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6 0 <br /> GUIDELINES FOR THE MEDICAL WASTE MANAGEMENT PLAN <br /> Small quantity generators that provide onsite treatment and all large quantity generators shall have a medical <br /> waste management plan on file with the local enforcement agency. Minimum required information: <br /> Business Name: Gambro Healthcare—San Joaquin <br /> Business Address: 3115 March Lane Stockton CA <br /> Business Phone: 209) 955 7527 <br /> Type of Facility: Hemodialysis Center <br /> Registered As; (Check One) <br /> Small Quantity Generator With Onsite Treatment(Generates<200 lbs/mo.) <br /> (X) Large Quantity Generator: (Generates 200 lbs,or more/mo.) <br /> Common Storage Generator With Onsite Treatment. (Generates 200 lbs. or more/mo.) <br /> O Common Storage Facility (Small Quantity Generators only.) <br /> Person Responsible For Implementation Of the Plan: <br /> Name: Sarah Elvin Title: Center Director Phone: (209) 955-7527 <br /> ATTACH THE FOLLOWING ADDITIONAL INFORMATION <br /> 1. List the types of regulated medical waste generated at your facility(include pharmaceutical waste). <br /> 2. Estimate the monthly amount of each waste stream in pounds, of medical waste generated at your <br /> facility. <br /> 3. Describe the medical waste handling procedures utilized by and applicable to your facility: <br /> a. Onsite location and method for segregation,containment,packaging, labeling,and collection. <br /> b. Storage area description with storage methods utilized, including duration and temperature <br /> controls, if applicable. <br /> C. Onsite treatment facility description, including type of treatment utilized,maximum capacity, <br /> time and temperature necessary, alternate contingency plan in case of equipment failure, etc. <br /> d. Name, address,registration number, and phone number, of the registered hazardous waste <br /> hauler employed by your facility. <br /> e. Name, address and phone number of offsite treatment facility where medical waste is <br /> transported for treatment, if different than the hauler. <br /> f. Do you have a Limited Quantity Hauling Exemption? Who on yours is authorized to <br /> transport your medical waste? <br /> 9. Do you have tracking documents for all medical wastes handled at your facility? All medical <br /> waste generators are required to keep accurate records regarding containment, storage, <br /> hauling,treatment and disposal. All medical waste records are to be maintained and <br /> available for 3 years. <br /> h. Describe your medical waste emergency action plan, including procedures for handling <br /> spills, exposures, equipment failures, etc. <br /> I hereby certify that to the best of my knowledge and belief that the statements made herein are correct and true. <br /> SIGNATUREcsc C' TITLE: a- \.X-,( '\1"rgjDATE: 61-7 IC)S <br />