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• . Date 2t ots> <br /> Record I l l <br /> Prog Elem ±i _ <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 /> Facility Name �ett6.���� (�i�. _Facility Address S5-5v), r, <br /> Facility ContactT ��yi"� Or,.Q gr ur-a.. _ Ril Title Phone # � -- <br /> INSPECTION TYPE: outine ❑Complaint ❑Reinspection <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 <br /> of medical waste. <br /> _2.HSC Section 117903-Permit from the <br /> enforcement agency required to treat medical �Pla I��( lA k1l,i7p AAIn <br /> waste., -A- ' �Of, A t <br /> _3.HSC Section 117890-No large LQG shall ZZ� ��"r l S n` 1 1 E-�� 1':I c) 7 C-f e0 6-A-1 c f <br /> generate medical waste unless registered with - 1— <br /> the enforcement agency. t,L< 4- C�(Z," [n'lrat ria C�-' <br /> _4.HSC Section 117895-SQG that treats med 11 <br /> pn-�- �P,-'f" <br /> waste shall register with enforcement agency. —rr <br /> _5.HSC Section 117900-Shalt not haul med L' r <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 <br /> facility shall be registered with local enforcement <br /> agency. <br /> Procedures o <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 /> 11.HSC Section 117960-LQG shall file --11 I, <br /> MWMP with enforcement agency. lz Q f .C�S1 C( o rl`J,t 1 L1� CY1P"�E���� �t'2� eA "' a <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 , <br /> _14.HSC Section 118135-Shall obtain a <br /> permit from the enforcement agency to treat <br /> medical waste prior to treating the waste. <br /> _15.HSC Section 118765-All treatment , <br /> records shall be kept for 3 years. <br /> _16.HSC Section 118215-All medical waste p <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 /> _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 /> che,mo,shall be labeled properly. <br /> 0.HSC Section 118280-MW label&contain <br /> �1.HSC Section 118285-Sharps label/contain <br /> 22.HSC Section 118295-Proper decon used. <br /> _41-ISC Section 118310-Enclosure labeled. <br /> _24ASC Section 118305-Cannot reuse drums <br /> _25.HSC Section 117630-Approved biohazard <br /> bag used. )/A A <br /> 26.Other-Describe in narrative. Ifi—s'p-actot Signat re I Received B <br />