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U"! <br /> . ...... SAN JOAQUIN COUNTY Dated t5-1 <br /> ENVIRONMENTAL HEALTH DEPARTMAN PR <br /> 600 East Main Street, Stockton, CA 95202 <br /> (209)468-3420 <br /> CRL1 .0 MEDICAL WASTE INSPECTION FORM <br /> FacilityName FacilityAddress 4!4Ire- -,yo <br /> FacilityContactAcy\ —Title <br /> 1 14 1 1- <br /> INSPECTION TYPE: Pqoutine ocomplaint []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 SC): <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 <br /> waste. <br /> —3.HSC Section 117890-No large LOG shall <br /> generate medical waste unless registered with the <br /> enforcement agency. <br /> —4.HSC Section 117895-SQG that treats med <br /> waste shall register with enforcement <br /> —5.HSC Section 117900-Shall not haul med A4 j <br /> waste unless registered or obtained LQHE. <br /> —6.HSC Section 117903-Shall not treat med ,J- <br /> waste without permit from enforcement agency' <br /> _7 <br /> THSC Section 117908-Common Storage <br /> T� <br /> Qb _SL04� Z3;2 <br /> a ility shall be registered with local enforcement <br /> agency. <br /> Procedures -%.e- 14a-jr, L= :tLg Vint lid <br /> —8.HSC Section 117935-SQG MWMP <br /> _9.HSC Section 117943-SQG Shall keep <br /> records for 3 years. A+10- LL)au C2 +0 AI(7-LJ- <br /> -10.HSC Section 117945-SQG not required to LIQQ �2 <br /> register shall keep records for 2 years. <br /> W <br /> —1 I.HSC Section 11 7960-LQG shall file MWMP <br /> with enforcement agency. 11=1 Z Olt- <br /> -12.HSC Section 117975-LQG shall keep <br /> records for 3 years. Zd6,1� <br /> Transportation CH-MAP 4.,e"Lj�k_4 y- I'm <br /> —13.HSC Section 118030-LQHE application. <br /> Treatment/Storage <br /> 14.HSC Section 118135-Shall obtain a permit <br /> from the enforcement agency to treat medical <br /> waste prior to treating the waste. 7 3 q, AC4 V1 OLO I L k <br /> —15.HSC Section 118766-All treatment records <br /> shall be kept for 3 years. <br /> 16.HSC Section 118215-All medical waste <br /> _shall be treated pursuant to this section. Ll- V Avrr"A I�iff� <br /> -17.HSC Section 118220-Recognizable human ril ,AAAr, ��Jvl <br /> anatomical parts shall be disposed of by interment <br /> unless otherwise hazardous. <br /> 18.HSC Section 118225-Treated sharps shall <br /> _6e destroyed or somehow prevent public access. r, <br /> __19.HSC Section 118275-MW red bags,path, Ur-, bvv -kf\p- /1 C_ <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 <br /> bag used. <br /> —27.HSC Section 118275(g)-Pharm label/store <br /> 28.HSC Section 118222-Incineration Required .4leop S 2 at <br /> 29 Other-Describe in narrative. Signature Rle#ved By <br />