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-1-EdNVIRON&ENTAL HEAL TH&EPARTMENT <br /> SAN JOAQUIN COUNTY UnitSuperyivors <br /> Donna K_Heran,R.E.H.S. 600 East Main Street Carl Borgman, R.E.H.S. <br /> Director Mike Huggins,R.E.K.$.,R.D.I. <br /> Stockton, Califorr�ja 95202 <br /> Laurie A.Cotulla,R.E.H,S. Margaret Lagorio,R.C.1i.S. <br /> Assistant Director Telephone- (209) 468-3420 Robert McClellon,]i.E.H.S. <br /> Fax: (209) 468-3433 Jeff Carruesco,R.E.K.S. <br /> Kasey Foley,R.E.H.S. <br /> INFORMATION PACKET FOR MEDICAL WASTE GENERATORS <br /> This packet contains the information and forms you will need to help you comply with the <br /> Medical Waste Management Act- <br /> Instructions <br /> Please return the completed forms prior to medical waste generation or txeatment. <br /> 1 Complete the "Pre-Application Questionnaire" on Page 2. If your answers indicate <br /> you are not required to register as a medical waste generator,then complete the <br /> "Certification Statement" on Page 3 and return both complete forms to the: mailing <br /> address below. <br /> 2. If you are required to register as a medical waste generator, as indicated by affirmative <br /> answers to questions 3 & 4 on the "Pre-Application Questionnaire", then: <br /> a. Complete the 64Registration for Medical Waste" form located on <br /> Page 4. <br /> b. Complete a "Medical Waste Management Plan'.' following the guidelines <br /> provided on Page 5. <br /> C. Return the completed forms and management plan to the mailing address <br /> below. <br /> Your cooperation in promptly registering and following the specified handling requirements is <br /> greatly appreciated. <br /> If you have any questions regarding registration or handling requirements, please contact (20 9) <br /> 468-3420 and ask for the Medical Waste Program. <br /> RETURN ALL COMPLETED FORMS TO: <br /> Attn: Medical Waste Program <br /> San Joaquin County Environmental Health Department <br /> 600 East Main Street <br /> Stockton, CA 95202-3029 <br /> EHI)45-03 <br /> 04/19/08 <br /> zoo 'j 'ON xvd WV 11 : 11 HI/610UH/aH <br />