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0 0 <br />SAN JOAQUIN COUNTY Date <br />ENVIRONMENTAL HEALTH DEPARTMENT PR 0KIVI <br />1868 East Hazelton Ave., Stockton, CA 95205 <br />(209) 468-3420 <br />MEDICAL WASTE INSPECTION FORM <br />Facility ame \[At , Lai t - i 4 . FacilityAddress Is I'l I nW6 cry r Dr. <br />$ Owelo -M Ns3k <br />FacilityContact O)cW < FI,.nt& � Title cooliXy`4a, Phone#[a���gs'� <br />VIOLATION(S) <br />Registration <br />THE ITEMS BELOW REPRESENT VIOLATIONS OF THE CALIFORNIA <br />_ 1. NSC Section 117955 -Large Quantity <br />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''tj <br />waste. <br />_3. HSC Section 117890 -No large LQG shall <br />generate medical waste unless registered with the <br />enforcement agency. <br />_4. NSC Section 117895-SQG that treats med <br />U nl p <br />4 <br />SC f(A C e 1 ' <br />` 1 <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 />waste without permit from enforcement agency. <br />_7.HSC Section 117908 -Common Storage <br />facility shall be registered with local enforcement <br />agency. <br />Procedures <br />L. g S (AY1 , . <br />P <br />41y"T (adaM-C! Qhls'M A L JAK A� I'MiAN Jim <br />sm <br />4v S 1ge. ol, 1 rt 0p(A •� �,a�� , Q s <br />wtA PuV 13o 5 s 1 tkr, - w} 4k -j <br />1 <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 />u�il�Cl, S L%O PAi Ma f ri dA A, j n V1 14 3 S <br />(-� r{i w► r 1eJ ® SU,1r.nTC Q,�li �. �1%`�ht�S�r� X11 `1+ <br />S S 1 <br />_12.HSC Section 117975-LQG shall keep <br />records for 3 years. <br />Transportation <br />3 — eS' <br />_13. HSC Section 118030-LQHE application. <br />TreatmentlSto rage <br />_14.HSC Section 118135 -Shall obtain a permit <br />� v (Jj <br />from the enforcement agency to treat medical <br />waste prior to treating the waste. <br />_15.HSC Section 118765 -All treatment records <br />shall be kept for 3 years. <br />_16.HSC Section 118215 -All medical waste <br />y <br />&i) a S M (J1�UJ <br />shall be treated pursuant to this section. <br />_17.HSC Section 118220 -Recognizable human <br />anatomical parts shall be disposed of by interment <br />unless otherwise hazardous. <br />, <br />W U, ' 'Ss L ;S M (i e <br />o <br />�."� ' 7 t1 Vr 5� e i <br />"� <br />_18.HSC Section 118225 -Treated sharps shall <br />be destroyed or somehow prevent public access. <br />u7 4 f W cki <br />_19.HSC Section 118275 -MW red bags, path, <br />c emo shall be labeled properly. <br />20.HSC Section 118280 -MW label & contain <br />_21.HSC Section 118285 -Sharps label/contain <br />_22.HSC Section 118295 -Proper decon used. <br />_23.HSC Section 118307 -Interim storage labeled <br />24.HSC Section 118310 -Enclosure labeled. <br />Section 118305 -Cannot reuse drums <br />_25.HSC <br />_26.HSC Section 117630 -Approved biohazard <br />bag used. <br />_27.HSC Section 118275(g)-Pharm label/store <br />p,1_28.HSC Section 118222 -incineration Required <br />_29 Other -Describe in narrative. <br />InSpfor SignatureReceived By Date <br />1 <br />