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0 SAN JOAQUIN COUNTY <br /> Environmental Health Department DIRECTOR <br /> Linda Turkafte,REHS <br /> 1868 E. Hazelton Avenue <br /> PROGRAM COORDINATORS <br /> Stockton, California 95205 <br /> Robert McClellon,REHS <br /> Jeff Carruesco,REHS,RDI <br /> Website: www.sjcehd.com Kasey Foley,REHS <br /> Phone: (209)468-3420 Adrienne Ellsaesser,REHS <br /> Fax: (209)468-8392 Rodney Estrada,REHS <br /> INFORMATION PACKET FOR MEDICAL WASTE GENERATORS <br /> This packet contains the information and forms you will need to help you comply with the <br /> Medical Waste Management Act. <br /> Instructions <br /> Please return the completed forms prior to medical waste generation or treatment. <br /> 1. Complete the"Pre-Application Questionnaire" on Page 2. If your answers indicate <br /> you are not required to register as a medical waste generator,then complete the <br /> "Certification Statement" on Page 3 and return both complete forms to the mailing <br /> address below. <br /> 2. If you are required to register as a medical waste generator, as indicated by affirmative <br /> answers to questions 3 &4 on the"Pre-Application Questionnaire",then: <br /> a. Complete the"Registration for Medical Waste" form located on Page 4. <br /> b. Complete a"Medical Waste Management Plan" following the guidelines <br /> provided on Page 5. <br /> c. Return the completed forms and management plan to the mailing address <br /> below. <br /> Your cooperation in promptly registering and following the specified handling requirements is <br /> greatly appreciated. <br /> If you have any questions regarding registration or handling requirements,please contact us at <br /> (209)468-3420 and ask for assistance in the Medical Waste Program. <br /> RETURN ALL COMPLETED FORMS TO: <br /> San Joaquin County Environmental Health Department <br /> 1868 E. Hazelton Ave. <br /> Stockton, CA 95205 <br /> Attn: Medical Waste Program <br /> EHD 45-03 <br /> 2015 <br />