THE CALIFORNIA <br />HEALTH & SAFETY CODE (HSC): <br />Generator shall register with the enforcement <br />agency prior to commencement of the generation of <br />medical waste. <br />E7t ��bl?� r�7ri'r�-�c-"l?- <br />_2. HSC Section 117903 -Permit from the2(fvy�FrJt <br />enforcement agency required to treat medical <br />fit' <br />1� �� �yi 16 C_ -,f)1 rx r-„ le—.°_k WC, <br />)aZ\AC, Z 4_ � i T U) �- f_') U- WP _ e -l- . rrl"'f"1?Yya <br />waste. <br />_3. HSC Section 117890 -No large LQG shall <br />generate medical waste unless registered with the <br />enforcement agency. <br />i+ T �►r �l a r?\� r%in"_):11 e ` 1 Trc � �°b l�Cc2e� ✓r^) " <br />_4. HSC Section 117895-SQG that treats med <br />waste shall register with enforcement agency. <br />616 <br />_5. HSC Section 117900 -Shall not haul med <br />c. , �• <br />waste unless registered or obtained LQHE. <br />Section 117903 -Shall not treat med <br />�"->'1 +C _A_)R eV- S ffig 4 k2r' n <br />\ \ <br />i410(Z I& 1e." Ckl <br />_6.HSC <br />waste without permit from enforcement agency. <br />_7.HSC Section 117908 -Common Storage <br />F cility shall be registered with local enforcement <br />rocedures <br />, �C'.Y�°)fa�f'' e ( �a?�l/l�L7Gt�� <br />z� <br />\ <br />8.HSC Section 117935-SQG MWMP <br />Section 117943-SQG Shall keep <br />L—'r e'' ll yl,@} <br />_9.HSC <br />records for 3 years. <br />_10.HSC Section 117945-SQG not required to <br />register shall keep records for 2 years. <br />_ <br />12 <br />_11.HSC Section 117960-LQG shall file MWMP <br />with enforcement agency. <br />r �1 _ <br />(�� h! e�L t71 <br />_12.HSC Section 117975-LQG shall keep <br />records for 3 years. <br />Transportation <br />l <br />T_ <br />_13. HSC Section 118030-LQHE application. <br />Treatment/Storage <br />_14.HSC Section 118135 -Shall obtain a permit <br />c <br />% r <br />Tom the enforcement agency to treat medical <br />waste prior to treating the waste. <br />7 ot <br />_15.HSC Section 118765 -All treatment recordsLam, <br />shall be kept for 3 years. <br />_16.HSC Section 118215 -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 />�i VY4 �� i �� ` <br />t - <br />_18.HSC Section 118225 -Treated sharps shall <br />be destroyed or somehow prevent public access. <br />_19.HSC Section 118275 -MW red bags, path, <br />ch mo shall be labeled properly. <br />20.HSC Section 118280 -MW label & contain <br />_21.HSC Section 118285 -Sharps label/contain <br />_22.HSC Section 118295 -Proper decon used. <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 />—_28.HSC Section 118222 -Incineration Required <br />' <br />n e r Signature Received By Date <br />29 Other -Describe in narrative. <br />