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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: ®a, <br /> Business Address: 1 I C4\-,l <br /> oC 4a <br /> City State Zip Code <br /> Phone Number: (20,11, ) I <br /> Type of Facility or Business: k emaA I M u s i :5 C �i ai c <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: C 1 Ir e-VX-L Title: mac® VXi Hca 1 Guloevviov- <br /> Phone: °�® L4 0 5 Date: ( 1 - <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 /> C,-,vAd b�A!q -fl i/iA 5, f2lA,,j C3f2 <br /> a) Do you generate aM pharmaceutical waste(expired/outdated, spent,partials,)? <br /> b) F71 Yes ❑No <br /> If yes, describe the type of pharmaceutical waste(expired, spent,partials,outdated,patient <br /> returns, etc): <br /> l f E.C)► 1� �5 - <br /> And estimate the monthly amount of pharmaceutical waste generated at your <br /> facility: +(3I\j-tih r , <br /> EHD 45-03 5 <br /> 10/6/2006 <br />