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o� UaH. o SAN JOAQUIN COUNTY Date 4125I1M <br /> ENVIRONMENTAL HEALTH DEPARTMENT PR ®53 IUS <br /> .� 1868 East Hazelton Ave., Stockton, CA 95205 <br /> a (209)468-3420 <br /> ea�ti;oR�`� MEDICAL WASTE INSPECTION FORM <br /> FacilityName (_N)t ,-(�1 m(?! ) ,. ubcr Fadlity ddress 101 C. L ,n l 'A. <br /> FacilityContact Qo vka Lac j Title elm &,ic, t'nta"b' Phone aM I'73--QRQ� <br /> INSPECTION PE: iR outine ❑Complaint ❑ 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 /> i <br /> medical waste. »�1 - ng OcheA (� ®r;lwt 'S 1�SP2c. ►�'� <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 Not , 1_ 1 1 1 9 4� <br /> QS P r.+r(Z10L(Qi< Ct®l 1hS cLLC(Lt1/1Q1� 1� p ksrcyt►1an <br /> enforcement agency. l.N �—T--T <br /> 4.HSC Section 117895-SQG that treats med 1IA t Pt�t <br /> waste shall register with enforcement agency. <br /> _5.HSC Section 117900-Shall not haul med lnD ti nfner <br /> waste unless registered or obtained LQHE. <br /> _6.HSC Section 117903-Shall not treat med <br /> waste without permit from enforcement agency. L <br /> _7.HSC Section 117908-Common Storagen� �ran l C ClWtn P <br /> facility shall be registered with local enforcement \`mac a <br /> agency. <br /> �1 <br /> Procedures 1 _V1 A -M,n� -ca 1A ,Ai� �C�ttjjn &A, <br /> _8.HSC Section 117935-SQG MWMP '1 <br /> _9.HSC Section 117943-SQG Shall keep '):,T14EMIMALALZ41, 1n?U.5 <br /> records for 3 years. <br /> _10.HSC Section 117945-SQG not required to 11 , // r► <br /> register shall keep records for 2 years. rj t;,rr"7cA GU tai 4- 1' t�aukj \A (''Xn <br /> _11.HSC Section 117960-LQG shall file MWMP <br /> with enforcement agency. lzgac. , <br /> _12.HSC Section 117975-LQG shall keep ,1 <br /> records for 3 years. Ul ty c �, �� (A t V\ MUS q),A ,t thA <br /> Transportation Stn -�s 1AA l �tv <br /> _13.HSC Section 118030-LQHE application. p <br /> Treatment/Storage KVA', c i . <br /> _14.HSC Section 118135-Shall obtain a permit Cj� n A - wi <br /> from the enforcement agency to treat medical <br /> waste prior to treating the waste. <br /> _15.HSC Section 11 8765-All treatment records ° , 7 <br /> shall be kept for 3 years. <br /> _16.HSC Section 118215-All medical waste ► f <br /> shall be treated pursuant to this section. <br /> _17.HSC Section 118220-Recognizable human (r_W.*c1 S. ` Afts 3 su <br /> anatomical parts shall be disposed of by interment to t�1, ` 1� <br /> unless otherwise hazardous. 'f <br /> _18.HSC Section 118225-Treated sharps shall y A <br /> be destroyed or somehow prevent public access. Lu (L�q i^ t k!A C1(1L 11L cc .U3 A,;- <br /> 19.HSC Section 118275-MW red bags,path, <br /> chemo shall be labeled properly. ll-- <br /> 20.HSC Section 118280-MW label&contain �1 <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 Insp for Signature ecelved y Date <br /> 29 Other-Describe in narrative. <br />