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GUIDELINES • THE rMANAGEMENT <br />(Please Type or Print) <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 local enforcement agency <br />(FHS-EHD). The medical waste management plan shall contain the following information, <br />as appropriate for your facility: <br />Business Name: T) P 11 P 1 V n r a t i Qua] T n a t' 1- + e <br />Business Address: 23500 Kasson Rd., Tracy, CA 95378-0400 <br />Business Phone: C 209 ) 835-4141, extension 4440 <br />Type Of Facility Or Business: <br />Registered As: (Check One) <br />State Prison <br />Small Quantity • Onsite Treatment.200 lbs./mo.) <br />(X) Large Quantity Generator. (Generates 200 lbs. or more/mo.) <br />O Large Quantity Generator With Onsite reatment. (Generates 200 lbs. or more/mo.) <br />Person Responsible For Implementation Of The Plan: <br />Name. Gilbert R. Sainz, M.D. <br />Title: Health Care Manager <br />Phone: '209 ) 835-4141, extension 4440 <br />M rr •' li •` f <br />1. List the types of medical waste generated at your facility, i.e., Laboratory Wastes, <br />Blood or Body Fluids, Sharps, Contaminated Animals, Surgical Specimens, or <br />Isolation Wastes. (See "Regulated Medical Wastes" on Page 3.) <br />See Medical Waste Plan <br />2. Estimate the monthly amount of medical waste generated at your facility. <br />300 pounds <br />3. Describe the medical waste handling procedures utilized by and applicable to your <br />facility: <br />See Medical Waste Plan <br />a. Onsite location and method for segregation, containment, packaging, <br />labelling, and collection. <br />-CONT . RSE- <br />fA <br />