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OPQui� <br /> 00 SAN JOAQUIN COUNTY Date Y-3-- t3 <br /> °c ENVIRONMENTAL HEALTH DEPARTMAR PR /6,7 <br /> r y <br /> { 600 East Main Street, Stockton, CA 95202 <br /> (209)468-3420 <br /> P MEDICAL WASTE INSPECTION FORM <br /> ew-e c rr <br /> FacilityName m 146161� Faci I ityAddress <br /> FacilityContact 4r _>_ Titled&„trArca4cAUcrj?jPhone# 9-7Z -9 x t-7 <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. 1 r_ <br /> tnt' <br /> _3.HSC Section 117890-No large LQG shall r'�✓ 1 N� 1L PfrA&� -r i� -. -�_ WI ftDyy _c <br /> � <br /> generate medical waste unless registered with the <br /> enforcement agency. L, <br /> _4.HSC Section 117895-SQG that treats med ��j YYG VlZ'i1}1�l !'A ?0 (��f�l� Yl 7Y►0 �1kiz✓Y 1 <br /> waste shall register with enforcement agency. <br /> _5.HSC Section 117900-Shall not haul med 4W A PVI D✓ : JIL Al 1,V-"-e_ 6j _r C_ �- <br /> waste unless registered or obtained LQHE. <br /> _6.HSC Section 117903-Shall not treat med <br /> waste without permit from enforcement agency. <br /> 7.HSC Section 117908-Common Storage <br /> lhall be registered with local enforcement <br /> agency. 410 <br /> n7�C� (t/ -),b4�C ��a li►'lt�r�2?�wZ�')'1 <br /> Procedures <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 /> register shall keep records for 2 years. <br /> _11.HSC Section 117960-LQG shall file MWMP <br /> with enforcement agency. <br /> ID�42.HSC Section 117975-LQG shall keep <br /> records for 3 years. <br /> Transportation -:f-- <br /> -13.HSC Section 118030-LQHE application. <br /> Treatment/Storage <br /> _14.HSC Section 118135-Shall obtain a permit 471 <br /> from the enforcement agency to treat medical <br /> waste prior to treating the waste. ✓ <br /> _15.HSC Section 118765-All treatment records l( <br /> shall be kept for 3 years. <br /> _16.HSC Section 118215-All medical waste `to OL <br /> shall be treated pursuant to this section. <br /> _17.HSC Section 118220-Recognizable human <br /> anatomical parts shall be disposed of by interment II / <br /> unless otherwise hazardous. S1/� i —lV� .� Eo�tyme- <br /> _18.HSC Section 118225-Treated sharps shall <br /> be destroyed or somehow prevent public access. cL O _� 1� S r)rY I AA15 Y1,I rS L <br /> _19.HSC Section 118275-MW red bags,path, l� � �r . <br /> chemo shall be labeled properly. t7LcAY)CA 11 <br /> 20.HSC Section 118280-MW label&contain <br /> _21.HSC Section 118285-Sharps label/contain <br /> _22.HSC Section 118295-Proper decon used. AIAv( d <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 <br /> ba2used. <br /> 27.HSC Section 118275(g)-Pharm label/store I <br /> _28.HSC Section 118222-Incineration Required 1hollySignature Rece�ed By Date <br /> 29 Other-Describe in narrative. <br />