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MEDICAL WASTASPECTION REPORT • Date: C San Joaquin County Environmental Health Department Program 1868 E.Hazelton Ave.,Stockton,CA 95205 Record: \ p (209)468-34 Program www.siogv.org/g/ehd Element: Facility Name Address City Zip Code Ambulatory Surgery Center of Stockton 2388 n.California street Stockton 95204 Facility Contact Title Phone Number Email Inspection Type Gary Bry Materials Manager 209-380-6149 ;16r� q, Lk Routine The above facility is inspected for compliance with Division 104,Part 14 of California Health and Safety Code(H C) Registration Treatment ❑ HSC 117890-No LOG shall generate medical waste unless HSC 118130-All onsite medical waste treatment facilities shall 1 registered with the EA. El 17' be permitted by the EA. ❑ 2 HSC 117950-LOG shall register with the EA prior to generating medical waste. El18. HSC 118165-All treatment records shall be kept for 3 years. ❑ 3 HSC 117903-Permit from the EA is required prior to treating ❑ 19 HSC 118215-All medical waste shall be treated pursuant to medical waste. this section. HSC 117925-SQG that treats medical waste onsite shall HSC 118220-Pathology waste of a human nature shall be ❑ 4' register with the EA. ❑ 20. disposed of by interment, incineration,or an approved alternative. HSC 117900-Shall not haul medical waste unless registered, HSC 118222-Contaminated pathology waste,trace chemo ❑ 5. common carrier,trauma scene practitioner,or exempted ❑ 21. waste,or pharm waste from health care settings shall be treated under the MOT exemption. by incineration or an approved alternative. ❑ 6 HSC 117928-Common Storage Facility shall have permit ❑ 22. HSC 118225-Sharps waste shall be treated pursuant to this issured by the EA. section. ❑ 7 HSC 117890-LOG shall notify EA 72 hours prior to Containment/Storage participating in temporary event. ❑ 8 HSC 117895-SQG shall notify EA 72 hours prior to ❑ 23 HSC 117630-Biohazard bag shall meet the standards set forth participating in temporary event. in this section. HSC 118275-Medical, biohazardous,sharps,trace chemo, Records/Documentation ® 24 pathology,or pharmaceutical waste shall be segregated and contained pursuant to this section. The container shall be properly labeled. ❑ 9. HSC 117935-Registered SQG shall file MWMP with the EA. ❑ 25 HSC 118280- Biohazard bags shall be containerized and stored pursuant to this section. ❑ 10. HSC 117943-SQG required to register shall maintain ❑ 26 HSC 118285-Sharps waste shall be containerized and stored treatment and shipping and tracking records for 3 years. pursuant to this section. ❑ 11. HSC 117945-SQG not required to register shall maintain El 27 HSC 118295-Containers shall be washed and decontaminated information document and transportation records for 3 years. pursuant to this section. ® HSC 118305- Reuseable drums or conainters used for medical 12. HSC 117960-LQG shall file MWMP with the EA. ❑ 28. waste shall not be used for other storage. ❑ HSC 117975-LOG shall maintain treatment and shipping and 29HSC 118307- Intermediate storage area shall be secured and 13. tracking documents for 2 years. ❑ ' marked with proper signage. Transportation ❑ 30. HSC 118310-Designated accumulation area shall be secured and marked with proper signage. ❑ 14. HSC 117946-MOT exemption requirements for SQG. Other ❑ 15. HSC 117976-MOT exemption requirements for LOG. ❑ •31. ❑ 16. HSC 118032-Pharmaceutical waste hauling exemption. ❑ 32. Received by: Print: Gary Bry Signature: Phone:-209-380-6149 Specialist: Print: J.Easter Signature: Phone: 209-953-7310 Reinspecion on/about: A reinspection fee of$152 per hour may be charged. Page 1 of 2 EH-11/17 &I-_-_