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�rN SAN JOAQUIN COUNTY Date 3-13 -- 1 V <br /> E RONMENTAL HEALTH DEPARTMEOP PR 536i-TI <br /> 600 East Main Street, Stockton, CA 95202 <br /> r <br /> (209)468-3420 <br /> q�rFO'�rMEDICAL WASTE INSPECTION FORM <br /> FacilityNamef�,L6,-A ei�a Z,_L-,x _ CV- FacilityAddress ;33L-1 ,04 1 vi-P <br /> FacilityContact Ang?" 6u,)30 0 Title A� yt► tywvye Phone# 3,?Li <br /> INSPECTION TYPE: ❑Routine []Complaint ❑Re-inspection <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. <br /> _2.HSC Section 117903-Permit from the <br /> enforcement agency required to treat medical ! <br /> waste. <br /> _3.HSC Section 117890-No large LQG shall <br /> generate medical waste unless registered with the <br /> enforcement agency. cam' <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 _ i Cr,-vsa <br /> waste unless registered or obtained LQHE. <br /> _6.HSC Section 117903-Shall not treat med �' l <br /> waste without permit from enforcement agency. <br /> _7.HSC Section 117908-Common Storage <br /> facility shall be registered with local enforcement 1 II rn-5— &1?,- <br /> agency. <br /> Procedures <br /> _8.HSC Section 117935-SQG MWMP <br /> _9.HSC Section 117943-SQG Shall keep <br /> records for 3 years. 4V <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 /> Transportation a71111AVZ�- r)vl- 'I'll 17 :11P� —rte <br /> _13.HSC Section 118030-LQHE application. fta � <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 /> _15.HSC Section 118765-All treatment records <br /> shall be kept for 3 years. <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 /> anatomical parts shall be disposed of by interment <br /> unless otherwise hazardous. <br /> 18.HSC Section 118225-Treated sharps shall <br /> e_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 //Ybag used. : J <br /> 27.HSC Section 118275(g)-Pharm label/storet-� <br /> —_28.HSC Section 118222-Incineration Required 'irisRecVved By Date <br /> 29 Other-Describe in narrative. <br />