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AL <br />SAN JOAQUIN COUNTY <br />ENVIRONMENTAL EALTH DEPARTMENT <br />600 East Main Street, Stockton, CA 95202 <br />(209) 468-3420 <br />MEDICAL WASTE INSPECTION FORM <br />Date Lq <br />PR okASOMIA <br />k=v <br />FacilityName <br />-, <br />_ 1. HSC Section 117955 -Large Quantity <br />Generator shall register with the enforcement <br />HEALTH & SAFETY CODE (HSC): <br />n { ¢ o a.^ , .. , ♦ r` <br />. <br />Title <br />, <br />.yr b ` <br />INSPECTION TYPE:1i. i, i ! 4.4 .sa , ry o i sit . d t x Je y o {..I.. <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 />waste. <br />_3. HSC Section 117890 -No large LQG shall <br />K kf- <br />U �, <br />� <br />generate medical waste unless registered with the <br />enforcement agency. <br />_4. NSC Section 117895-SQG that treats med3A <br />waste shall register with enforcement agency. <br />_5. HSC Section 117900 -Shall not haul med <br />waste unless registered or obtained LQHE. <br />Rin 1� r %l Is <br />r <br />_6.HSC Section 117903 -Shall not treat med <br />waste without permit from enforcement agency. <br />_7.HSC Section 117908 -Common Storage <br />I A <br />S <br />facility shall be registered with local enforcement <br />agency. <br />` ( r <br />0-jt1.1k(jV_j 4W <br />Procedures <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 />11.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 <br />_13. NSC Section 118030-LQHE application. <br />Treatent/Storae <br />_14.HSC Section 118135 -Shall obtain a permit <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 />an_atomical 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 />_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 />' <br />_27.HSC Section 118275(g)-Pharm label/store <br />l� <br />_28.HSC Section 118222 -Incineration Required <br />29 Other -Describe in narrative. <br />InSpe r Signature Received By Date <br />