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GUIDELINES O' THE MEDICALMANAGEMENT <br />PLAN <br />Small quantity generators that provide Onsite Treatment and all large quantity generators <br />shall have a Medical Waste Management plan on file with the San Joaquin County <br />Environmental Health Department. The Medical Waste Management Plan shall contain the <br />following information as appropriate for your facility: <br />Business Name: r--�— <br />Business Address: <br />City State Zip Code <br />Phone Number: ( Z-61 ) 9 Ll 3 _ (Y� J� <br />Type of Facility or Business: O cd�(s) '!> 0 a:�Xd `i{ <br />REGISTRATION FOR: <br />❑ Small Quantity Generator with Onsite Treatment (Generates less than 200lbs/month). <br />Large Quantity Generator Only (Generates 200 lbs or more/month). <br />❑ Large Quantity Generator with Onsite Treatment (Generates 200 lbs or more/month). <br />Person responsible for implementation of the Medical Waste Management Plan: <br />Name: L Title: 1 <br />Phone: (Z.-Ocl) 9 Lf j—Opj I{ Date: 8 — b6-3 <br />List the types of medical waste generated at your facility, i.e., laboratory wastes, blood or body <br />fluff s, sharps, contaminated animals, surgical specimens, trace the@@mo o isolation wast <br />y <br />a) Do you generate M pharmaceutical waste (expired/outdated, spent, partials,)? <br />b) Yes ❑ No <br />8.6 <br />If yes, describe the type of pharmaceutical waste (expired, spent, partials, outdated, patient <br />returns, etc): __ _1 1 f) 1 1 C' <br />And estimate the monthly amount of pharmaceutical waste generated at your <br />facility: 40 S_ <br />EHD 45-03 <br />10/6/2006 <br />