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SAN JOAQUIN COUNTY Date,' • r / <br />ENVIRONMENTAL HEALTH DEPARTME9 PR' <br />600 East Main Street, Stockton, CA 95202 <br />(209) 468-3420 <br />MEDICAL WASTE INSPECTION FORM <br />FacilityName6a.,ne.- hhs FacilityAddress ` an 6YC,rjs::'i-f jtfcr pl <br />owlirlv- <br />FacilityContact ftr-14) CrAjp r.,_ Title Phone#,2cr-c - �q -7y-5d.s_a— <br />INSPECTION TYPE: ❑Routine <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 />HEALTH & SAFETY CODE (HSC): <br />Generator shall register with the enforcement <br />agency prior to commencement of the generation of <br />medical waste. <br />in ea I <br />_2. HSC Section 117903 -Permit from the <br />enforcement agency required to treat medical <br />waste. <br />' I <br />_3. HSC Section 117890 -No large LQG shall <br />11e:�V-r <br />.6-y— Me -r10 t 17K) r-)"4 L� -` <br />generate medical waste unless registered with the <br />enforcement agency. <br />�'� ���1 ���� , L' �' `� �'� <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 />_6.HSC Section 117903 -Shall not treat med <br />waste without permit from enforcement agency. <br />_7.HSC Section 117908 -Common Storage <br />facility shall be registered with local enforcement <br />agency. <br />Procedures <br />1 <br />_8.HSC Section 117935-SQG MWMP <br />_9.HSC Section 117943-SQG Shall keep <br />records for 3 years. <br />, <br />_10.HSC Section 117945-SQG not required to <br />register shall keep records for 2 years. <br />Q j tic_ 4 Ll -14 LI'A <br />_11.HSC Section 117960-LQG shall file MWMP <br />with enforcement agency. <br />`i A g --M -, _ Ail, P— V V1 6L b" i A! e�!1 rh 2� t � GUi'c t 1 1 rm <br />_12.HSC Section 117975-LQG shall keep <br />records for 3 years. <br />Transportation <br />��� . IVI e KS <br />_13. HSC Section 118030-LQHE application. <br />Treatment/Storage <br />_14.HSC Section 118135 -Shall obtain a permit <br />from the enforcement agency to treat medical <br />waste prior to treating the waste. <br />_,9(45.HSC Section 118766 -All treatment records <br />shall be kept for 3 years. <br />- <br />_16.HSC Section 118215 -All medical waste <br />shall be treated pursuant to this section. <br />_17.HSC Section 118220 -Recognizable human} <br />anatomical parts shall be disposed of by interment <br />unless otherwise hazardous. <br />len e, <br />: a k <br />_18.HSC Section 118225 -Treated sharps shall <br />be destroyed or somehow prevent public access. <br />_19.HSC Section 118275 -MW red bags, path, <br />chemo shall be labeled properly. <br />,&20.HSC Section 118280 -MW label & contain <br />_21.HSC Section 118285 -Sharps label/contain <br />_ 22.HSC Section 118295 -Proper decon used. <br />�23.HSC Section 118307 -Interim storage labeled <br />_24.HSC Section 118310 -Enclosure labeled. <br />_25.HSC Section 118305 -Cannot reuse drums <br />_26.HSC Section 117630 -Approved biohazard <br />bag used. <br />_27.HSC Section 118275(g)-Pharm label/store <br />7-` % 7 T <br />+ r Signature c Ive Da e <br />_28.HSC Section 118222 -Incineration Required <br />29 Other -Describe in narrative. <br />