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0 <br /> SAN JOAQUIN COUNTY Date LA1\51AH <br /> ENVIRONMENTAL HEALTH DEPARTMENT PR rj536535- <br /> UO). 1868 East Hazelton Ave., Stockton, CA 95205 <br /> (209)468-3420 <br /> A MEDICAL WASTE INSPECTION FORM <br /> FacilityName k-lf'1041 Sjuaj, (`o6� Acxte- 9-,k6- FacilityAddress 1012 N, UrNLOyn- <br /> FacilityContact 3Qn fuge- AA <br /> C Title nn)n-1, Phone#(,jb�) <br /> ,j . <br /> INSPECTION TYPE: Routine []Complaint 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 of <br /> medical waste. <br /> 2.HSC Section 117903-Permit from the <br /> enforcement agency required to treat medical No V'ola'riw�l 0( r' inSOctkiUn, <br /> waste. <br /> —3.HSC Section 117890-No large LQG shall <br /> generate medical waste unless registered with the <br /> enforcement agency. <br /> —4.HSC Section 117895-SQG that treats med Note t. -TV\,L MXj coP A"& IA.11� &.1 f&,,A (AA <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 -\-A16&!20-4 <br /> waste without permit from enforcement agency. <br /> THSC Section 117908-Common Storage <br /> facility shall be registered with local enforcement <br /> I's -ty\9. j <br /> agency. <br /> Procedures <br /> 8.HSC Section 117935-SQG MVVMP <br /> —9.HSC Section 117943-SQG Shall keep <br /> records for 3 years. <br /> 10.HSC Section 117945-SQG not required to -TIN' f ILy- <br /> Teiister shall keep records for 2 years. (.1AIA16 +X)J- C4�1)' <br /> I IMSC Section 117960-LQG shall file MWMP <br /> �ith enforcement agency. 1 YL <br /> —12.HSC Section 117975-LQG shall keep •in Qk-,� 6, A\1 <br /> records for 3 years. <br /> Transportation +U' vA /5-hmi:Q'S �e, <br /> —13.HSC Section 11 8030-LQHE application. <br /> Treatment/Storage a J e- 4(A 11'Q <br /> 14.HSC Section 118135-Shall obtain a pen-nit <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 /> shall be treated pursuant to this section. <br /> 17.HSC Section 118220-Recognizable human <br /> -a-n—atomlcal parts shall be disposed of by interment <br /> unless otherwise hazardous. <br /> 1 S.HSC Section 118225-Treated sharps shall <br /> be—destroyed or somehow prevent public access. <br /> I 9.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 113285-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 /> 25.HSC Section 118305-Cannot reuse drums <br /> 26.HSC Section 117630-Approved biohazard <br /> bag used. <br /> 27.HSC Section 118275(g)-PharTn label/store <br /> —28.HSC Section 118222-Incineration Required � nature Re�dved bO Date <br /> 29 Other-Describe in narrative. Insp effir Signature <br />