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aPq"r"' o SAN JOAQUIN COUNTY Date %-< <br /> ARONMENTAL HEALTH DEPARTMEP PRJ <br /> 600 East Main Street, Stockton, CA 95202 <br /> (209)468-3420 <br /> gcrFORc' MEDICAL WASTE INSPECTION FORM <br /> FacilityNameJ)j:2jaig✓ I%A1rttilr L jY__ FacilityAddress i,3r_ i�rnrrn ..>�yt v <br /> FacilityContact'r,Cr4�"�ka1,�i, �� _ Title { �� Phone# 6l-?-z,--a Z <br /> INSPECTION TYPE: pMoutine []Complaint []Re-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 <br /> enforcement agency required to treat medical <br /> waste. <br /> _3.HSC Section 117890-No large LQG shall r; jZ <br /> generate medical waste unless registered with the <br /> enforcement agency. <br /> _4.HSC Section 117895-SQG that treats med <br /> waste shall register with enforcement agency. Al�� ��� C`-' ��� <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 0j7-,C a <br /> waste without permit from enforcement agency. <br /> _7.HSC Section 117908-Common Storage �� ✓� �'=�t�I �'i�= 0-Yiv �rK�=-` ff1D✓r,� <br /> facility shall be registered with local enforcement : , <br /> agency. �PrT�-f✓1 t �. rA 6� ��� � ci 1 c.JC�� <br /> Procedures , <br /> _8.HSC Section 117935-SQG MWMP <br /> _9.HSC Section 117943-SQG Shall keep / ilk �t,✓l,i/�w /7P ,^c�1— 7T2'G <br /> records for 3 years. / <br /> _10.HSC Section 117945-SQG not required to <br /> register shall keep records for 2 years. ,d -F{?� <br /> 11.HSC Section 117960-LQG shall file MWMP <br /> with enforcement agency. <br /> _12.HSC Section 117975-LQG shall keep <br /> records for 3 years. t1�f�"/r� 7_- [-) /n <br /> Transportation <br /> _13.HSC Section 118030-LQHE application. <br /> Treatment/Storage n T, o- <br /> _14.HSC Section 118135-Shall obtain a permit Y11 <br /> From the enforcement agency to treat medical <br /> waste prior to treating the waste. <br /> 15.HSC Section 118765-All treatment records Y� <br /> sh_all be kept for 3 years. 1 f ly <br /> _16.HSC Section 118215-All medical waste <br /> shall 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 /> be destroyed or 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 Jay- ` <br /> bag used. ���� �/`.� �� <br /> _27.HSC Section 118275(g)-Pharm label/store <br /> _28.HSC Section 118222-Incineration Required I S C Or i nature eceived By Date <br /> 29 Other-Describe in narrative. <br />