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Small quantity generators that provide Onsite Treatment and all large quantity generators shall have a <br />Medical Waste Management plan on file with the San Joaquin County Environmental Health Department. <br />The Medical Waste Management Plan shall contain the following information as appropriate for your <br />facility: <br />Business Name: <br />Business Address: <br />Phone Number: <br />Type of Facility or Business: <br />11:7KIT(.`m <br />City State Lip Code <br />M, <br />❑ Small Quantity Generator with Onsite Treatment (Generates less than 200 lbs/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: Title: eiC/ Date: <br />1. List the types of medical waste generated at your facility, i.e., laboratory wastes, blood or body <br />fluids, sharps, contaminated animals, s rgical specimns or isolation wastes: (See "Regulated <br />Medical Waste" listecj on Page 2). � � �O��a, S('1 J'� � <br />2. Estimate the monthly amount of medical waste generated at your facility: <br />3. Describe the medical waste handling procedures utilized by and applicable to your facility, including, <br />but not limited to the following: <br />a. On to location anq me�od for segregation, containment, packaging, labeling and collection: <br />GI11) 45-02-003 web Page 5 of 7 <br />8'14`07 <br />