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L _J <br />SAN JOAQUIN COUNTY <br />1868 E. Hazelton Avenue <br />Stockton, California 95205 <br />Telephone: (209) 468-3420 <br />Fax: (209) 468-8392 <br />0 on 1003 151 � <br />Small quantity generators that provide onsite treatment and all large quantity generators shall have a <br />Medical Waste Management plan on file with the San Joaquin County Environmental Health Department. <br />The Medical Waste Management Plan shall contain the following information as appropriate for your <br />facility: <br />Business Name: <br />Business Address: <br />Phone Number: <br />San Joaquin general Hospital <br />500 West Hospital Road <br />French Camp CA 95231 <br />City State Zip Code <br />�• 468-6000 <br />Type of Facility or Business: Acute Care Hospital <br />REGISTRATION FOR: <br />❑ Small Quantity Generator with Onsite Treatment (Generates less than 200 lbs/month). <br />X❑ 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: Paul Martinez <br />Title: Housekeeping Manager, <br />Phone: 209 468-6998 Date: 12/03/2015 <br />1. List the types of medical waste generated at your facility (i.e. laboratory wastes, blood or body <br />fluids, sharps, contaminated animals, surgical specimens, trace chemo or isolation wastes): <br />a) Do you generate aM pharmaceutical waste (expired, spent, partials, patient returns)? X❑ Yes ❑ <br />No <br />EHD 45-03 5 <br />2015 <br />