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ONO'ON z z[H til ,env ;wli pania3a� <br />NVQ ENTA HEALT#�EPARTMENT <br />Pa�IN <br />SAN JOA UIN COUNTY Y <br />?Q 'c <br />Donna K. 1•1cran, R.E.H.S. <br />UnitSupervisurs <br />a` ?a <br />Director <br />600 East Main Street <br />curl Borgman, R.E. I.S. <br />yi .4 <br />Laurie A. Cotulla, R.E.I•I.S. <br />Stockton, California 95202 <br />Mike I lugoins, REM- R.D.I. <br />• • <br />Gael <br />,assistant Director <br />Telephone: (209) 4683420 <br />Margaret I,agorio. R.E.H.S. <br />Robc l McClellon, R.r.H.S. <br />i ij�e��p <br />Fax: (209) 468-3433 <br />Jeff Carruesco, R.P;.I P.S, <br />Kasey holey, R.r•,.i-I.S. <br />INFORMATION PACKET <br />FOR MEDICAL WASTE GENERATORS <br />This packet contains the information and forms you will need to help you comply with the <br />Medical Waste Management Act. <br />Instructions <br />Please return the completed forms prior to medical waste generation or treatment. <br />Complete the "]Pre -Application Questionnaire" on Page 2. If your answers indicate <br />you are not required to register as a medical waste generator, then complete the <br />"Certification Statement" on Page 3 and return both complete forms to the mailing <br />address below. <br />2. if you are required to register as a medical waste generator, as indicated by affirmative <br />answers to questions 3 & 4 on the "Pre -Application Questionnaire", then: <br />a. Complete the ":registration for Medical Waste" form located on <br />Page 4. <br />b. Complete a "Medical Waste Management ]`Tarn" following the guidelines <br />provided on Page 5. <br />c. Return the completed forms and management plan to the mailing address <br />below. <br />Your cooperation in promptly registering and following the specified handling requirements is <br />greatly appreciated. <br />If you have any questions regarding registration or handling requirements, please contact (209) <br />468-3420 and ask for the Medical Waste Program. <br />RETURN ALL COMPLETED FORMS TO: <br />Attn: Medical Waste Program <br />San Joaquin County Environmental Health Department <br />600 East Main Street <br />Stockton, CA 95202 <br />17+11) 45.03 WEE <br />04/IS/08 <br />OL/2 d ME99 O2 << <br />Md - <br />MUM <br />5�:tL tL-80-ZL <br />