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51 <br />M <br />Cl <br />ENVIRONMMNTAHEATH MP-MARTMIN-T <br />SAN JOAQUN COUNTy <br />600 East Main Street <br />Stockton, California 95202-3029 <br />T61ePhone: (269) 468-3420, <br />Pax. -,(2109) 469-3453. <br />GUIDELMSFOR THEMIE, DIC ASL WASTE -MkNAGS MIENT PLAN <br />Small quaztity generators that. provide, Onsite Treatment and all Igrge qua�tity . generators shall have a <br />Medical Waste h�.anggemznt plan 0, - fil Onsite <br />aquin <br />: . a e'w'th the San 36 COuatY F-P7irdnInclital Health Dppartjment. <br />The Medical Waste "Mafiagement, plan shall <br />facility: contain the f0Uow'ng':'nf0.rmit6n' as appropriatefor your <br />Business Address: <br />Phone Number:. ., <br />TYPO of Facility or Business,' <br />REGISTRATION FOR:❑ , <br />Small Quantity Generator with Onsite Trea <br />ent (Generates less than 206 lbs/month), <br />Large Quantity Generator 0111k0ePerates 200 lbs or more/month), <br />Large Quantity Generator with OusikTreatment (Generates 200 lbs or more/month). <br />Person responsible for implementation of the Medical Wastp, <br />Management Plan:' <br />19010 "MA090 <br />City <br />state . _—EP—CoMe <br />Phone.-- 99DC� C�Cbl -.45sa—Dit., A <br />1. List the types of med'i'qal-wasto -generated at, your fazHity, ix'.�'laborafory wastes, blood <br />r - M <br />trace ahelno or isolaton wastes,,: <br />ot �s TO -9- <br />a) Do YOU generate AM pharmieeutieW wa,$te.(apire� <br />spett, Partials.. patient retums)? Kyes 140 <br />11JIM111111 <br />AURAI is ~KTAOTUM� <br />. ___ __ P—M-FIV5771—woste genqrato,,d at your facfli`T-__a:�M1 <br />MMATM <br />5 <br />