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'pPaU I <br /> SAN JOAQUIN COUNTY Date m17/1) <br /> ENVIRONMENTAL HEALTH DEPARTMENT PR OSS( SjS <br /> 600 East Main Street, Stockton, CA 95202 <br /> (209)468-3420 <br /> llio MEDICAL WASTE INSPECTION FORM <br /> FacifityName L(nt, SA laut, sk A c4c, FacilityAddress 103). p7. bor)ID ,n Sk- <br /> FacilityContact—Jkcrxos CM%'I Title'kqlo-"- 1;,et tir ops_ Phone# of L% <br /> INSPECTION TYPE: bkRoutine ElComplaint EiRe-inspection <br /> VIOLATION(S) <br /> Registration THE ITEMS BELOW REPRESENT VIOLATIONS OF THE CALIFORNIA <br /> 1.HSC Section 117955-Large Quantity HEALTH & SAFETY CODE (HSC): <br /> 'Generator shall register with the enforcement <br /> agency prior to commencement of the generation o <br /> medical waste. <br /> 2.HSC Section 117903-Permit from the <br /> enforcement agency required to treat medical Df) <br /> waste. ,4 U <br /> —3.HSC Section 117890-No large LQG shall S (an" 5 <br /> fil 124 <br /> generate medical waste unless registered with the <br /> enforcement agency. (p pm 1&tl� (V'UA2 -E 0, <br /> 4.HSC Section 117895-SQG that treats med <br /> nils Tf-% <br /> waste shall register with enforcement agency. I <br /> —5.HSC Section 117900-Shall not haul med •1;k® 6V f L)c.4' A f*4 I (I u, <br /> waste unless registered or obtained LQHE. <br /> —6.HSC Section 117903-Shall not treat med bkA 10'3-,'11 <br /> waste without permit from enforcement agency. <br /> THSC Section 117908-Common Storage <br /> facility shall be registered with local enforcement <br /> agency. Nae->,. �Ikl,' 2(,r�c-4 tkl> <br /> Procedures LOTWU"\-NawtL' <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 /> I 1.HSC Section 117960-LQG shall file MWMP <br /> with enforcement agency. <br /> —12.HSC Section 117975-LQG shall keep <br /> records for 3 years. <br /> Transportation (-D4V\(:jj)n4 <br /> —13.HSC Section 118030-LQHE application. <br /> Treatment/Storage <br /> 14.HSC Section 118135-Shall obtain a permitea�rryjh)USV, CALLUSS <br /> From the enforcement agency to treat medical <br /> waste prior to treating the waste. OA- <br /> 15.HSC Section 118765-All treatment records <br /> Th-all be kept for 3 years. <br /> 16.HSC Section 118215-All medical waste <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 /> 18.HSC Section 118225-Treated sharps shall <br /> be destroyed or somehow prevent public access. <br /> 19.HSC Section 118275-MW red bags,path, <br /> chemo 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 /> -K23.HSC Section 118307-interim storage labeled <br /> —24.HSC Section 118310-Enclosure labeled. <br /> —26.HSC Section 118305-Cannot reuse drums <br /> —26.HSC Section 117630-Approved biohazard <br /> bag used. <br /> —27.HSC Section 118275(g)-Pharm label/store L-u <br /> —28.HSC Section 118222-Incineration Required Insp4ctor Signature ec i e y Date <br /> 29 Other-Describe in narrative. <br />