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El <br />SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 East Hazelton Ave., Stockton, CA 95205 <br />(209) 468-3420 <br />MEDICAL WASTE INSPECTION FORM <br />Date Sha M <br />PR x014 00 4 <br />_ ` Cfii, rrr r <br />-N'kde. (le -14 Title Phone!c <br />INSPECTION TYPE: A. r []Complaint olle-inspection <br />VIOLATION(S) <br />Registration <br />THE ITEMS BELOW REPRESENT VIOLATIONS OF THE CALIFORNIA <br />_ 1. NSC Section 117955 -Large Quantity <br />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 <br />` L �" ` L <br />1> r, -� (),I `S — FEW" Vk-A t\ atll t fCaTerrfl� nll� T1 t n A <br />—, l y <br />R a 0 MLIM ren. 04 LYLu� `rj t 13 until T (� Or) <br />waste. <br />NSC Section 117890 -No large LQG shall <br />a. 1►� `1ti1. -t PQ,&2eeM Q C(A w-nJ+) "n <br />J c <br />generate medical waste unless registered with theLw, <br />enforcement agency. <br />4. HSC Section 117895-SQG that treats med <br />waste shall register with enforcement agency. <br />, <br />_5. HSC Section 117900 -Shall not haul med <br />waste unless registered or obtained LQHE. <br />Section 117903 -Shall not treat med <br />NJ1 / <br />LO (�A Q ('tiliSl nll KliAei-, <br />_6.HSC <br />waste without permit from enforcement agency. <br />_7.HSC Section 117908 -Common Storage <br />facility shall be registered with local enforcement <br />agency. <br />ProceduresPlw�,1 <br />_8.NSC 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 />witl enforcement agency. <br />_12.HSC Section 117975-LQG shall keep <br />records for 3 years. <br />R -gym 'p <br />\� <br />� �S 1",,&r% �1' l YY <br />k 1 S �tulfi� t <br />_ V')tJV-jCt 3bCAVc, Ck fnj&eP <br />® C&LUW <br />J d <br />Transportation <br />e�'" ' , �S <br />_13. HSC Section 118030-LQHE application. <br />Treatment/Storage <br />_14.HSC Section 118135 -Shall obtain a permit <br />From the enforcement agency to treat medical <br />'eIn <br />aste prior to treating the waste. <br />15.HSC Section ( All treatment records <br />shall be kept for 3 years. <br />Gr/t <br />16.HSC Section 118215 -All medical waste <br />sh_all 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 />_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)-Pharm label/store <br />_28.HSC Section 118222 -Incineration Required <br />v` �l <br />InS ctor Signature Received Bi') Date <br />29 Other -Describe in narrative. <br />