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i <br /> oPa�'•N. c SAN JOAQUIN COUNTY Date Vqih _ <br /> ENVIRONMENTAL HEALTH DEPARTMENT PR D 5'1 <br /> X 600 East Main Street, Stockton, CA 95202 <br /> (209)468-3420 <br /> MEDICAL WASTE INSPECTION FORM <br /> FacilityName NA-1 X064 FacilityAddress S15i kc*c, I�Itie . <br /> FacilityContact Title GrW. M,n& Phone J OtgSU-S%35 <br /> INSPECTION TYPE: outine ❑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. �� �� •� ' t/��Ifl S e_ �! DT <br /> _2.HSC Section 117903-Permit from the <br /> enforcement agency required to treat medical <br /> waste. pp <br /> _3.NSC Section 117890-No large LQG shall <br /> generate medical waste unless registered with the 1 <br /> enforcement agency. 1 11 <br /> _4.HSC Section 117895-SQG that treats med S,,nl�t)�• SU'9mi1" 0 Vii <br /> waste shall register with enforcement agency. <br /> _5.HSC Section 117900-Shall not haul med <br /> waste unless registered or obtained LQHE. �/ 1 <br /> _6.HSC Section 117903-Shall not treat med <br /> waste without permit from enforcement agency. l <br /> _7.HSC Section 117908-Common Storage n SS -L-A �� h PION,- <br /> facility shall be registered with local enforcement SI i1 <br /> agency. <br /> Procedures ti--" <br /> _8.HSC Section 117935-SQG MWMP <br /> _9.HSC Section 117943-SQG Shall keep <br /> records for 3 years. S•, ' (� aK W J 1 L 1 <br /> _10.HSC Section 117945-SQG not required to <br /> register shall keep records for 2 years. U.s A& iLIA pl`e& ('v in <br /> —I 1.HSC Section 117960-LQG shall file MWMP f <br /> with enforcement agency. 70f(t1W <br /> _12.HSC Section 117975-LQG shall keep1 v 1_ <br /> records for 3 years. V",A c i l 1013A L�kl. <br /> Transportation ('Aft.1 <br /> _13.HSC Section 118030-LQHE application. <br /> Treatinent/Storage <br /> _14.HSC Section 118135-Shall obtain a permit I(\ clino, b tt ; <br /> From the enforcement agency to treat medical 1 —( <br /> waste prior to treating the waste. on i4,1A I }�1 sl, - 1 <br /> _15.HSC Section 118765-All treatment records <br /> shall be kept for 3 years. D' <br /> _16.HSC Section 118215-All medical waste i 11lr <br /> shall be treated pursuant to this section. <br /> _17.HSC Section 118220-Recognizable human �. jJ� IIlk <br /> anatomical parts shall be disposed of by interment <br /> unless otherwise hazardous. LU1,'� fl u <br /> _18.HSC Section 118225-Treated sharps shall , 1 <br /> be destroyed or somehow prevent public access. S <br /> _19.HSC Section 118275-MW red bags,path, kniA 4f I F. <br /> chemo shall be labeled properly. <br /> _20.HSC Section 118280-MW label&contain �-4 <br /> _21.HSC Section 118285-Sharps label/contain <br /> 22.HSC Section 118295-Proper decon used. <br /> K23.HSC Section 118307-Interim storage labeled 1 <br /> �24.HSC Section 118310-Enclosure labeled. �' FUJI► t S % S r klA <br /> _25.HSC Section 118305-Cannot reuse drums <br /> _26.HSC Section 117630-Approved biohazard <br /> bag used. 9 1 _ �� <br /> _27.HSC Section 118275(g)-Pharm label/store U�p <br /> _28.HSC Section 118222-Incineration Required Insp for Signature ecei y ate <br /> 29 Other-Describe in narrative. <br />