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ENVIRONMENTAL HEALTH DEPARTMENT <br /> SAN JOAQUIN COUNTY <br /> 1868 E. Hazelton Avenue <br /> Stockton, California 95205 <br /> Telephone: (209)468-3420 <br /> Fax: (209) 468-8392 <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: y <br /> Business Name: <br /> Business Address: *tut ti nc <br /> City State Zip Code <br /> Phone Number: ( 2 " ) /� ` W <br /> Type of Facility or Business: 'D1 nl u S MS GA i n t G <br /> REGISTRATION-FOR:- <br /> ❑ Small 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 for implementation of the Medical Waste Management Plan: <br /> Name: Title: <br /> Phone: Date: <br /> 1. List the types of medical waste generated at your facility(i.e. laboratory wastes, blood or body <br /> fll.ids, sharps, contaminated animals, surgical specimens,trace chemo or isolation wastes): <br /> 1 <br /> a) Do you generate any pharmaceutical waste (expired, spent,partials, patient returns)? N Yes ❑No <br /> If yes, describe the type of pharmaceutical waste (expired, spent,partials, atient returns): <br /> f� Gita t Gi� C S. 1 1 °`' 'r' �c <br /> r �tyle <br /> And estimate the monthly amount of pharmaceutical waste generated at your facility: <br /> EHD 45-03 5 <br /> 2015 <br />