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1% SAN JOAQUIN COUNTY Date r -1ZI - . <br />*IRONMENTAL HEALTH DEPARTMENT PR <br />600 East Main Street, Stockton, CA 95202 <br />(209) 468-3420 <br />MEDICAL WASTE INSPECTION FORM <br />FaciliityContact_.�,.yA1 t R' 1. _ i! i • <br />INSPECTION 2LRoutine ■ • r oRe-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 />_2. HSC Section 117903 -Permit from the <br />- <br />< - <br />enforcement agency required to treat medical <br />waste. <br />llAcc <br />HSC Section 117890 -No large LQG shall <br />i�:f2�� P (' Fr.. ,��np_+,� . �t fir,✓►. �C. 11nP ,� <br />_3. <br />generate medical waste unless registered with the <br />enforcement agency. <br />, t ` S <br />e �" t Ca 6 C _=.17a .r)Oif r _ <br />_4. HSC Section 117895-SQG that treats med <br />waste shall register with enforcement agency. <br />_ <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 />waste without permit from enforcement agency. <br />_7.HSC Section 117908 -Common Storage <br />�` 1 <br />1 <br />facility shall be registered with local enforcement <br />agency. <br />Procedures <br />_8.HSC Section 117935-SQG MWMP <br />_9.HSC Section 117943-SQG Shall keep <br />records for 3 years. <br />_10.HSC Section 117945-SQG not required toVIA <br />register shall keep records for 2 years. <br />r` <br />,� ' <br />11.HSC Section 117960-LQG shall file MWMP <br />ff( <br />with enforcement agency. <br />} F' t/) 7 kJ 11' 3�y-t" Yl®t L2 11 1 (Cc. I' c ✓C.L <br />_ <br />\ <br />_X_12.HSC Section 117975-LQG shall keep <br />records for 3 years. <br />Transportation <br />� <br />_13. HSC Section 118030-LQHE application. <br />Treatment/Storage <br />'� ` ✓S n"J20- <br />--16 1� <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 />hall 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 />_ <br />18.HSC Section 118225 -Treated sharps shall <br />be_destroyed or somehow prevent public access. <br />ca <br />_19.HSC Section 118275 -MW red bags, path, <br />chemo shall be labeled properly. <br />,_20.HSC Section 118280 -MW label & contain <br />-- �� ��� 1�� - e% - L)o= re D,'.✓S <br />_21.HSC Section 118285 -Sharps label/contain <br />_22.HSC Section 118295 -Proper decon used. <br />Lac Zule. ' l <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 />oe <br />_28.HSC Section 118222 -incineration Required <br />29 Other -Describe in narrative. <br />I Signature Received By Date <br />