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SAN JOAQUIN COUNTY Date®113 <br /> ENVIRONMENTAL HEALTH DEPARTMENT PR 0 S3(o 141 <br /> { 1868 East Hazelton Ave., Stockton, CA 95205 <br /> (209)468-3420 <br /> eR`;FQR�`Q MEDICAL WASTE INSPECTION FORM <br /> FacilityName Cj:5,4enL.,<�t Care- LocAl LLC. FacilityAddress ` 00 Unkrt�) - <br /> FacilityContact �e,S I J►Ao.I(4b Title L.:y-�+ �Q S-�- Phone#(2081 3-�117 . <br /> INSPECTION TYPE: dARoutine ❑Complaint ❑ e-inspection <br /> VIOLATION(S) <br /> Registration THE ITEMS BELOW REPRESENT VIOLATIONS OF THE CALIFORNIA <br /> _1.NSC 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 }S v Cc J a, 40 3 a l <br /> waste. r <br /> _3.HSC Section 117890-No large LQG shall S Cl/l 5.1 Ck V ® `t s ft21 "22 <br /> generate medical waste unless registered with the -��2 <br /> enforcement agency. vT 3 U 6..s S s <br /> 4.HSC Section 117895-SQG that treats med �'�0�,3 <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 c �• U 21'-Cs L-k i O MIA,, <br /> waste without permit from enforcement agency. IN�+F <br /> _THSC Section 117908-Common Storage <br /> facility shall be registered with local enforcement <br /> agency. <br /> Procedures a ( �► <br /> _8.HSC Section 117935-SQG MWMPS 11 n] gc�1 <br /> _9.HSC Section 117943-SQG Shall keep <br /> records for 3 years. <br /> _10.HSC Section 117945-SQG not required to 3 <br /> register shall keep records for 2 years. S 2y. •Tr 4V i br\A, C fl 1 U!>e <br /> _11.HSC Section 117960-LQG shall file MWMP <br /> with enforcement agency. <br /> -r412'HSC Section 117975-LQG shall keep <br /> rWco'rdfor 3 years. <br /> Transportation �:Pv-1' k 's S7� 'v sfCA ms fof <br /> _13.HSC Section 118030-LQHE application. r 1 y � ' U Q _ <br /> Treatment/Storage <br /> _14.HSC Section 118135-Shall obtain a permit <br /> from the enforcement agency to treat medical 1 -tT ' L <br /> waste prior to treating the waste. UI l <br /> _15.HSC Section 11 8765-All treatment records b, tLj,��1 <br /> shall be kept for 3 years. , <br /> _16.HSC Section 11 8215-All medical waste �� _ oul� <br /> shall be treated pursuant to this section. -11 -- h <br /> _17.HSC Section 118220-Recognizable human C�� \ I h aAml k-00 L u 4Un, <br /> anatomical parts shall be disposed of by interment ,, i , <br /> unless otherwise hazardous. `amu• <br /> _18.HSC Section 118225-Treated sharps shall �W ('b CI\US &UP t <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 ' (A } 1 <br /> _21.HSC Section 118285-Sharps label/contain <br /> _22.HSC Section 118295-Proper decon used. L 5 Win 1 O �' t-J ' S <br /> _23.HSC Section 118307-Interim storage labeled NJ <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 /> 28.HSC Section 118222-Incineration Required Insp for SignatureeceiV y Date <br /> 29 Other-Describe in narrative. <br />