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0 <br /> ui 0 <br /> oPq ^+ SAN JOAQUIN COUNTY Date to 2:(0:t- <br /> 2,.' °? ENVIRONMENTAL HEALTH DEPARTMENT PR 4Sn�lo <br /> { 600 East Main Street, Stockton, CA 95202 <br /> (209)468-3420 <br /> 9�1jr-Z0 �P MEDICAL WASTE INSPECTION FORM <br /> Facility Name _ s r ,`�I-t�>�i-�1� Facility Address I b() <br /> Facility Contact Title hone# <br /> INSPECTION TYPE: Routine []Complaint ❑Reinspection <br /> VIOLATION(S) <br /> Registration THE ITEMS BELOW REPRESENT VIOLATIONS OF THE CALIFORNIA <br /> _1.HSC Section 117955-Large Quantity HEALTH & SAFETY CODE (HSC): <br /> Generator shall register with the enforcement <br /> agency prior to commencement of the generation of <br /> medical waste. C <br /> _2.HSC Section 117903-Permit from the z <br /> enforcement agency required to treat medical -� I t B I tX n.��h An In/ran.ti e t�w 'cam." -t- nn r-ecry-A <br /> waste. <br /> _3.HSC Section 117890-No large LQG shall <br /> generate medical waste unless registered with the <br /> enforcement agency. ��� h j��a,-J- -4.0:: SZ Q- "�a,cnn�o d" i C)a A <br /> _4.HSC Section 117895-SQG that treats med 1r,c-t o <br /> waste shall register with enforcement agency. ��� I t Lp -t-j\ a,-,J-0j f7` 6 ,. - t.S <br /> _5. HSC Section 117900-Shall not haul med <br /> waste unless registered or obtained LQHE. <br /> _6.HSC Section 117903-Shall not treat med 7 X71° F 00,,c) <br /> waste without permit from enforcement agency. <br /> _THSC Section 117908-Common Storage mt���a �br 2609 1 kAw <br /> facility shall be registered with local enforcement �� <br /> agency. <br /> Procedures hr� t i a I 1 <br /> _8.HSC Section 117935-SQG MWMP <br /> _9.HSC Section 117943-SQG Shall keep 1 tires ah <br /> records for 3 years. o <br /> _10.HSC Section 117945-SQG not required to d S. .i -E 1.� n t r o S rnn n i Sl <br /> register shall keep records for 2 years. tIN(\p A L j G-,-u- <br /> 1 <br /> ,-1u-. <br /> with <br /> Section 117960-LQG shall file MWMP <br /> with enforcement agency. <br /> _12.HSC Section 117975-LQG shall keep <br /> records for 3 years. A• n A v.r n n ('o <br /> Transportation r��t 1...� „�e �i� a S, ��,� <br /> _13.HSC Section 118030-LQHE application. <br /> Treatment/Storage ` <br /> From <br /> 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 /> 1 b\ <br /> shall be kept for 3 years. 11 <br /> 16.HSC Section 11 8215-All medical waste shall < - <br /> be treated pursuant to this section. <br /> _1 THSC Section 118220-Recognizable human A . <br /> anatomical parts shall be disposed of by interment <br /> unless otherwise hazardous. 4;"Y7, r-e /-P/L <br /> _18ASC Section 118225-Treated sharps shall I nt-_ <br /> be destroyed or somehow prevent public access. <br /> _19.HSC Section 118275-MW red bags,path, co <br /> chemo shall be labeled properly. <br /> 20.HSC Section 118280-MW label&contain <br /> _21 ASC Section 118285-Sharps label/contain _ <br /> _22.HSC Section 118295-Proper decon used. \-A �. i ntiP.I :1A.1 <br /> 23ASC Section 118310-Enclosure labeled. <br /> _24.HSC Section 118305-Cannot reuse drums <br /> _25.HSC Section 117630-Approved biohazard <br /> bag used. <br /> _26.HSC Section 118275(g)Pharm label/store <br /> _27.HSC Section 118222 Incineration Only <br /> Treatment Insbectot Signature Received By Date <br /> 28.Other-Describe in narrative. <br />