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10/10/2012 18:04 2094770522 <br />WINDSOR ELMHAVEN CAR <br />is <br />SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />600 East Main Street, Stockton, CA 95202 <br />(209) 468-3420 <br />MEDICAL WASTE INSPECTION FORM <br />PAGE 02/05 <br />Date• lel <br />PR —5XA L!_>? <br />Address -E 11• 4r1 <br />w:ct-j - n '1. <br />.. s. l .L" �,._ w 1 <br />VIOLATION($) <br />Registration <br />THE ITEPAS 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 Elgf to commencement of the generation -of <br />--� <br />med c I 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. <br />\ L� <br />HSC Section 117895-SQG that treats mod <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 />Pr <br />waste without permit from enforcement agency, <br />7.1-180 Section 117908 -Common Storage <br />facility shall be registered with local enforcement <br />agency. <br />Procedures <br />:...........: -- <br />h- <br />_8.HSC Section 117935-SQG MWMP <br />_9.HSC Section 117943-SQG Shall keep <br />records for 3 years. <br />_10.HSC Section 117945-SQG not required to <br />R , f14r' m l+,,,,aig= 7 � 2 <br />- <br />register shall keep records for 2 years. <br />l <br />r�- r�LStiuC C_lfln [' <br />11.HSC Section 11 7960 -LOG shall file MWMP <br />with enforcement agency. <br />records for Section 117975-LQG shall keep���, <br />r3years. <br />Transportation <br />s (1 S. -Ly, .r- ��, ry►,_►_ln c5_l__ <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 tgtCinq_ the waste. <br />15.HSC Section 118765 -All treatment records <br />snail be kept for 3 years. <br />nn. ,f�� ��(�,5?� r,•� �inr�� C,,In r�rr�lY <br />_16.HSC Section 11821 5 -All medical waste <br />shall be treated pursuant to this section. <br />_17.HSC Section 118220-Recogniz2ble human <br />anatomical parts shall be disposed of by interment <br />unless otherwise hazardous. <br />- <br />01 - <br />�I <br />"6'n \ ► J �I,��i «\ lr�'J /'tA^l'�� 4.2geks's•. r7ga <br />�- s'' <br />f,.y J LF/\ �r�/� o 4i2a L 91 L -)t/1- ._ 4, Z )jQ <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 />-;K_,20.HSC Section 118280 -MW label & contain <br />21.HSC Section 118285 -Sharps label/contain <br />—22.HSC Section 118295-Properdecon used. <br />- <br />`I r�l Y„� �� L =N1 �:n9 <br />-„_-23.HSC Section 118307 -Interim storage labeled <br />24.HSC Section 118310 -Enclosure labeled. <br />^ Q <br />� / / <br />i <br />I. ecf rtiignature Rive Date.1 <br />�_ J <br />25.HSC Section 118305 -Cannot reuse drums <br />_26.HSC Section 117630 -Approved biohazard <br />bag used. <br />�27.WSC Suction 118275(8)-Pharm label/store__ <br />28.HSC Section 118222 -Incineration Required <br />—.29 Other -Describe in narrative. <br />Received Time Oct. 11. 2012 7-46AM No. 0297,->, Ile <br />N <br />