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Date 3tholoz <br /> Record 10 Fix SI 3Zg <br /> Prog Elem !q!5� <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 304 E.Weber Ave.,Third Floor, Stockton, CA 95202 <br /> (209)468-3420 <br /> MEDICAL WASTE INSPECTION FORM <br /> Facility Name i Facility Address Zcc✓✓ <br /> Facility Contact Title -yj. M#x'jPFSone#fie <br /> INSPECTION TYPE: ❑Routine ❑Complaint IfReinspection <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 <br /> of medical waste. <br /> _2.HSC Section 117903-Permit from the <br /> enforcement agency required to treat medical y- S <br /> waste. <br /> _3.HSC Section 117890-No large LQG shall <br /> generate medical waste unless registered with 1 Icai,I r\P��..fi`r ^ u1. <br /> the enforcement agency. [1 <br /> _4.HSC Section 117895-SQG that treats med S ��� �ra be,( DC\ -e-),A n Or--<,- <br /> waste shall register with enforcement agency. <br /> _5.HSC Section 117900-Shall not haul med <br /> waste unless registered or obtained LQHE. ;� n <br /> _6.HSC Section 117903-Shall not treat med 1115 n+tomfn�� I(1P i1A 1 )SCC 40 1 <br /> waste without permit from enforcement agency. <br /> _7.HSC Section 117908-Common Storage t�-»�� Cn(l( A n0 r\Pv1S tC- <br /> facility shall be registered with local enforcement ` <br /> ca- <br /> agency. <br /> Procedures <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 /> treter shall keep records for 2 years. <br /> 1.HSC Section 117960-LQG shall file <br /> MWMP with enforcement agency. <br /> _12.HSC Section 117975-LQG shall keep <br /> records for 3 years. <br /> Transportation o- n a cL U m r+-e QU -Eitu I�ur_�. � <br /> 13.HSC Section 118030-LQHE application. �l L �`'--'�t n i— ` '} 5 t- <br /> PD[�f7�( <br /> Treatment/Storage 0 <br /> _14.HSC Section 118135-Shall obtain a <br /> permit from the enforcement agency to treat *� I <br /> medical waste prior to treating the waste. <br /> _15.HSC Section 118765-All treatment <br /> records 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 <br /> human anatomical parts shall be disposed of by <br /> interment unless otherwise hazardous. <br /> _18.HSC Section 118225-Treated sharps shall <br /> be destroyed or somehow prevent public access. <br /> be destroyed <br /> Section 118275-MW red bags,path, <br /> chemo shall be labeled properly. <br /> 20.HSC Section 118280-MW label&contain <br /> ]1.HSC Section 118285-Sharps label/contain <br /> 2.HSC Section 118295-Proper decon used. <br /> 23.HSC Section 118310-Enclosure labeled. <br /> 24.HSC Section 118305-Cannot reuse drums <br /> _25.HSC Section 117630-Approved biohazard <br /> bag used. <br /> 26.Other-Describe in narrative. <br /> Ins ect r Signature Rec ived By <br />