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A <br /> GUIDELINES FOR THE MEDICAL WASTE MANAGEMENT <br /> PLAN <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 San Joaquin County <br /> Environmental Health Department. The Medical Waste Management Plan shall contain the <br /> following information as appropriate for your facility: <br /> ( "r—&V <br /> Business Name: Nol Ac, <br /> Business Address: / <br /> Wu CP- <br /> City State Zip Code <br /> Phone Number: ( ) <br /> Type of Facility or Business: A"452� /�� <br /> REGISTRATION FOR: <br /> ❑ Small Quantity Generator with Onsite Treatment(Generates less than 2001bs/month). <br /> Large Quantity Generator Only(Generates 200 lbs or more/month). <br /> Large Quantity Generator with Onsite Treatment(Generates 200 lbs or more/month). <br /> Person responsible for implementation of the Medical Waste Management Plan: <br /> Name: 9r Title: <br /> Phone: r Date: 194d OL <br /> I. List the types of medical waste generated at your facility,i.e., laboratory wastes,blood or body <br /> fl ids, sharps,contami ed ani als, surgical specimens,trace chemo or isolation wastes": <br /> l1714 <br /> a) Do you generate aM pharmaceutical waste(expired/outdated, spent,partials,)? <br /> b) Yes ❑No <br /> If yes, describe the type of pharmaceutical waste(expired, spent,partials,outdated,patient <br /> returns etc): ' <br /> And estimate the monthly amount of pharmaceutical waste generated at your <br /> facility: -- ,�- <br /> EHD 45-03 5 <br /> 10/6/2006 <br />