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0 SAN JOAQUIN COUNTY 0 <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 East Hazelton Ave., Stockton, CA 95205 <br />(209) 468-3420 <br />MEDICAL WASTE INSPECTION FORM <br />FacilityName �'i (cD-- 1 1AQ&? 1 Fac' ' Address <br />kub <br />FacilityContact faiA Myrh'ncbb 1 .nji (U r Title <br />, c c <br />INSPECTION TYPE: PRoutine ❑Complaint <br />VIOLATION(S) <br />Date IA I I-)- _ <br />PR bkSOWS <br />o7 404)D"'`1 Lt t PM e <br />❑Re -inspection <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 medical <br />waste. <br />_3. HSC Section 117890 -No large LQG shall <br />We -b'- 40 i a LOS Q Z <br />1 -';-11 G qt G►�i/� <br />,i <br />, C - 11 <br />i <br />generate medical waste unless registered with theU <br />enforcement agency. <br />_4. HSC Section 117895-SQG that treats medM <br />waste shall register with enforcement agency. <br />_5. HSC Section 117900 -Shall not haul med <br />j Uf <br />g <br />Nl 1 s - <br />waste unless registered or obtained LQHE. <br />Section 117903 -Shall not treat med <br />LL <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 />LA <br />c :,, tt M W <br />_8.1-11SC Section 117935-SQG MWMP <br />_9.HSC Section 117943-SQG Shall keep <br />records for 3 years. <br />_10.1-11SC Section 117945-SQG not required to <br />register shall keep records for 2 years. <br />3- '�^ CUJ S W Cfel <br />i <br />1 <br />11.HSC Section 117960-LQG shall file MWMP <br />With enforcement agency. <br />_12.HSC Section 117975-LQG shall keep" <br />records for 3 years. <br />Transportation <br />pinT n SSS 1 <br />t ® t i 5 Q.(jIxk <br />1� �. O rU�111 <br />1 , -r R e (� <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 />l <br />_15.HSC Section 118766 -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 human <br />anatomical parts shall be disposed of by interment <br />unless otherwise hazardous. <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 />chemo shall be labeled properly. <br />_20.HSC Section 118280 -MW label & contain <br />_21.1-11SC Section 118285 -Sharps Iabel1contain <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 />, <br />_28.HSC Section 118222 -Incineration Required <br />_29 Other -Describe in narrative. <br />InspEWtor Signature ReCce y Dat <br />�® <br />