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SAN JOAQUIN COUNTY Date I 0,11of 0 <br />E VIRONMENTAL HEALTH DEPARTM NT PR (0S (oj3L <br />1868 East Hazelton Ave., Stockton, CA 95205 <br />(209) 468-3420 <br />MEDICAL WASTE INSPECTION FORM <br />FacilityName Sk. S� ,I� �m�r,u�_C�1�FacilityAddress 19o1 C_ fn,,A L,. *MIQ8 <br />FacilityContact aO30 n ��enc�`�_ Title N -g -c6, cif mz!,S Phone#(;io4Nyj�u`I <br />• <br />❑Complaint ❑Re -inspection <br />VIOLATION(S) <br />Registration <br />THE ITEMS BELOW REPRESENT VIOLATIONS OF THE CALIFORNIA <br />_ 1. HSC Section 117955 -Large Quantity <br />Generator shall register with the enforcement <br />HEALTH & SAFETY CODE (HSC): <br />agency prior to commencement of the generation of <br />medical waste. <br />1 11 L <br />C011a�L� <br />_2. HSC Section 117903 -Permit from the <br />(?U1i CU� IA�(d S�� n�Aet�it)1� t✓� <br />enforcement agency required to treat medical <br />_ <br />waste. <br />_3. HSC Section 117890 -No large LQG shall <br />N f7 1,� t7' !.t i v113 t1 0 eek _ <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 agency. <br />_5. HSC Section 117900 -Shall not haul med <br />11 <br />Q l_ l; V l US <br />waste unless registered or obtained LQHE. <br />q <br />_6.HSC Section 117903 -Shall not treat med <br />1 1W [A GTA <br />waste without permit from enforcement agency. <br />_7.HSC Section 117908 -Common Storage <br />fa cility shall be registered with local enforcement <br />agency. <br />Procedures <br />^ <br />_8.HSC Section 117935-SQG MWMP <br />_9.HSC Section 117943-SQG Shall keep <br />records for 3 years. <br />_10.HSC Section 117945-SQG not required to <br />register shall keep records for 2 years. <br />�� { 14 <br />t <br />_11.HSC Section 117960-LQG shall file MWMP <br />with enforcement agency. <br />1�1/LS q e, <br />Q ] Q e/ 7b <br />_12.HSC Section 117975-LQG shall keep <br />records for 3 years. <br />Transportation <br />S t NAZA,1,J-Mo .n <br />_13. HSC Section 118030-LQHE application. <br />Treatment/Storage <br />_14.HSC Section 118135 -Shall obtain a permit <br />t Mem n <br />T \ ®1 J_ <br />\ <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 />Section 118225 -Treated sharps shall <br />-6e—destroyed <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 <br />bag used. <br />_27.HSC Section 118275(g)-Pharm label/store <br />Insp for Signature Received By Date <br />_28.HSC Section 118222 -Incineration Required <br />29 Other -Describe in narrative. <br />