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a <br />• <br />C� <br />SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />304 E. Weber Ave., Third Floor, Stockton, CA 95202 <br />(209) 468-3420 <br />MEDICAL WASTE INSPECTION FORM <br />Dateo <br />Record ID_Z <br />Prog Elem • <br />Facility Name Facility Address ZSR <br />Facility Contact U1r,be-( I p itle 9e-t`i 2— Phone # g3' ' f / <br />INSPECTION TYPE: ❑Routine <br />❑Complaint <br />VIOLATION(S) <br />❑Reinspection <br />Registration <br />THE ITEMS BELOW REPRESENT VIOLATIONS OF THE CALIFORNIA <br />_ 1. HSC Section 117955 -Large Quantity <br />Generator shall register with the enforcement <br />HEALTH & SAFETY CODE (HSC): <br />\ <br />Lam <br />agency prior to commencement of the g <br />Q 1 by tir ') r _ �26 n Q- E <br />Leneration <br />-� <br />of medical waste. <br />_2. HSC Section 117903 -Permit from the <br />71 <br />_ ` �,� 1 CJ <br />r? t ckn 14- <br />—� <br />R T::- u1 to( L) <br />enforcement agency required to treat medical <br />waste., <br />_3. HSC Section 117890 -No large LQG shall <br />�rr <br />W C;t� �� D ry ktr' <br />generate medical waste unless registered with <br />the enforcement agency. <br />C <br />_4. HSC Section 117895-SQG that treats med <br />waste shall register with enforcement agency. <br />_5. HSC Section 117900 -Shalt not haul med <br />waste unless registered or obtained LQHE. <br />6.HSC Section 117903 -Shall not treat med <br />A fi- <br />waste without permit from enforcement agency. <br />_7.HSC Section 117908 -Common Storage <br />r <br />facility shall be registered with local enforcement <br />agency. <br />Procedures <br />r - f <br />- v <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 />4- ,n cit- i r Ccs `tro t_ YZ ILS <br />register shall keep records for 2 years. <br />- 10 -7- - _ t i-\+ -A4b c -i I � r <br />�p T <br />_ 11.HSC Section 117960 -LOG shall file <br />MWMP with enforcement agency. <br />_12.HSC Section 117975-LQG shall keep <br />records for 3 years. <br />Transportation <br />U - <br />_13. HSC Section 118030-LQHE application. <br />Treatment/Storage , <br />_14.HSC Section 118135 -Shall obtain a <br />permit from the enforcement agency to treat <br />'cal waste prior to treating the waste. <br />i 1 <br />1'me <br />5.HSC Section 118765 -All treatmentdin <br />records shall be kept for 3 years. <br />i k 1 61�.n n' ��r t<t .n Y� i-E� S l�itl Q% <br />_16.HSC Section 118215 -All medical waste <br />shall be treated pursuant to this section. <br />Section 118220 -Recognizable <br />_17.HSC <br />human anatomical parts shall be disposed of by <br />interment unless otherwise hazardous. <br />t 1 <br />ti <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 />ch o shall be labeled properly. <br />O.HSC Section 118280 -MW label & contains <br />_21.HSC Section 118285 -Sharps label/contain <br />HSC Section 118295 -Proper decon used. <br />; <br />.HSC Section 118310-Endosure labeled. <br />_24.HSC Section 118305 -Cannot reuse drums <br />_25.HSC Section 117630 -Approved biohazard <br />baV ed. <br />✓26.Other-Describe in narrative. <br />Insoctoi Signat re +Rc ived By <br />N <br />1F. <br />