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SAN-JOAQUIN Environmental Health Department <br /> COUNTY <br /> Greainess grows here. <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 treatment. <br /> 9. 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 4 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 "Registration for Medical Waste" form located on Page 5. <br /> b. Complete a "Medical Waste Management Plan" following the guidelines <br /> starting on Page 6. <br /> c. Return the completed forms and management plan to the mailing address below. <br /> Your cooperation in promptly registering and following the specified handling requirements <br /> is greatly appreciated. <br /> If you have any questions regarding registration or handling requirements, please contact <br /> us at (209) 468-3420 and ask for assistance in the Medical Waste Program. <br /> RETURN ALL COMPLETED FORMS TO: <br /> San Joaquin County Environmental Health Department <br /> 1868 E. Hazelton Ave. <br /> Stockton, CA 95205 <br /> Attu: Medical Waste Program <br /> 104ZQ 1= L:-4— p.. 1— f (Z+nnl`4nn f'o lifnrnio Or,)nr, 1 7 ')00 AnQ_1A')n 1 C 7nQ ARA11'11A i a.......ainch.l r-nm <br />