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SAN JOAQUIN COUNTY Date aq 12. <br /> c ENVIRONMENTAL HEALTH DEPARTMENT PR 6SIS t <br /> { 1868 East Hazelton Ave., Stockton, CA 95205 <br /> (209)468-3420 <br /> P MEDICAL WASTE INSPECTION FORM <br /> FacilityName AMbI��A�-�f , S �e��-�r FacilityAddress a"Mt N� wi�()Jnvlckl 4. <br /> FacilityContact Title Phone#(.109) 94L[-110b <br /> INSPECTION TYPE: VRoutine ❑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 tt ` <br /> medical waste. f ,)e. no Q o0 e A a U f of L ti <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 e ' <br /> enforcement agency. 0 c5'• Ce>> ((1 f N <br /> _4.HSC Section 117895-SQG that treats medAo LAP'Ji S 111' ° T <br /> waste shall register with enforcement agency. <br /> _5.HSC Section 117900-Shall not haul med Z 0'PAII 's <br /> waste unless registered or obtained LQHE. ,1 f e n� <br /> _6.HSC Section 117903-Shall not treat med �� ) f rl <br /> waste without permit from enforcement agency. CU �, S 'C �5� 'a. <br /> _7.HSC Section 117908-Common Storage <br /> facility shall be registered with local enforcement <br /> agency. <br /> Procedures �- �cr ° i ^s (10 n m' <br /> _8.HSC Section 117935-SQG MWMP ® 0 <br /> _9.HSC Section 117943-SQG Shall keep rr <br /> records for 3 years. Ckf \n . r U ° <br /> _10.HSC Section 117945-SQG not required to y ;S , G ' ° <br /> register shall keep records for 2 years. (,l l �( Al <br /> 11.HSC Section 117960-LQG shall file MWMP <br /> with enforcement agency. 1- W- 00 CkJ, <br /> 11106011 1A <br /> _12.HSC Section 117975-LQG shall keep I�UST� Und. tYlvls pS� P/tI > <br /> records for 3 years. <br /> Transportation <br /> _13.HSC Section 118030-LQHE application. l .1 SIL CAI <br /> r <br /> Treatment/Storage r <br /> _14.HSC Section 118135-Shall obtain a permit <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. `T <br /> _16.HSC Section 118215-All medical waste ` _ <br /> shall 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 3 n <br /> be destroyed or somehow prevent public access. LA) AWI <br /> _19.HSC Section 118275-MW red bags,path, 1 in - <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 Inspfffitor Signature keceiveZf By ate <br /> 29 Other-Describe in narrative. <br />