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�oPa�: • co SAN JOAQUIN COUNTY V Date 1,1110 _ <br /> ENVIRONMENTAL HEALTH DEPARTMENT PR OgSDQ0.6 <br /> { 600 East Main Street, Stockton, CA 95202 <br /> (209)468-3420 <br /> MEDICAL WASTE INSPECTION FORM <br /> t/FOS <br /> FacilityName (`IlaAcc.,,, CcAre.d f1�ln,_1�. teCLe_r FacilityAddress 1410 Ea4t,, A ftlu(1�cc.w <br /> FacilityContact Latc,lt I�u� rnu•, T it1e__AarajA-k%_Phone#6 <br /> INSPECTION ® KRoutine EiComplaint ®i s cti <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 <br /> medical waste. 1 'i0% i !Q J ' 1 <br /> 2.HSC Section 117903-Permit from the <br /> e_nforcement agency required to treat medical f_ C&ILSII (11b n s i to <br /> waste. 11 <br /> _3.HSC Section 117890-No large LQG shall b n ANL <br /> N L J%)l-, si48101) r1 CLnA 7 rc Ptd M - A%,rg <br /> generate medical waste unless registered with the ,\ p <br /> enforcement agency. � ,�"" L - <br /> _4.HSC Section 117895-SQG that treats med f , ' a�X Si 't a, <br /> waste shall register with enforcement agency. <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 11 <br /> waste without permit from enforcement agency. a 3 (� .. O�t� , t G (U S° <br /> _7.HSC Section 117908-Common Storage <br /> facility shall be registered with local enforcement ^ feW CkAGk AQ11:1121CALIA <br /> \h. <br /> agency. <br /> Procedures 5;c,r�,�e �1n9: Si4nutie� ��n�.,l rc�� ®' Cru tin-W&utr'd� <br /> _8.HSC Section 117935-SQG MWMP CJ w e S A <br /> _9.HSC Section 117943-SQG Shall keep l <br /> records for 3 years. ryjA i t1 Spg n,Sn :1" lwiy,® I ASA <br /> _10.HSC Section 117945-SQG not required to 1 <br /> register shall keep records for 2 years. -��� c}u�� ( a. TivAl c a, Uaf t.Sh. "ko a (LIP-rd, I LIta Vc . <br /> 11.HSC Section 117960-LQG shall file MWMP tn1 y <br /> with enforcement agency. l 071 S e t.1 9� 1� 11't ilk- <br /> �k,12.HSC Section 117975-LQG shall keep <br /> records for 3 years. <br /> Transportation 3 11'1`t"15— °`i <br /> _13.HSC Section 118030-LQHE application. o <br /> Treat ent/ torae <br /> _14.HSC Section 118135-Shall obtain a permit _ Z. 10 b 1 lU - y11S 1D <br /> From the enforcement agency to treat medical `_ <br /> waste prior to treating the waste. 5Ial9 1U �L11']1-0n�tA a 11 1b• g 1-M I to . Syj) (ec.Osas <br /> _15.HSC Section 118765-All treatment records nuc 11� MKlr1T`ti nod Otl Sti�G '1t9f�'1!,f�,�4tA iS (kna ILIA) <br /> shall be kept for 3 years. 11 <br /> _16.HSC Section 118215-All medical waste <br /> shall be treated pursuant to this section. <br /> _17.HSC Section 118220-Recognizable human 9- o i <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 label/contain <br /> _22.HSC Section 118295-Proper decon used. <br /> K23.HSC Section 118307-Interim storage labeled <br /> Y24.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 ,_ 4 <br /> 28.HSC Section 118222-Incineration Required Inspe or Signature ReC d By ate <br /> 29 Other-Describe in narrative. <br /> PPE 1 <br />