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GUIDELINES FOR THE MEDICAL WASTE MANAGEMENT <br /> PLAN <br /> Small quantity generators that provide Onsite Treatment and all large quantity generators <br /> shall have a Medical Waste Management plan on file with the San Joaquin County <br /> Environmental Health Department. The Medical Waste Management Plan shall contain the <br /> following information as appropriate for your facility: <br /> Business Nam,96 " .L4 <br /> Business Address:d Ls�dCO N" Ccj 1, _T o 1/n i' <br /> City State Zip Code <br /> Phone Number: o q ) 4 (o ') (- ") <br /> Type of Facility or Business: at C"i c� f c ' C � <br /> REGISTRATION FOR: <br /> ❑ Small Quantity Generator with Onsite Treatment(Generates less than 200lbs/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: s(�L13' t q x '' � �'y�I tIe: �`� c Cs-�"�E y C-t' <br /> Phone( <br /> 05 tD Lo � LODate: <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 /> a) Do you generate M pharmaceutical waste(expired/outdated,spent,partials,)? <br /> b) 'KYes ❑No <br /> If yes,describe the type of pharmaceutical waste(expired, spent,partials,outdated,patient <br /> returns,etc)• ' ��,L ��„�� <br /> �G•r•>�+ �- S i T <br /> And estimate th�,lnonthly amount of pharmaceutical waste generated at your <br /> facility: <br /> EHD 45-03 5 <br /> 10/6/2006 <br />