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SAN JOAQUIN COUNTY Date <br /> ENVIRONMENTAL HEALTH DEPARTMENT PR 05 (01$3 <br /> 1868 East Hazelton Ave., Stockton, CA 95205 <br /> (209)468-3420 <br /> MEDICAL WASTE INSPECTION FORM <br /> Facility Name SgIr,11-itc. N4%1wSis ill Address 2,1,sto W, (,r4-4 Li -RA,4156 <br /> 13 <br /> FacilityContact P.,,ul 1ka1i:A-Lr Title Ej,4,j?oy4Tey6 Phone#(a 8—) —40 <br /> INSPECTION TYPE: Routine oComplaint olle-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. ID4 -+Wl,,, <br /> 2.HSC Section 117903-Permit from the all <br /> enforcement agency required to treat medical <br /> waste. <br /> —3.HSC Section 117890-No large LQG shall <br /> generate medical waste unless registered with the <br /> enforcement agency. N <br /> —4.HSC Section 11 7895-SQG that treats med \j <br /> waste shall register with enforcement agency. Al �)k'(A -tA-&1r 1.1, fjymn� <br /> —6.HSC Section 117900-Shall not haul med <br /> waste unless registered or obtained LQHE. <br /> 6.HSC Section 117903-Shall not treat med "T- ni- PAI'n of-) S;h- <br /> waste without permit from enforcement agency. <br /> -THSC Section 117908-Common Storage <br /> Facility shall be registered with local enforcement 3 Ili, ±11L c 1. jLK)oh'CA WtA sh- <br /> agency. <br /> Procedures <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. 1.1LaDiJIA It 41L <br /> 11.HSC Section 117960-LQG shall file MWMP <br /> �ith enforcement agency. n+ fi'l I ty <br /> (e'Alu <br /> —12.HSC Section 117975-LQG shall keep s 1 N I-J11A <br /> records for 3 years. <br /> Transportation A IL-N jd\ Ina' <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. ckl t4 11�'z I A.XP 1, u Qkkt X-4 Q <br /> 15.HSC Section 11 8765-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. j. <br /> --17.HSC Section 118220-Recognizable human <br /> anatomical parts shall be disposed of by interment -IM3 <br /> unless otherwise hazardous. a CL +f C'r^ <br /> 18.HSC Section 118225-Treated sharps shall <br /> be destroyed or somehow prevent public access. U-.Ae- <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 /> ba g used. <br /> 27.HSC Section 11 8275(g)-Pharm label/store <br /> —28.HSC Section 118222-Incineration Required lnspE(Jtor Signature Received By Date <br /> 29 Other-Describe in narrative. <br />