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} 4 - Date Z 0 <br />• Record ID_, l,,(g'L <br />Prog Elem_Lf� <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 />7, <br />Facility Name U 1 Facility Address 'Zh50-Q <br />Facility Contact. a °I C-aj I CtLoh� Title GJrL(',I 2- Phone # <br />INSPECTION TYPE: routine DComplaint ❑Reinspection <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 <br />\ <br />of medical waste. <br />_2. HSC Section 117903 -Permit from the <br />enforcement agency required to treat medical <br />waste., <br />_3. HSC Section 117890 -No large LQG shall <br />l <br />generate medical waste unless registered with <br />the enforcement agency. <br />,� _ �� - Lj) h t i , -+ t 2 ('rd l' <br />_4. HSC Section 117895-SQG that treats med <br />waste shall register with enforcement agency. <br />HSC Section 117900 -Shall not haul medmj <br />I,�y� r �� _ <br />_5. <br />waste unless registered or obtained LQHE. <br />- 6.HSC Section 117903 -Shall not treat med <br />C O <br />waste without permit from enforcement agency. <br />_THSC Section 117908 -Common Storage <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 />register shall keep records for 2 years. <br />Oro <br />_11.HSC Section 117960-LQG shall file <br />MWMP with enforcement agency. <br />II9129)0 (a <br />_12.HSC Section 117975-LQG shall keep <br />records for 3 years. <br />Transportation <br />r)[o - . r) t��nLe <br />n—} O} - <br />_13. HSC Section 118030-LQHE application. <br />Treatment/Storage <br />_14.HSC Section 118135 -Shall obtain a <br />) cy - 2 - <br />4/?- O -11 11" / D� <br />permit from the enforcement agency to treat <br />me cal waste prior to treating the waste. <br />5.HSC Section 118765 -All treatment <br />records shall be kept for 3 years. <br />_16.HSC Section 118215 -All medical waste <br />�j` D� - i n � <br />shall be treated pursuant to this section. <br />_17.HSC Section 118220 -Recognizable <br />human anatomical parts shall be disposed of by <br />interment unless otherwise hazardous. <br />�Yy , y; ,�1 C��� i �" JA <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 />,AO.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 118310 -Enclosure labeled. <br />24ASC Section 118305 -Cannot reuse drums <br />_25.HSC Section 117630 -Approved biohazard <br />bag used. <br />/ <br />26. Other -Describe in narrative. <br />ThslIpctod Signature Re elved By <br />