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�pPq`'!^'..cQ SAN JOAQUIN COUNTY 16 Date S (01 I <br /> c ENVIRONMENTAL HEALTH DEPARTMENT PR 018161L42, <br /> Q Z� 600 East Main Street, Stockton, CA 95202 <br /> (209)468-3420 <br /> ..... P MEDICAL WASTE INSPECTION FORM <br /> FacilityName Qnw rk 1 MuMcaCe,)rtc FacilityAddress lol <br /> FacilityContact Suu.,6:0L Title r3i niC,1'(1L&n Cf Phone4Q li -11'713 <br /> INSPECTION TYPE: outine oComplaint ❑ e-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 't' a e,� U U 4cllrl- <br /> waste. <br /> _3.HSC Section 117890-No large LQG shall ('V Lt'tQrs <br /> generate medical waste unless registered with the it o c 4POA <br /> G <br /> enforcement agency. ) <br /> _4.HSC Section 117895-SQG that treats med ° 1� lA <br /> waste shall register with enforcement agency. <br /> _5.HSC Section 117900-Shall not haul med 1 9s j a <br /> waste unless registered or obtained LQHE. <br /> _6.HSC Section 117903-Shall not treat med <br /> waste without permit from enforcement agency. <br /> _7.HSC Section 117908-Common Storage �- c T 1 t1 <br /> facility shall be registered with local enforcement ► 12 °Lfit ° $ <br /> agency. , <br /> Procedures ' c <br /> _8.HSC Section 117935-SQG MWMP c f�1 Lt e UJ S <br /> _9.HSC Section 117943-SQG Shall keep <br /> records for 3 years. fAI23, t 0 p <br /> _10.HSC Section 117945-SQG not required to <br /> register shall keep records for 2 years. U v ' P rk <br /> 11.HSC Section 117960-LQG shall file MWMP <br /> With enforcement agency. <br /> _12.HSC Section 117975-LQG shall keep t <br /> records for 3 years. Gtl1 <br /> Transportation u 12 L.1 ' e- <br /> _13.HSC Section 118030-LQHE application. t 1 S ` <br /> Treatment/Storage <br /> _14.HSC Section 118135-Shall obtain a permit VA�(IfAeZk t 00 71 TO V `U (TV <br /> from the enforcement agency to treat medical <br /> waste prior to treating the waste. 14 <br /> _15.HSC Section 118765-All treatment records <br /> 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 human G t S t K.t? <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 /> _19.HSC Section 118275-MW red bags,path, ( f G L <br /> chemo shall be labeled properly. <br /> -IL20.HSC Section 118280-MW label&contain bi 1LI,l� <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 /> ba_g used. <br /> _27.HSC Section 118275(g)-Pharm label/store <br /> _28.HSC Section 118222-Incineration Required Inspe r Signature Received By Date <br /> 29 Other-Describe in narrative. <br />