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GUIDE124ES FOR THE MEDICAL WASTE MANAGEbEENT PLAN <br /> (Please Type or Print) <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 local 0i",0 n n�cy <br /> (PHS-EHD). The medical waste management plan shall contain the P inienP <br /> as appropriate for your facility: 0 CT 0 1 1999 <br /> Business Name: kt j'fl,E.,\l I ��. 7 i��d-. r <br /> Delta Health Care t�i'��9R.,�s� tr <br /> Business Address: 914 North Center Street StoCkf--0n T5�0,2, <br /> Business Phone: (209 ) 466-3245 <br /> Type Of Facility Or Business: Community Clinic <br /> c <br /> Registered As: (Check One) <br /> �j Small Quantity Generator With Onsite Treatment. (Generates < 200 lbs./mo.) <br /> ( ) Large Quantity Generator. (Generates 200 lbs. or more/mo.) <br /> ( ) Large Quantity Generator With Onsite Treatment. (Generates 200 lbs. or more/mo.) <br /> Person Responsible For Implementation Of The Plan: <br /> Name: Sara Godwin, N.P. <br /> Title: Director, Clinical Services Phone: ( 209 ) 466-3245 <br /> ATTACH ADDITIONAL INFORMATION <br /> 1. List the types of medical waste generated at your facility, i.e., Laboratory Wastes, <br /> Blood or Body Fluids, Sharps, Contaminated Animals, Surgical Specimens, or <br /> Isolation Wastes. (See "Regulated Medical Wastes" on Page 3.) <br /> 2. Estimate the monthly amount of medical waste generated at your facility. <br /> 3. Describe the medical waste handling procedures utilized by and applicable to your <br /> facility: <br /> a. Onsite location and method for segregation, containment, packaging, <br /> labelling, and collection. <br /> -CONTINUED ONREVERSE- <br /> 7 <br />