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SAN JOAQUIN COUNTY Date �j bi ta, <br /> ENVIRONMENTAL HEALTH DEPARTMENT PR 0,5317 [144 <br /> 1868 East Hazelton Ave., Stockton, CA 95205 <br /> ® (209)468-3420 <br /> MEDICAL WASTE INSPECTION FORM <br /> FadlityName—S4kr-kV1Ve, s ilityAddress5qC?CC. o Ar pr. IU <br /> PacilityContact �g rC (eft , Title�ec�. Sti�o. Phone#� StDD <br /> INSPECTION TYPE: Dgoutine ❑Complaint ❑Re-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. <br /> _2.HSC Section 117903-Permit from the <br /> enforcement agency required to treat medical c1J� SOID ak ^I1 _ ® U 1 n <br /> waste. <br /> _3.HSC Section 117890-No large LQG shall ' ^roK b GL s3 <br /> generate medical waste unless registered with the �q Ji , <br /> enforcement agency. <br /> V 1011A,0 tg <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 /> waste unless registered or obtained LQHE. <br /> _6.HSC Section 117903-Shall not treat med S'. i i Gt'S no <br /> waste without permit from enforcement agency. i vn <br /> _7.HSC Section 117908-Common Storage <br /> facility shall be registered with local enforcement <br /> agency. <br /> Procedures -T MIA I <br /> _8.HSC Section 117935-SQG MWMP .A ' QS <br /> _9.HSC Section 117943-SQG Shall keep <br /> records for 3 years. <br /> _10.HSC Section 117945-SQG not required to r ' s <br /> register shall keep records for 2 years. _ C�T/� 1n U <br /> 11.HSC Section 117960-LQG shall file MWMP <br /> with enforcement agency. 1 L <br /> _12.HSC Section 117975-LQG shall keep <br /> records for 3 years. <br /> Transportation <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. <br /> _15.HSC Section 118765-All treatment records <br /> shall be kept for 3 years. <br /> 16.HSC Section 118215-All medical waste <br /> ;—hall 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 /> _18.HSC Section 118225-Treated sharps shall <br /> e 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 /> ]k 24.HSC Section 118310-Enclosure labeled. <br /> 5.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 /> _28.HSC Section 118222-Incineration Required nsl4ctor Signature Receive0y Date <br /> 29 Other-Describe in narrative. <br />