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SAN JOAQUIN COUNTY ' Date 10, !3[M <br /> ENVIRONMENTAL HEALTH DEPARTMENT PR OU �ynto[e <br /> 1868 East Hazelton Ave., Stockton, CA 95205 <br /> (209)468-3420 <br /> cQCii�or'`h MEDICAL WASTE INSPECTION FORM <br /> FacilityName SA- 5aSto_�3t)S '�V\ FacilityAddresslgOON, Wt'f nr 1,. S ta1-, <br /> FacilityContact Jd�1t1 <br /> Title Q;f4c}ol OF ('ate Phone# �q ��� �1', <br /> INSPECTION TYPE: Moutine ❑Complaint ❑Re-inspection <br /> I <br /> VIOLATION(S) <br /> Registration THE ITEMS BELOW REPRESENT VIOLATIONS OF THE CALIFORNIA ' <br /> _1.HSC Section 117955-Large Quantity HEALTH & SAFETY CODE (HSC): <br /> Generator shall register with the enforcement <br /> agency prior to commencement of the generation of k <br /> medical waste. + `` d�„ 4 4 } -� �'�- � 1 <br /> _2.HSC Section 117903-Permit from the 11 <br /> eLlf <br /> nforcement agency required to treat medical LkS tD fWS d <br /> waste. , y� <br /> _3.HSC Section 117890-No large LQG shall U17G1 '3S lM Q. <br /> generate medical waste unless registered with the 1 t 1 ,l� 1} <br /> enforcement agency. 5�+ti t Yll o GtA am 1 r1 � 1t Stl'6A lyt 1 r <br /> _4.HSC Section 117895-SQG that treats med <br /> I waste shall register with enforcement agency. L Y <br /> f _5.HSC Section 117900-Shall not haul med S�,j1, [a7,nV'V%; 1 Y <br /> waste unless registered or obtained LQHE. } f 1 I <br /> _6.HSC Section 117903-Shall not treat med 1 1(1 1 T <br /> waste without permit from enforcement agency. <br /> _7.HSC Section 117908-Common Storage 1 ! <br /> facility shall be registered with local enforcement <br /> agency. 26 , <br /> Procedures <br /> _8.HSC Section 117935-SQG MWMP <br /> _9.HSC Section 117943-SQG Shall keep _4`_ •{ <br /> records for 3 years. <br /> _10.HSC Section 117945-SQG not required to }} <br /> register shall keep records for 2 years. ' S Afl n b <br /> _11.HSC Section 117960-LQG shall file MWMPm_ p <br /> with enforcement agency. '0 ry 1 <br /> _12.HSC Section 117975-LQG shall keep ` l� <br /> records for 3 years. <br /> Transportation _rk IA y <br /> _13.HSC Section 118030-LQHE application. <br /> TreatmentlStorage <br /> _14.HSC Section 118135-Shall obtain a permit <br /> from the enforcement agency to treat medical {�, i r r <br /> waste prior to treatingthe waste. 1 o e v_ L 1 <br /> 15.HSC Section 118765-AlI treatment records aS M U� <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 I <br /> anatomical parts shall be disposed of by interment <br /> unless otherwise hazardous. I =C--, T e.. Mb V4'Ai <br /> _18.HSC Section 118225-Treated sharps shall AD 1A\1S ILA �1()KL4,17COCA sk <br /> be destroyed or somehow prevent public access. <br /> _119.HSC Section 118275-MW red bags, path, <br /> chemo shall be labeled properly. <br /> X20.HSC Section 118280-MW label&contain <br /> 21.HSC Section 118285-Sharps labellcontain <br /> �22.HSC Section 118295-Proper decon used. <br /> 23.HSC Section 118307-Interim storage labeled <br /> ^24.HSC Section 118310-Enclosure labeled. <br /> P<25.HSC Section 118305-Cannot reuse drums <br /> 26.HSC Section 117630-Approved biohazard <br /> ba_g used. a J Via <br /> _27.HSC Section 118275(g)-Pharm labellstore <br /> _28.HSC Section 118222-Incineration Required Insp or Signature Received By Date <br /> 29 Other-Describe in narrative. <br />