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P city SAN JOAQUIN COUNTY Date LAIld 11 <br /> c <br /> ENVIRONMENTAL HEALTH DEPARTMENT PR bS 43 <br /> z 600 East Main Street, Stockton, CA 95202 <br /> (209)468-3420 <br /> T <br /> MEDICAL WASTE INSPEC I ION FORM <br /> Facili lcaiw krmtkAe- t, Facility rens a185 W_ GtkA Urv, Rra. <br /> Faceli Contact 'j®nio,. Sin w Title SIAJIA (J004f)4,hbr Phone# `15-$Its <br /> INSPECTItine []Complaint oRe-Inspection <br /> VIOLATION(S) <br /> Registration THE ITEMS BELOW REPRESENT VIOLATIONS OF THE CALIFORNIA <br /> _1.HSC Section 117955-Large Quantity HEALTH o: SAFETY CODE (HSC): <br /> Generator shall register with the enforcement <br /> agency prior to commencement of the generation of <br /> medical waste. o <br /> � <br /> _2.HSC Section 117903-Permit from the *° C (A 10 U G blA� <br /> enforcement agency required to treat medical Cb4fAlntf <br /> waste. <br /> _3.HSC Section 117890-No large LQG shall 1lC141xWra U <br /> generate medical waste unless registered with theAw <br /> W u <br /> enforcement agency. a <br /> _4.NSC Section 117895-SQG that treats medt a ` S S f _-1 , <br /> waste shall register with enforcement agency. C!!� <br /> _5.HSC Section 117900-Shall not haul med <br /> waste unless registered or obtained LQHE. \- , p <br /> _6.HSC Section 117903-Shall not treat med d\ ►'kAl rAl 0 n Wou M 'C <br /> waste without permit from enforcement agency. 19A \1 <br /> 7.HSC Section 117908-Common Storage c+ <br /> _facility shall be registered with local enforcement G <br /> agency. <br /> Procedures <br /> _8.HSC Section 117935-SQG MWMP j\ ; �l ^T 1 ; 1Al� ll7G <br /> _9.HSC Section 117943-SQG Shall keep <br /> records for 3 years. (N <br /> _10.HSC Section 117945-SQG not required to a <br /> register shall keep records for 2 years. <br /> with <br /> Section 117960-LQG shall file MWMP q <br /> with enforcement agency. `1 p c� t° a t. <br /> _12.HSC Section 117975-LQG shall keep , <br /> records for 3 years. a S <br /> Transportati®n In A o..[,c_&5S I U0 incnm SA&A <br /> _13.HSC Section 118030-LQHE application. ® ® <br /> Treatment/St®rage <br /> _14.HSC Section 118135-Shall obtain a permit ® Cc�m AIN <br /> from the enforcement agency to treat medical , \ , <br /> waste prior to treating the waste. I UUm <br /> _15.HSC Section 118765-All treatment records <br /> shall be kept for 3 years. <br /> _16.HSC Section 118215-All medical waste ` i U� <br /> shall be treated pursuant to this section. <br /> _17.HSC Section 118220-Recognizable human ba&� CA V_uc f tA L0 <br /> anatomical parts shall be disposed of by interment <br /> unless otherwise hazardous. epS��ru, catlq <br /> _18.HSC Section 118225-Treated sharps shall <br /> e destroyed or somehow prevent public access. l u� <br /> - V1 9.HSC Section 118275-MW red bags,path, r j <br /> chemo shall be labeled properly. <br /> _)Q20.HSC Section 118280-MW label&contain \ <br /> _21.HSC Section 118285-Sharps label/contain <br /> 22.HSC Section 118295-Proper decon used. <br /> 23.HSC Section 118307-Interim storage labeled <br /> _ .HSC Section 118310-Enclosure labeled. <br /> _25.HSC Section 118305-Cannot reuse drums <br /> _26.HSC Section 117630-Approved biohazard <br /> bag used. ��� 1 <br /> 27.NSC Section 118275(g)-Pharm label/store _ <br /> �&_28.HSC Section 118222-Incineration Required rnspdtor Signature Received By Date <br /> 29 Other-Describe in narrative. <br />