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r,c'RUi" MEDICAL WAS TASPECTION REPORT • Date: San Joaquin County Environmental Health Department a II p /jq O y q p Program 1868 E. Hazelton Ave.,Stockton,CA 95205 Record: F R d 6,2 77116 (209)468-3420 Program www.siogv.org/ehd Element: 4530 Facility Name Address City Zip Code Pacific Medical Inc 1700 n chrisman rd Tracy 95304 Facility Contact Title Phone Number Email Inspection Type Lori Vukmirovich Surgical Lab Coordinator 1-800-726-9180 Routine (ext 7600) The above facility is inspected for compliance with Division 104,Part 14 of California Health and Safety Code(HSC). Registration Treatment HSC 117890-No LOG shall generate medical waste unless HSC 118130-All onsite medical waste treatment facilities shall 1 registered with the EA. 17' be permitted by the EA. ❑ HSC 117950-LOG shall register with the EA prior to 2. generating medical waste. El18. HSC 118165-All treatment records shall be kept for 3 years. HSC 117903-Permit from the EA is required prior to treating HSC 118215-All medical waste shall be treated pursuant to El 3. medical waste. El 19. this section. HSC 117925-SQG that treats medical waste onsite shall HSC 118220-Pathology waste of a human nature shall be ❑ 4. register with the EA. ❑ 20. disposed of by interment,incineration,or an approved alternative. HSC 117900-Shall not haul medical waste unless registered, HSC 118222-Contaminated pathology waste,trace chemo ❑ 5. common carrier,trauma scene practitioner,or exempted ❑ 21. waste,or pharm waste from health care settings shall be treated under the MOT exemption. by incineration or an approved alternative. HSC 117928-Common Storage Facility shall have permit HSC 118225-Sharps waste shall be treated pursuant to this F1 6' issured by the EA. El 22. section. ❑ 7 HSC 117890-LOG shall notify EA 72 hours prior to Containment/Storage participating in temporary event. HSC 117895-SQG shall notify EA 72 hours prior to HSC 117630-Biohazard bag shall meet the standards set forth F1 8" participating in temporary event. El 23. in this section. HSC 118275-Medical,biohazardous,sharps,trace chemo, Records/Documentation ® 24 pathology,or pharmaceutical waste shall be segregated and contained pursuant to this section. The container shall be properly labeled. ❑ 9. HSC 117935-Registered SQG shall file MWMP with the EA. ❑ 25 HSC 118280- Biohazard bags shall be containerized and stored pursuant to this section. HSC 117943-SQG required to register shall maintain HSC 118285-Sharps waste shall be containerized and stored El 10. treatment and shipping and tracking records for 3 years. El 26. pursuant to this section. HSC 117945-SQG not required to register shall maintain HSC 118295-Containers shall be washed and decontaminated ❑ 11. information document and transportation records for 3 years. El 27 pursuant to this section. HSC 118305- Reuseable drums or conainters used for medical ❑ 12. HSC 117960-LOG shall file MWMP with the EA. ❑ 28. waste shall not be used for other storage. HSC 117975-LOG shall maintain treatment and shipping and 29HSC 118307- Intermediate storage area shall be secured and ❑ 13. tracking documents for 2 years. ❑ . marked with proper signage. Transportation El 30. HSC 118310-Designated accumulation area shall be secured and marked with proper signage. ❑ 14. HSC 117946-MOT exemption requirements for SQG. Other ❑ 15. HSC 117976-MOT exemption requirements for LOG. ® 31. HSC 117630-Medical waste containers not lined. ❑ 16. HSC 118032-Pharmaceutical waste hauling exemption. ❑Al 32. j&& �LReceived by: Print: Lori Vukmirovich Signature: 1AB Phone: 1-800-726-9180 Specialist: Print: Sandip Singh Signature: Phone: 209-468-3526 Reinspecion on/about: A reinspection fee of$152 per hour may be charged. Page 1 of 2 EH-11/17