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0 SAN JOAQUIN COUNTY Date Y,.4-Q- <br /> ENVIRONMENTAL HEALTH DEPARTMEP PR t <br /> a. 600 East Main Street, Stockton, CA 95202 <br /> (209)468-3420 <br /> MEDICAL WASTE INSPECTION FORM <br /> Faci1ityName-j)eAVrA-&NxGlzi,t- Lxe- 42&- FacifityAddress i -S. L-Lia, Lyl <br /> FacilityContact &b tc.N`ilrillTitleflam,"4 +A=P" - hone#_3"3L-i-19AS- <br /> Wz - <br /> INSPECTION TYPE: -58outine ElComplaint EiRe-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. ev--c- <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 0%- !�±Lr 4% <br /> generate medical waste unless registered with the <br /> enforcement agency. <br /> 4.HSC Section 11 7895-SQG that treats med <br /> -A <br /> waste shall register with enforcement agency. <br /> —5.HSC Section 117900-Shall not haul <br /> waste unless registered or obtained LQHE. <br /> —6.HSC Section 117903-Shall not treat med adte., imcl&YZ=- 0L -xlw --'sov p aia- ta 4-&,rmt-s <br /> waste without permit from enforcement agency. T <br /> _7 <br /> THSC Section 117908-Common Storage <br /> T�a ility shall be registered with local enforcement <br /> agency. <br /> Procedures 4 <br /> 8.HSC Section 117935-SQG MWMP <br /> —9.HSC Section 117943-SQG Shall keep <br /> records for 3 years. .411 h VOL. <br /> —10.HSC Section 117945-SQG not required to <br /> register shall keep records for 2 years. Ax A5k to C,- jae-jj�= <br /> 1 I.HSC Section 11 7960-LQG shall file MWIMP I <br /> Wth enforcement agency. ✓A 16 tan <br /> z(12.HSC Section 11 7975-LQG shall keep <br /> records for 3 years. <br /> cenn L <br /> Transportation "mrShl3f. LaD-30. PAja <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. S1Pr j j 2-T�:2 io 6,a i'Lac la LY, <br /> 15.HSC Section 118765-All treatment records <br /> shall be kept for 3 years. "Sc' <br /> 16.HSC Section 118215-All medical waste <br /> shall be treated pursuant to this section. 'a Isr-Q <br /> --17.HSC Section 118220-Recognizable human a51LZCZZ::,Z-e-r2-1- Aaw-nz A'o inj jwa-47 L= <br /> anatomical parts shall be disposed of by interment 14 :L 1 <br /> unless otherwise hazardous. Z�11V&L'%Xvv CA -&I'm jr.A VAA t2wr,,/L <br /> —18.HSC Section 118225-Treated sharps shall I'l 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 118286-Sharps label/contain <br /> —22.HSC Section 118295-Proper decon used. 05�1 <br /> —23.HSC Section 118307-interim storage labeled <br /> —24.HSC Section 1118310-Enclosure labeled. <br /> —25.HSC Section 118306-Cannot reuse drums <br /> —26.HSC Section 117630-Approved biohazard <br /> bag used. IZO <br /> "8,27.HSC Section 118275(g)-Pharm label/store <br /> 28.HSC Section 118222-incineration RequiredDate <br /> 29 Other-Describe in narrative. I n ignature Rec <br />