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ENVIRONMENTAL AL E ENT <br /> SAN JAUIN COUNTY RECEIVED <br /> 1868 E. Hazelton Avenue NOV 0 9 2015 <br /> Stockton, California 95205 <br /> Telephone: (209)468-3420 ENVIRONMENTAL HEALTH <br /> Fax: (209)468-8392 PERMIT/SERVICES <br /> CES <br /> GUIDELINES FOR THE MEDICAL WASTE MANAGEMENT PLAN <br /> 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: &4 ho_ Wscopy <br /> Cew n-e OF t0®1= <br /> Business Address: 94 • Fnimw A6 . ' �n <br /> 1CA 950-4 <br /> City state Zip Code <br /> Phone Number: (toll ) 311- 83 <br /> Type of Facility or Business: IOIt:.AL —n. BURGMY c.CaTU. <br /> RE ISTRATION--FOR:_- <br /> 4Small 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 <br /> Poc-luc <br /> for implementation of the Medical Waste Management Plan: <br /> Name: l wy Title: A bM ig is Tpe <br /> Phone: - Sm- M09 Date: 10 •I9-a,015 <br /> 1. List the types of medical waste generated at your facility(i.e. laboratory wastes, blood or body <br /> fluids sharps,contaminated animals, surgical specimens,trace chemo or isolation wastes): <br /> bQ s <br /> s m <br /> a)Do you generate ggy pharmaceutical waste(expired, spent,partials,patient returns)?[ Yes ❑No <br /> If yes, describe the type of pharmaceutical waste(expired, spent,partials,patient returns): <br /> EXbir d and rbcn4 <br /> And estimate the monthly amount of pharmaceutical waste generated at your facility: <br /> D 45-03 5 <br /> 5 <br />