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GUIDELINES FOR THE MEDICAL WASTE MANAGEMENT <br /> PLAN <br /> Small quantity generators that provide Onsite Treatment and all large quantity generators <br /> shall have a Medical Waste Management plan on file with the San Joaquin County <br /> Environmental Health Department. The Medical Waste Management Plan shall contain the <br /> following information as appropriate for your facility: <br /> Business Name. .���to_T- SWC 9_r_ �" C '9+6 , 4 <br /> Business Address: 2-3 7% a c-C,-1, o r✓\'<— �:5t <br /> e l S2_G <br /> City State Zip Code <br /> Phone Number: ( ?-0") ) N q- 91 or) <br /> Type of Facility or Business:_ y w r'ak r J�z c' <br /> REGISTRATION FOR: <br /> ❑ Small Quantity Generator with Onsite Treatment(Generates less than 200lbs/month). <br /> N Large Quantity Generator Only(Generates 200 lbs or more/month). <br /> ❑ Large Quantity Generator with Onsite Treatment(Generates 200 lbs or more/month). <br /> Person responsible for implementation of the Medical Waste Management Plan: <br /> Name: Title: �- <br /> Phone: ZVI 01 C Date: <br /> 1. List the types of medical waste generated at your facility, i.e., laboratory wastes,blood or body <br /> quips, sharp ,contaminated animals,surgical specimens,trace chemo or isolation wastes": <br /> te <br /> ® l S e S <br /> cclS <br /> a) Dyou generate ay pharmaceutical waste(expired/outdated,spent,partials,)? <br /> b) Yes ❑No <br /> If yes, describe the type of pharmaceutical waste(expired, spent,partials,outdated,patient <br /> returns,etc): 1 ( <br /> And estimate the monthly amount of pharmaceutical waste generated at your <br /> facility: <br /> EHD 45-03 5 <br /> 10/6/2006 <br />