Laserfiche WebLink
WIFF., M- of I W."I 0, N -rum 3 W."I 11,1,4 VLV41 OWN I <br />1868 E. Hazelton Avenue <br />Stockton, California 95205 <br />Telephone: (209) 469-3420 <br />Fax: (209) 468-8392 <br />Small quantity generators that provide onsite treatment and all large quantity generators shall have a <br />Medical Waste Management plan on file with the San Joaquin County Environmental Health Department. <br />The Medical Waste Management Plan shall contain the following information as appropriate for your <br />facility: <br />Business Name: &"rC!A 04(tc ceAvew- <br />Business Address. -//0 c5dS7-A.?QO.O t -VC <br />6f *'/une-it tf C4 k-33& <br />City State Zip Code <br />Phone -Number: ;20 <br />� ) 122 2. <br />Typeof Facility or Business:A)Ue-,'T"& F4CXZ-r7-Y <br />REGLSTRATIONFOR:- <br />❑ Small Quantity Generator with Onsite Treatment (Generates less than 200 lbs/month). <br />Large Quantity Generator Only (Generates 200 lbs or more/month). <br />❑ Large Quantity Generator with Onsite Treatment (Generates 200 lbs or more/month). <br />Person responsible for implementation of the Medical Waste Management Plan: <br />Name: W; ((c '- &( OW Title: <br />Phone:C2,d,'X2Z5—'-Z22,2= Date: <br />1. List the types of medical waste generated at your facility (i.e. laboratory wastcs, blood or body <br />fluids, sh s; contaminated animals, surgical Specimens, trace chemo <br />or isolation wastes): <br />dod-4 62", <br />IR 0 <br />If yes, describe the type of pharmaceutical waste (expired, spent, partials, patient returns): <br />EV4�ieeA--eadr�A- <br />E14D AS -03 5 <br />2015 <br />