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6 <br />SAN JOAQUIN COUNTY 0 Date <br />ENVIRONMENTAL HEALTH DEPARTMENT PR (34SQ1'1-7 <br />600 East Main Street, Stockton, CA 95202 <br />(209) 468-3420 <br />MEDICAL WASTE INSPECTION FORM <br />Facility a e S1 t \Ae'C FacilityAddress tW E- %1 aaeAvr\ Ayc... <br />FacilityContact Nuts.. L?J;1 Ary itle5ACom WsPN Phone#(�Oq) 9( 11 <br />VIOLATION(S) <br />Registration <br />THE ITEMS BELOW REPRESENT VIOLATIONS OF THE CALIFORNIA <br />_ 1. HSC 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 />e—nforcement agency required to treat medical, <br />`oslttt <br />l (- <br />S1� <br />1, t OS y U 10� S 1 1` y rl • f 3C <br />r\VS A tY CA AIUL cm WS <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 <br />waste unless registered or obtained LQHE. <br />``t <br />CU.re �V, k&I eek STltc ()Ox\ - m i t5)i WC42k, <br />w S oA,fws R A� Q f� <br />0` <br />S51m, u0uc. (a1f kACA 00 Sl C <br />_6.HSC Section 117903 -Shall not treat med <br />a ` Mrs S 1 C O V t<` S n 1i ®1 , a <br />�`1- lf\ ly�g <br />waste without permit from enforcement agency. <br />7.HSC Section 117908 -Common Storage <br />.L. tic i ; <br />facility shall be registered with local enforcement <br />agency. <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 />U�t� \, )\ eJ1 Su SY\® <br />'C Jcr\i b '% 1L11 t . <br />register shall keep records for 2 years. <br />\ mvo)i W S , c <br />' "` <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 />` lJl <br />_13. HSC Section 118030-LQHE application. <br />Treatment/Storage <br />AA <br />14.HSC Section 118135 -Shall obtain a permit <br />fro_m the enforcement agency to treat medical <br />waste rior to treatingthe waste. <br />_15.HSC Section 118765 -All treatment records <br />shall be kept for 3 years. <br />`\ A I <br />! i 1 alp► <br />tAS 15 <br />16.HSC Section 118215 -All medical waste <br />;—hail 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 />v t <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 />Section 118280 -MW label & contain <br />_20.HSC <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 />4 <br />V25.HSC Section 118305 -Cannot reuse drums <br />`26.HSC Section 117630 -Approved biohazard <br />27.HSC Section 118275(8)-Pharm label/store <br />_28.HSC Section 118222 -Incineration Required <br />—29 Other -Describe in narrative. <br />Inspe or Signature Received B <br />Date <br />MW <br />