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2015-11-02 12:24 2094688392 P 2/5 <br />ENVIRONMENTAL AIN'T°DEPARTMENT <br />1868 E. Hazelton Avenue <br />Stockton, California 95205 <br />Telephone: (209) 468-3420 <br />Fax: (209) 468-8392 <br />Small quantity generators that provide onsite treatment atad all large quantity generators shall :have a <br />Medical Waste Management plan on file with the San Joaquin County Environmental Health Department. <br />The Medical Waste Management Plan shall contain the following information as appropriate for your <br />facility: ) II ( <br />Business Name: 1;_W 6v <br />Business Address: <br />V o-11 j C-1 af —d eY) 5 <br />City State Zip Code <br />Phone Number: (109) c1 S' _1 --145 3 "i <br />Type of Facility or Business: <br />RE GI S T RAT,I, ON Y O R: <br />❑ Small Quantity Generator with Onsite Treatment (Generates less than 200 lbs/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:%( J Title: r <br />Lt+, (D -re <br />/ <br />Phone: i} — 49 S_ 7 —44 Date: 9-01 <br />1. List the types of medical waste generated at your facility (i.e. laboratory wastes, blood or body <br />fluids, sharps, contarninated animals, surgical specimens, trace chemo or isolation wastes): % <br />1r1Q J'v✓1Q C'. �►� e rte\ ri Lal, tw ��"�Y v. f ,>A S+e s , i doCA ak,,,j f NV <br />a) Do you generate = pharmaceutical waste (expired, spent, partials, patient returns)'? Yes ❑ No <br />If yes, describe the type of pharmaceutical waste (expired, spent, partials, patient returns): <br />And estimate the anonthly amount of pharmaceutical waste generated at your facility. "7 !9- <br />171 <br />r•.r In a;-nz <br />S <br />Received Time Nov, 2, 2015 12:41PM No -1407 <br />