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aaQ!''^► ° SAN JOAQUIN COUNTY Date C'), <br /> ENVIRONMENTAL HEALTH DEPARTME T PR ()S3(p tL13 <br /> 1868 East Hazelton Ave., Stockton, CA 95205 <br /> < (209)468-3420 <br /> MEDICAL WASTE INSPECTION FORM <br /> FacilityName C�&nt)e! TflaeL cal (Q�,�LFacilityAddress 901 E. c6nry( <br /> FacilityContact C.q- S w C�c_ Titleli tli c, ('nay c� r Phone# a19 -q 1 G <br /> INSPECTION TYPE: KRoutine ❑Complaint []Re-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. wn U1y u�i�,.,s at�k AX11"!lL J\ ) S <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 ��° �' ; S <br /> enforcement agency. S'. a <br /> _4.HSC Section 117895-SQG that treats med �ty ncf r of(� ° <br /> waste shall register with enforcement agency. l <br /> _5.HSC Section 117900-Shall not haul med j J2 S nSi f <br /> waste unless registered or obtained LQHE. <br /> _6.HSC Section 117903-Shall not treat med rw <br /> waste without permit from enforcement agency. 0�1 1, r <br /> _7.HSC Section 117908-Common Storage <br /> fat <br /> cility shall be registered with local enforcement <br /> agency. <br /> Procedures <br /> _8.HSC Section 117935-SQG MWMP S@,r� t�Q Sc,Lt7S <br /> _9.HSC Section 117943-SQG Shall keep <br /> records for 3 years. ° i <br /> _10.HSC Section 117945-SQG not required to <br /> register shall keep records for 2 years. ti& t �$ f <br /> 11.HSC Section 117960-LQG shall file MWMP 11 <br /> with enforcement agency. k K)1A S�e Qtjf)k)Al� (IJIL '!lT ile <br /> _12.HSC Section 117975-LQG shall keep 1 , <br /> records for 3 years. C"'Vj MCC C <br /> Transportation <br /> _13.HSC Section 118030-LQHE application. <br /> Treatment/Storage <br /> _14.HSC Section 118135-Shall obtain a permit i S <br /> Tom the enforcement agency to treat medical <br /> waste prior to treating the waste. <br /> _15.HSC Section 118765-All treatment records A ' > i ;,_\ M <br /> shall be kept for 3 years. 1.1 qh 1 <br /> _16.HSC Section 118215-All medical waste ` �� �1 0� �� <br /> shall be treated pursuant to this section. <br /> _17.HSC Section 118220-Recognizable human Cly i? �n <br /> anatomical parts shall be disposed of by interment \_ r 1 <br /> unless otherwise hazardous. o 2'r\"-°f b 1'- A c1/\ +j) �Q 'U t� O L LU T- <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, <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. 01)4 <br /> �a �L <br /> 27.HSC Section 118275(g)-Pharm label/store <br /> _28.HSC Section 118222-Incineration Required Insp for Signature Received By Date <br /> 29 Other-Describe in narrative. <br />