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E&SAN JOAQUIN COUNTY Date 8`�4-! z_ <br />ONMENTAL HEALTH DEPARTMEOP PR <br />600 East Main Street, Stockton, CA 95202 <br />(209) 468-3420 <br />MEDICAL WASTE INSPECTION FORM <br />FacilityName�f ;,jr-)eA L y%yLe4 teell j.— Facili Address <br />ty Int t1.c`,.,..m<r y i e-- 1-n _ <br />FacilityContact K ,- Title i- c.U., b'e-fv-� Phone# 47�-d2E�E��/ <br />INSPECTION TYPE: Woutine <br />[]Complaint []Re -inspection <br />VIOLATION(S) <br />Registration <br />THE ITEMS BELOW REPRESENT VIOLATIONS OF THE CALIFORNIA <br />_ 1. HSC Section 117955 -Large Quantity <br />Generator shall register with the enforcement <br />HEALTH & SAFETY CODE (HSC): <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 LOG shall <br />\/I <br />generate medical waste unless registered with the <br />enforcement agency. <br />Ae✓ <br />— <br />r <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 />e -e <br />_6.HSC Section 117903 -Shall not treat med <br />waste without permit from enforcement agency.1 <br />/ <br />_7.HSC Section 117908 -Common Storage <br />Ca i1nP �' Z A1/ S�WC�- rNc� J t 7rw I <br />j.Lkl.� OL } ke <br />-4fs e7+1 SX�r._ 1 ( A0 All at <br />facility shall be registered with local enforcement' <br />agency. <br />P <br />Procedures <br />1 -,",I eA <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 />_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 />�_r�n� V" t- i,JL�.� JSP �� 1n V, <br />Transportation <br />_13. HSC Section 118030-LQHE application. <br />Treatment/Storage <br />—i. ! { nn M rPL 4-\,-4,1,-7l�t.r�� Llc,U <br />_14.HSC Section 118135 -Shall obtain a permitU.Si <br />from the enforcement agency to treat medical <br />waste prior to treating the waste. <br />l_J <br />P_ )LJY[i L A, JR)': �l t 7a <br />Section 118765 -All treatment records <br />_15.HSC <br />shall be kept for 3 years.—t,,) <br />4a AAk.9-- 0A 64-14 AA Z 12, A 7- Z, - <br />fit -et <br />_16.HSC Section 11821 5 -All medical waste <br />shall be treated pursuant to this section. <br />_17.HSC Section 118220 -Recognizable human <br />;��}� '��/l i� gNtr ►?Cit /��tfn t� <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 />X19.HSC Section 118275 -MW red bags, path, <br />!i/ 'Zr) [��l.1�/ S P)��r _i�w►i�✓1.I�Z. ,7�liYt <br />+ <br />chemo shall be labeled properly. <br />_20.HSC Section 118280 -MW label & contain <br />(� Ni F 1. Z t h fr) k C 74, y- OL.), <br />_21.HSC 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 />_Z25.HSC Section 118305 -Cannot reuse drums <br />_26.HSC Section 117630 -Approved biohazard <br />b used. <br />27.HSC Section 118275(g)-Pharm label/store <br />y -Y 7 <br />_28.HSC Section 118222 -Incineration Required` <br />29 Other -Describe in narrative. <br />e o Signature Ri4ceived B Date <br />C/)O,g - -I- <br />