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11 <br />SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 East Hazelton Ave., Stockton, CA 95205 <br />(209) 468-3420 <br />MEDICAL WASTE INSPECTION FORM <br />Date 11f x`13, <br />PR o00001p <br />FacilityName Srk• 1coe3,4� s r'Dsoi�'a, FacilityAddress '�yv N• G�i�olnio� 4.)Skac'lto^ <br />FacilityContact 76yn kenJ l - Title Ops-- Phone ab4 <br />111 � MU A1111111111 <br />���� • ;� <br />oComplaint olke-inspection <br />VIOLATION(S) <br />Registration <br />_ 1. NSC 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 />_2. HSC Section 117903 -Permit from the <br />enforcement agency required to treat medical <br />waste. <br />HSC Section 117890 -No large LQG shall <br />t syj s ' a A } S S ,JUir� <br />L Sol lA Il (Lk 3 J lJtr, <br />n t0 rtl Ti (A le!A, <br />_3. <br />generate medical waste unless registered with the <br />enforcement agency. <br />4. HSC Section 117895-SQG that treats med <br />waste shall register with enforcement agency. <br />_5. NSC Section 117900 -Shall not haul med <br />waste unless registered or obtained LQHE. <br />_6.HSCSection 117903 -Shall not treat med <br />waste without permit from enforcement agency. <br />_7.HSC Section 117908 -Common Storage <br />Cy �i nlM <br />p Uva I.S.Tv\tLC UOL—At t1t. Ila& ��5�el� On 2 S . Skbm <br />t t <br />Ul A.c-nu- t3f 4.a1>VA14w% if sib?� Cc hlrA1 gill <br />T— <br />facility shall be registered with local enforcement <br />agency. <br />Procedures <br />a 1 U 'l 5 " r, A� I& ►+' n <br />, 1 " i n i; DS1l 1 r1 rca, <br />In <br />_8.HSC Section 417935-SQG MWMP <br />_9.HSC Section 117943-SQG Shall keep, <br />records for 3 years. <br />_10.HSC Section 117945-SQG not required to1 <br />register shall keep records for 2 years. <br />11.HSC Section 117960-LQG shall file MWMP <br />with enforcement agency. <br />_12.HSC Section 117975-LQG shall keep <br />1 SS ILL, \'& ,a Lb S U n 5; C® <br />(,u,n t18 evs M \"- 1 ��G� �; � 13 <br />�}i� U �1�+/�( <br />records for 3 years. <br />Transportation <br />ll�l�) S c art- 144;ncfs <br />_13. NSC Section 118030-LQHE application. <br />Treatment/Storage <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 118765-AII treatment records <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 />_18.HSC Section 118225 -Treated sharps shall <br />destroyed or somehow prevent public access. <br />destroyed <br />Section 118275 -MW red bags, path, <br />Sm� f� Q ��^5 �' <br />` <br />S i 3 !/ti� ywc� red% <br />w no n- AN, r� i �� Sl_ % f � - (�_ �; <br />`�" <br />G e v 1 �l 16,O _ �rW o <br />4 L l,' A� Jj� S L { <br />M 1 W� d� S i _ l - -Aid Ist) <br />t <br />a <1 W W At �Me t.►� <br />oshall be labeled properly. <br />Rch;20.HSC Section 118280 -MW label &contain <br />1.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 />_-- <br />Kmp <br />Ins ctor Signature Received By Date <br />29 Other -Describe in narrative. <br />