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0 SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMEO <br />600 East Main Street, Stockton, CA 95202 <br />(209) 468-3420 <br />MEDICAL WASTE INSPECTION FORM <br />Date /0- / 13 <br />PR ySn it h <br />FacilityName FacilityAddress L,c41y7 t° <br />FacilityContact 6A4,k,ALjyZ, �,,� „ .n Title �t 14 s , e,.I'c AI 7 3- Phone# X01- LCA -Ct5_h03 <br />I INSPECTION TYPE: O13outine []Complaint []Re -inspection I <br />VIOLATION(S) <br />Registration <br />THE ITEMS BELOW REPRESENT VIOLATIONS OF THE CALIFORNIA <br />_ 1. HSC Section 117955 -Large Quantity <br />Generator shall register with the enforcement <br />HEALTH & SAFETY CODE (HSC): <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 />_3. HSC Section 117890 -No large LQG shall <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. HSC Section 117900 -Shall not haul med <br />waste unless registered or obtained LQHE. <br />_6.HSC Section 117903 -Shall not treat med <br />-1 <br />waste without permit from enforcement agency. <br />_7.HSC Section 117908 -Common Storage <br />facility shall be registered with local enforcement <br />agency. <br />Procedures <br />/ <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 />_11.HSC Section 117960-LQG shall file MWMP <br />with enforcement agency. <br />►' <br />_12.HSC Section 117975-LQG shall keep <br />records for 3 years. <br />C, <br />Transportation <br />yv <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 118765 -All treatment records <br />shall be kept for 3 years. <br />i <br />Section 118215 -All medical waste <br />_16.HSC <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 />y <br />_18.HSC Section 118225 -Treated sharps shall <br />be destroyed or somehow prevent public access. <br />1a h <�-� L .� �,i `� ✓� <br />40C-ti�.loe <br />-D9.HSC Section 118275 -MW red bags, path, <br />chemo shall be labeled properly. <br />420.HSC Section 118280 -MW label & contain <br />:tln --p ��� �� S �>n G� " <br />_21.HSC Section 118285 -Sharps label/contain <br />I ( g <br />_22.HSC Section 118295 -Proper decon used. <br />Ar) -t-, '(4l5 v I/ <br />_23.HSC Section 118307 -Interim storage labeled <br />_24.HSC Section 118310 -Enclosure labeled. <br />1 <br />,Za -mss —? 1 <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 />1t0 Signature eceived By Date <br />_28.HSC Section 118222 -Incineration Required <br />29 Other -Describe in narrative. <br />