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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 t la h3 <br />PR 0'AS oobb <br />FacilityNa a <br />5A, us�1,° s <br />Ido ior�d, <br />FacilityAddress W30 t1. Culo�'os�, S� ; S�Uc�cc Gn <br />FacilityContact <br />S�Chn nla <br />k <br />Title C,f`jor jy�,S_ Phone# ��O'7" <br />' ■ ;i <br />[]Complaint oRe-inspect= <br />VIOLATION(S) <br />Registration <br />THE ITEMS BELOW REPRESENT VIOLATIONS OF THE CALIFORNIA <br />_ 1. NSC Section 117955 -Large Quantity <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 />en_forcement agency required to treat medical <br />9 _- <br />waste. <br />_3. HSC Section 117890 -No large LQG shall <br />generate medical waste unless registered with the� <br />enforcement agency. <br />4. NSC Section 117895-SQG that treats med <br />waste shall register with enforcement agency. <br />_5. HSC Section 117900 -Shall not haul med <br />waste unless registered or obtained LQHE. <br />1nx 1� <br />Q A', " 5,9 SLkoAcn b <br />Section 117903 -Shall not treat med <br />_6.HSC <br />waste without permit from enforcement agency. <br />_THSC Section 117908 -Common Storage <br />facility shall be registered with local enforcement <br />agency. <br />Procedures <br />3 e �Ln, ��, Ky�i cy+ .�S <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 to <br />register shall keep records for 2 years. <br />5f1k9 'p k <br />f �, <br />W til �liU,oC� rr <br />_II.HSC Section 117960-LQG shall file MWMP <br />with enforcement agency. <br />_12.HSC Section 117975-LQG shall keep <br />records for 3 years. <br />WN 61 Ur 1 fir' <br />Transportation <br />_13. HSC 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 11 8765 -All 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 />be destroyed or somehow prevent public access. <br />_19.HSC Section 118275 -MW red bags, path, <br />chemo shall be labeled properly. <br />20.HSC Section 118280 -MW label & contain <br />_21.HSC Section 118285 -Sharps Iabel1contain <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 />��l <br />27.HSC Section 118275(8)-Pharm label/storeA'1.. <br />_28.HSC Section 118222 -Incineration Required <br />29 Other -Describe in narrative. <br />-- -- <br />— <br />Inspe or Signature Received By Date <br />WWI <br />