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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 Name: WfA <br /> Business Address: uj. 6(1-,&t�; -\t4 C V-9. 711. I <br /> to" 1 01. 1�3 <br /> City State Zip Code <br /> Phone Number: ( 2 D C1 ) f <br /> Type of Facility or Business: Q1 v11 5 <br /> REGISTRATION FOR: <br /> ❑ Small Quantity Generator with Onsite Treatment(Generates less than 2001bs/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: k H CS Title: P IN-tni Clot, (ClAt� <br /> Phone: xc� • iii' , ® Date: 116 05 ;"Ol 7 <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 /> PtOOD, ftoy LU119� 51a f5. <br /> a) Do you generate any pharmaceutical waste(expired/outdated,spent,partials,)`? <br /> b) Yes ❑ No <br /> If yes,describe the type of pharmaceutical waste(expired, spent,partials,outdated,patient <br /> returns, etc): (0LLr<-1Ti? 4 '915f���� <br /> lXP1f169 mg,�3, ,-PON pA'z-n fAS'eo �0PGIC-t3X PAA e A4SI)rCA-1-5E <br /> And estimate the monthly amount of pharmaceutical waste generated at your <br /> facility: ilnl-1f., <br /> EHD 45-03 5 <br /> 10/6/2006 <br />