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ENVIRONMENTAL HEALTH DEPARTMENT <br /> SAN JOAQUIN COUNTY <br /> 1868 E. Hazelton Avenue <br /> Stockton, California 95205 <br /> Telephone: (209)468-3420 <br /> Fax: (209) 468-8392 <br /> GUIDELINES FOR THE MEDICAL WASTE MANAGEMENT PLAN <br /> Small quantity generators that provide onsite treatment and all large quantity generators shall have a <br /> Medical Waste Management plan on file with the San Joaquin County Environmental Health Department. <br /> The Medical Waste Management Plan shall contain the following information as appropriate for your <br /> facility: <br /> Business Name: INO 4-- P" a <br /> Business Address: <br /> City State Zip Code <br /> Phone Number: ( ) <br /> Type of Facility or Business: ,0 sis sN:.0 <br /> REGISTRATION FOR: <br /> ❑ Small Quantity Generator with Onsite Treatment(Generates less than 200 lbs/month). <br /> 54 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: � &4 Title: D,y^e--J 14Xftf— <br /> L07 <br /> Phone: M® V6 "0733 Date: /0- /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 /> a)Do you generate M pharmaceutical waste(expired, spent,partials, patient returns)?V Yes ❑No <br /> If yes, describe the type of pharmaceutical waste(expired, spent,partials,patient returns): <br /> Spe'-:0C- <br /> And estimate the monthly amount of pharmaceutical waste generated at your facility: '00/6s <br /> EHD 45-03 5 <br /> 2015 <br />