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SAN JOAQUIN COUNTY Date/0-c2-7-/g2 <br /> OIRONMENTAL HEALTH DEPARTO PR EU z-f4cam <br /> 600 East Main Street, Stockton, CA 95202 <br /> (209)468-3420 <br /> MEDICAL WASTE INSPECTION FORM <br /> FacilityName SJ J, pj A. ilityAddress Q5'oS- 4), I-Iq <br /> FacilityContact �S r.Lf,-iNrd_-7 —Title-0-ani- ope&,,26,,y�, A,&,W/Phone# 5D( - 6oq::7 <br /> INSPECTION TYPE: Moutine []Complaint oRe-inspection <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. <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 Lr. Ing-dc, a <br /> generate medical waste unless registered with the <br /> enforcement agency. <br /> CDC lals Z j= In <br /> 4.HSC Section 117895-SQG that treats med C J� <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 /> waste without permit from enforcement agency. <br /> THSC Section 117908-Common Storage <40,C4 t<AjV)ej"Z: � CA ) 1:�a :Al2 cd <br /> facility shall be registered with local enforcement Lk <br /> agency. =Aj A 1 ZE6 d r--Znd I 6AZ I C23 Jk_ <br /> Procedures ZL2 <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 LaC4 <br /> register shall keep records for 2 years. <br /> I I.HSC Section 11 7960-LQG shall file MWMP <br /> �with enforcement agency. -.ffiy� P leij,-,-. YY-CeA Ar-c it <br /> —12.HSC Section 117975-LQG shall keep <br /> records for 3 years. 012� cd dec)32 <br /> Transportation <br /> —13.HSC Section 118030-LQHE application. <br /> Treatment/Storage <br /> 14.HSC Section 118135-Shall obtain a permit AfrAAA k2 :1h,a, Y, <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 /> 16.HSC Section 118215-All medical waste <br /> _s_h`all 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 /> —18.HSC Section 118225-Treated sharps shall <br /> be-destroyed or somehow prevent public access. <br /> X 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 /> —23.HSC Section 118307-interim storage labeled <br /> —24.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 <br /> —28.HSC Section 118222-Incineration Required 14Ye 1co�rSignature � eceived By <br /> e <br /> 29 Other-Describe in narrative. L-.,/Da( <br />