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ENVIRONMENTAL HEALTH DEPARTMENT- <br /> SAN JOAQUIN COUNTY <br /> 1868 E. Hazelton Avenue <br /> Stockton, California 95205 <br /> Telephone: (209)468-3420 <br /> Fax: (209)468-8392 <br /> GUIDELINES FOR THE MEDICAL WASTE MANAGEMENT PLAN <br /> Small quantity generators that provide onsite treatment and all large quantity generators shall have a <br /> Medical Waste Management plan on file with the San Joaquin County Environmental Health Department. <br /> The Medical Waste Management Plan shall contain the following information as appropriate for your <br /> facility: �, `� <br /> Business Name: ( bo r / l�cAw S f ✓�r�, �e�t <br /> r <br /> Business Address: `70 D r0 a &kAWC1_ 5 . <br /> �_®c�_ (- �. 5®12_40 <br /> City State Zip Code <br /> Phone Number: 205 ) 3 3 3 �— <br /> Type of Facility or Business: 0 _e _ f= <br /> REGISTRATION'FOR:_- <br /> ❑ Small Quantity Generator with Onsite Treatment(Generates less than 200 lbs/month). <br /> dLarge Quantity Generator Only(Generates 200 lbs or more/month). <br /> ❑ Large Quantity Generator with Onsite Treatment(Generates 200 lbs or more/month). <br /> Person responsible for implementation of the Medical Waste Management Plan: <br /> Name: G� �-S Title: <-x�e c c-.c--F-`°y e <br /> Phone: 2-09 '3 3 3® f--2- -)- : Date: S -?—(s <br /> 1. List the types of medical waste generated at your facility(i.e. laboratory wastes,blood or body <br /> fluids, sharps,contaminated animals, surgical specimens,trace chemo or isolation wastes): <br /> nlur wx n G e i c,a C c .5 b J c`c, <br /> a)Do you generate M pharmaceutical waste(expired, spent,partials,patient returns)? [ Yes ❑No <br /> If yes, describe the type of pharmaceutical waste(expired, spent,partials,patient returns): <br /> And estimate the monthly amount of pharmaceutical waste generated at your facility: <br /> EHD 45-03 5 <br /> 2015 <br />