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P. <br /> SAN JOAQUIN COUNTY Date <br /> ENVIRONMENTAL HEALTH DEPARTMENT PR OS 119'7 <br /> 1868 East Hazelton Ave., Stockton, CA 95205 <br /> 0. X <br /> (209)468-3420 <br /> MEDICAL WASTE INSPECTION FORM <br /> FacilityName kcrr-,,it-t.n Xcal (4*9fnsc, FacifityAddress X100 S Ave— <br /> FacifityContact N(OCA11 Titlea4h�na ("01j',r'A2.y PhoneKa—ot-1-411-w3l) <br /> INSPECTION TYPE: p(Routine oComplaint EiRe-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 V)O iW.5 <br /> 'en—forcement agency required to treat medical \j <br /> waste. <br /> —3.HSC Section 117890-No large LQG shall <br /> generate medical waste unless registered with the <br /> enforcement agency. <br /> 4.HSC Section 117895-SQG that treats med L <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 a *AwAilc\4 <br /> waste without permit from enforcement agency. <br /> 7.HSG Section 117908-Common Storage <br /> facility shall be registered with local enforcement <br /> agency. <br /> Procedures 3. uLLthl x"4(, i0l' SC/Vl 61dll J"%14 Of'12:� <br /> —8.HSC Section 117935-SQG MWMP Jr <br /> —9.HSC Section 117943-SQG Shall keep L41 LAXA Lk CA", (""A Akio <br /> records for 3 years. <br /> —10.HSC Section 117945-SQG not required to <br /> register shall keep records for 2 years. <br /> —11.HSC Section 117960-LQG shall file MWMP \l® V)1AS P04191 LM21-4 MQMAI'cu� <br /> with enforcement agency. ��u 11AI A ACP&L.LC Qcrn�h <br /> —12.HSC Section 117975-LQG shall keep <br /> L <br /> records for 3 years. 6 <br /> Transportation <br /> —13.HSC Section 11 8030-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 /> ;—hall be kept for 3 years. <br /> 16.HSC Section 118216-All medical waste <br /> s'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 /> bedestroyedor 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 /> —24.HSC Section 118310-Enclosure labeled. <br /> —25.HSC Section 118305-Cannot reuse drums <br /> —26.HSC Section 117630-Approved biohazard <br /> bag used. <br /> —27.HSC Section 118275(g)-Pharm labellstore &4 - <br /> 1yvw,. C3N <br /> y <br /> —28.HSC Section 118222-incineration Required Insp6dtor Signature ReL Date <br /> 29 Other-Describe in narrative. <br />