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oaq�! o a SAN JOAQUIN COUNTYDatez-i I--1U <br /> ENVIRONMENTAL HEALTH DEPARTMENT PR Uh'4�1-1 <br /> U) Z< <br /> 600 East Main Street, Stockton, CA 95202 <br /> (209)468-3420 <br /> gc,FORa`P MEDICAL WASTE INSPECTION FORM <br /> FacilityName f)PX�,_ FacilityAddress . Aj_�t�mmr��e� <br /> tY 1'Q�� o Title �N'��Ch�l�l' p 0-e�Phone# <br /> Facili Contact 1 r-�1. <br /> INSPECTION TYPE: Routine []Complaint []Re-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 AA0c <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 <br /> waste shall register with enforcement agency. <br /> _5.HSC Section 117900-Shall not haul med A <br /> waste unless registered or obtained LQHE. <br /> _6.HSC Section 117903-Shall not treat med <br /> waste without permit from enforcement agency. <br /> _7.HSC Section 117908-Common Storage �ti4� - t' <br /> k. <br /> facility shall be registered with local enforcement l �� <br /> agency. <br /> Procedures ` <br /> _8.HSC Section 117935-SQG MWMP r. <br /> _9.HSC Section 117943-SQG Shall keep n�r� `'�, '`"� • <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. l <br /> _12.HSC Section 117975-LQG shall keep <br /> records for 3 years. <br /> Transportation <br /> _13.HSC Section 118030-LQHE application. <br /> Treatment/Storage e�-- <br /> / <br /> _14.HSC Section 118135-Shall obtain a permit r <br /> from the enforcement agency to treat medical <br /> waste prior to treating the waste. r <br /> _15.HSC Section 118765-All treatment records <br /> shall be kept for 3 years. <br /> _shall <br /> Section 118215-All medical waste <br /> shall be treated pursuant to this section. I <br /> _17.HSC Section 118220-Recognizable human j <br /> anatomical parts shall be disposed of by interment <br /> unless otherwise hazardous. — Z <br /> _18.HSC Section 118225-Treated sharps shall / <br /> be destroyed or somehow prevent public access. n <br /> _19.HSC Section 118275-MW red bags, path, <br /> chemo shall be labeled properly. <br /> _20.HSC Section 118280-MW label&contain IL <br /> _21.HSC Section 118285-Sharps label/contain q_ <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/store71`ac ;�o y- 7—!y <br /> _28.HSC Section 118222-Incineration Required r Signature Received By Date <br /> 29 Other-Describe in narrative. <br />