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6 <br />SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />600 East Main Street, Stockton, CA 95202 <br />(209) 468-3420 <br />MEDICAL WAS I E INSPECTION FORM <br />FacilityNa me _ <br />� <br />ilityAddress <br />a <br />_ 1. HSC Section 117955 -Large Quantity <br />Generator shall register with the enforcement <br />A <br />r A it <br />FacilityContact <br />Title <br />n <br />t o S . ) <br />i 0�' i tee. ii ` [. t : l a i i .. � - n tw , r `l; ; E <br />Registration <br />THE ITEMS BELOW REPRESENT VIOLATIONS OF THE CALIFORNIA <br />_ 1. HSC Section 117955 -Large Quantity <br />Generator shall register with the enforcement <br />HEALTH & SAFETY CODE (HSC): <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 <br />1- <br />► ^ 1 °Cb to lei`le S <br />waste. <br />_3. HSC Section 117890 -No large LQG shall <br />` f b <br />T <br />generate medical waste unless registered with the <br />enforcement agency. <br />_4. HSC Section 117895-SQG that treats med <br />waste shall register with enforcement agency. <br />HSC Section 117900 -Shall not haul med <br />`\_� 1 <br />N 10`(1(a ti tt�rluS A) �'c.1? D f l,Je h� 71t) 2fiS� �lA Tt1�l�, <br />_5. <br />waste unless registered or obtained LQHE. <br />_6.HSC Section 117903 -Shall not treat med <br />"T�tS IS�UIiC. lA7U S l.Ai Se rA �n Sl�(e, _ <br />waste without permit from enforcement agency. <br />_7.HSC Section 117908 -Common Storage <br />facility shall be registered with local enforcement <br />Y <br />agency. <br />Procedures <br />` ' L �.- <br />j �Q,S f� S O <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 to1 <br />register shall keep records for 2 years. <br />_11.HSC Section 117960-LQG shall file MWMP <br />r 1 <br />{'� i3 1• �� ,f �1�Y1 <br />SUt ton�C�, ®3 ISs1A4- ..19t/l� W Ic(ilaA on 5 -AC . <br />IVenforcement agency. <br />iC 12.HSC Section 117975-LQG shall keep <br />records for 3 years.CA. <br />Transportation <br />J LCbA au 1' Is <br />n d-cccss a ril2t' <br />r' , C <br />' t •(, u <br />_13. NSC Section 118030-LQHE application. <br />`I°reatment/Storage <br />_14.HSC Section 118135 -Shall obtain a permit <br />from the enforcement agency to treat medicalp <br />waste prior to treating the waste. <br />\ , lU \ 11 U <br />& LttS% l� <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 />anatomical parts shall be disposed of by interment <br />unless otherwise hazardous. <br />Np �L <br />`� -� L1 ` S M15 <br />SGLV cam, f <br />_18.HSC Section 118225 -Treated sharps shall <br />e destroyed or somehow prevent public access. <br />_19.HSC Section 118275 -MW red bags, path, <br />m.shall be labeled properly. <br />HSC Section 118280 -MW label &containo <br />_21.HSC Section 118285 -Sharps label/contain <br />22. -HSC Section 118295 -Proper decon used. <br />3.HSC Section 118307 -Interim storage labeled <br />4.HSC Section 118310 -Enclosure labeled. <br />S <br />Ar- <br />r <br />(� <br />_25.HSC Section 118305 -Cannot reuse drums <br />_26.HSC Section 117630 -Approved biohazard <br />bag used. <br />a <br />Q� <br />_27.HSC Section 118275(g)-Phann label/store <br />�J <br />Insp for Signature Received By to <br />_28.HSC Section 118222 -Incineration Required <br />29 Other -Describe in narrative. <br />