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ONO 'IN A " l ZI0 til 'And avail pania3a� <br />GUIDELINES FOR THE MEDICAL <br />PLAN <br />Small quantity generators that provide Onsite Treatment and all large quantity generators <br />shall have a Medical Waste Management plan on file with the San Joaquin County <br />Environmental Health Department. The Medical Waste Management Plan shall contain the <br />following information as appropriate for your facility: <br />Business Name: ri e C1 C�. rr— — �a,A` e u G"ok rokn S Ae-OA-4-1 C -Q re, <br />Business Address: `51~[. , lfc, i1 i <br />GA ct5 ! D _ <br />City State Zip Code <br />Phone Number: ( 209 L 957-q539 <br />Type; of Facility or Business: `JVN I `` <br />RF,GISTRA,TION FOR: <br />.A <br />❑ Small Quantity Generator with Onsite Treatment (Generates less than 200lbs/month). <br />Large 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:Title: <br />Phone: A0FA 3:5 7— q5 -39 Date: <br />I . 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 />a) Do ou generate an pharmaceutical waste (expired/outdated, spent, partials,)? <br />b) MYes ❑ No <br />If yes, describe the type of pharmaceutical waste (expired, spent, partials, outdated, patient <br />returns, etc): , % L <br />And estimate the monthly amount of pharmaceutical waste generated at your <br />facility: 75 WS, <br />EHD 45-03 <br />10/6/2006 <br />OVS d 26£869W2 << WtL tL-80-2W <br />