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SAN JOAQUIN COUNTY Date tf Jq-ly <br /> EN IRONMENTAL HEALTH DEPARTMEN i PR n <br /> 600 East Main Street, Stockton, CA 95202 <br /> (209)468-3420 <br /> P MEDICAL WASTE INSPECTION FORM <br /> ���FORa <br /> FacilityName D:jj,6— FacilityAddress3i 2,---�, 10, dlca^ L can e_ <br /> FacilityContactP'l0C-ywU V IWUAy Title tf =' ! Phone#.2, -- 4-;,-7-44t3:Z <br /> INSPECTION TYPE: p9eutine []Complaint ❑Re-inspection <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 of <br /> medical waste. <br /> _2.HSC Section 117903-Permit from the _ <br /> enforcement agency required to treat medical L✓C fig <br /> waste. <br /> _3.HSC Section 117890-No large LQG shall <br /> generate medical waste unless registered with the <br /> enforcement agency. !y n ?: e" S <br /> _4.HSC Section 117895-SQG that treats med <br /> waste shall register with enforcement agency. <br /> _5.HSC Section 117900-Shall not haul med <br /> waste unless registered or obtained LQHE. <br /> _6.HSC Section 117903-Shall not treat med <br /> waste without permit from enforcement agency. I <br /> _7.HSC Section 117908-Common Storage A La-uar-c.> (-,L -41tL\ ±rc c- I j1-v s ��/rc ��aV►!a <br /> facility shall be registered with local enforcement <br /> agency. <br /> Procedures <br /> _8.HSC Section 117935-SQG MWMP / <br /> _9.HSC Section 117943-SQG Shall keep <br /> records for 3 years. �� „� pyt f:d r�✓lr',\�)ri,Ll <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 MWMP r <br /> with enforcement agency. d S70 r D✓I _ -�YDY✓1_ O" S <br /> _12.HSC Section 117975-LQG shall keep <br /> records for 3 years. _l <br /> Transportation 3.1 /�� �f v�eo,. �-rnrn �,r c ayz�.l '.4 rja: <br /> _13.HSC Section 118030-LQHE application. <br /> Treatment/Storage n�'�" U�''�2— t�`�'"' �c"^ 1- - `Znt 4.,-' <br /> From <br /> Section 118135-Shall obtain a permiti�. <br /> from the enforcement agency to treat medical <br /> waste prior to treating the waste. <br /> _15.HSC Section 118765-All treatment records <br /> shall be kept for 3 years. <br /> _16.HSC Section 11 8215-All medical waste <br /> shall be treated pursuant to this section. <br /> _17.HSC Section 118220-Recognizable human <br /> anatomical parts shall be disposed of by interment <br /> 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 /> chemo shall be labeled properly. <br /> _20.HSC Section 118280-MW label&contain <br /> _21.HSC Section 118285-Sharps label/contain <br /> _22.HSC Section 118295-Proper decon used. <br /> _23.HSC Section 118307-Interim storage labeled <br /> _24.HSC Section 118310-Enclosure labeled. <br /> _25.HSC Section 118305-Cannot reuse drums <br /> _26.HSC Section 117630-Approved biohazard /J <br /> bag used. 1/✓/ <br /> 27.HSC Section 118275(g)-Pharm label/store <br /> —_28.HSC Section 118222-Incineration Requiredp ct Si nature Recei ed By Date <br /> 29 Other-Describe in narrative. <br />