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0 <br />SAN JOAQUIN COUNTY 9 <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 East Hazelton Ave., Stockton, CA 95205 <br />(209) 468-3420 <br />MEDICAL WASTE INSPECTION FORM <br />Date 1111=1 <br />PR nk50,0u S <br />FacilityName SJ� %c.WLA lAgp!N a1 "j ty ddress 6U ll,�. � + <br />(Puwt t 'dog W_LV0'4' <br />FacilityContact eN�i ti1�s�;nr3 L®ji Lif Title r %. Phone c� <br />vl aaf <br />INSPECTION TYPE: outine ❑Complaint ❑Re -inspection <br />•Zi <br />Registration <br />THE ITEMS BELOW REPRESENT VIOLATIONS OF THE CALIFORNIA <br />_ 1. HSC Section 117955 -Large Quantity <br />HEALTH & SAFETY CODE (HSC): <br />Generator shall register with the enforcement <br />agency prior to commencement of the generation of <br />medical waste. <br />_2. HSC Section 117903 -Permit from the <br />enforcement agency required to treat medical01 <br />L r7 51 (� Ct,f eth� t c t <br />n b <br />waste. <br />_3. HSC Section 117890 -No large LQG shall <br />Q ,j 1A,4S: 1 XA <br />`� �� nl C <br />generate medical waste unless registered with the, <br />enforcement agency. <br />_4. HSC Section 117895-SQG that treats med <br />waste shall register with enforcement agency. <br />_5. HSC Section 117900 -Shall not haul med <br />waste unless registered or obtained LQHE. <br />Section 117903 -Shall not treat med <br />L2W) CA <br />3 S CLO v <br />ti <br />, I <br />Ll lhn i <br />w� rp i <br />t 2. t1tf"►�J �A ,n M <br />_6.HSC <br />waste without permit from enforcement agency. <br />_7.HSC Section 117908 -Common Storage <br />facility shall be registered with local enforcement <br />agency. <br />Procedures <br />t7 l�$ 5-- ThLk rrrtti <br />U t,t1 S <br />_8.HSC Section 117935-SQG MWMP <br />_9.HSC Section 117943-SQG Shall keep <br />records for 3 years. <br />_10.HSC Section 117945-SQG not required to <br />register shall keep records for 2 years. <br />C Q 5 L.» <br />Cul us CUn nv u <br />11.HSC Section 117960-LQG shall file MWMP <br />With enforcement agency. <br />y <br />ul� U11 U � I <br />"tr g (Y11+1 �1 -I �t (A1 <br />_12.HSC Section 117975 LQG shall keepj <br />records for 3 years. <br />Transportation <br />LaAi a ` eJ s Jz,sn'� <br />llW II <br />_13. HSC Section 118030-LQHE application. <br />Treatment/Storage <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 11 8765 -All treatment records <br />shall be kept for 3 years. <br />_16.HSC Section 118215 -All medical waste <br />shall be treated pursuant to this section. <br />_17.HSC Section 118220 -Recognizable humanV <br />anatomical parts shall be disposed of by interment <br />unless otherwise hazardous. <br />�1 Q[ <br />O ® —7 "n /1Q r <br />ut e k "h�l� u r d1 Vt. iluLts'�� n ww <br />(� U `� S \ �U-r�� <br />CI1 d 1 to C9 tt (O� -V\ <br />Cu 1 1 (0 <br />,e y\ 17 q A <br />�1 �1 p W�yUn �AA 0 <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 />N <br />chemo shall be labeled properly. <br />_20.HSC Section 118280 -MW label & contain <br />51 <br />G 'I <br />lU1 t B,t gcG m tt l �LS t1� (� f@ r 1CA D <br />_21.1-11SC Section 118285 -Sharps label/contain <br />22.HSC Section 118295 -Proper decon used.- <br />1 <br />23.HSC Section 118307 -Interim storage labeled <br />24.HSC Section 118310 -Enclosure labeled. <br />f j� <br />Gl, L4� At t1 sR(D'{Uri 11 CJI <br />_ <br />�5.HSC Section 118305 -Cannot reuse drums <br />_26.HSC Section 117630 -Approved biohazard <br />+ <br />bag used. <br />_27.HSC Section 118275(g)-Pharm label/store <br />_ <br />InspUbtor Signature Re c a Da <br />_28.HSC Section 118222 -Incineration Required <br />29 Other -Describe in narrative. <br />QN(,e / <br />