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MEDICAL WASTASPECTION REPORT • Date: ti /36/Zo Is / GZ fly San Joaquin County Environmental Health Department Program p 1868 E. Hazelton Ave.,Stockton,CA 95205 Record: \ 1ZOS—97 0 I cI P (209)468-3420 Program <%FQR�� www.s'ogv.org/ehd Element: y S 3Z Facility Name Address City Zip Code Bella Terra Dental 1110 w.kettleman In. Lodi 95240 Facility Contact Title Phone Number Email Inspection Type Dr.Joseph DMD (209)224-8104 bellaterradentallo Routine di@gmail.com The above facility is inspected for compliance with Division 104,Part 14 of California Health and Safety Code(HSC). is ration �E ryT reatment HSC 117890-No LQG shall generate medical waste unless HSC 118130-All onsite medical waste treatment facilities shall El 1' registered with the EA. ❑ 17' be permitted by the EA. HSC 117950-LQG shall register with the EA prior to E] 2. E] 18. HSC 118165-All treatment records shall be kept for 3 years. generating medical waste. HSC 117903-Permit from the EA is required prior to treating HSC 118215-All medical waste shall be treated pursuant to ❑ 3. medical waste. ® 19. this section. HSC 117925-SQG that treats medical waste onsite shall HSC 118220-Pathology waste of a human nature shall be ❑ 4' register with the EA. ❑ 20. disposed of by interment, incineration,or an approved alternative. HSC 117900-Shall not haul medical waste unless registered, HSC 118222-Contaminated pathology waste,trace chemo ❑ 5. common carrier,trauma scene practitioner,or exempted ❑ 21. waste,or pharm waste from health care settings shall be treated under the MOT exemption. by incineration or an approved alternative. HSC 117928-Common Storage Facility shall have permit HSC 118225-Sharps waste shall be treated pursuant to this ❑ 6' issured by the EA. ❑ 22' section. ARI: c v n= ❑ 7 HSC 117890-LQG shall notify EA 72 hours prior to gcpltaInle participating in temporary event.' HSC 117895-SQG shall notify EA 72 hours prior to HSC 117630-Biohazard bag shall meet the standards set forth El 8' participating in temporary event. ❑ 23' in this section. HSC 118275-Medical,biohazardous,sharps,trace chemo, Re"cords/Documentation ® 24 pathology,or pharmaceutical waste shall be segregated and contained pursuant to this section. The container shall be .. properly labeled. ® 9. HSC 117935-Registered SQG shall file MWMP with the EA. ❑ 25 HSC 118280- Biohazard bags shall be containerized and stored pursuant to this section. HSC 117943-SQG required to register shall maintain HSC 118285-Sharps waste shall be containerized and stored ® 10. treatment and shipping and tracking records for 3 years. ❑ 26' pursuant to this section. HSC 117945-SQG not required to register shall maintain HSC 118295-Containers shall be washed and decontaminated ❑ 11. information document and transportation records for 3 years. El 27' pursuant to this section. HSC 118305- Reuseable drums or conainters used for medical ❑ 12. HSC 117960-LQG shall file MWMP with the EA. ❑ 28. waste shall not be used for other storage. HSC 117975-LQG shall maintain treatment and shipping and HSC 118307- Intermediate storage area shall be secured and ❑ 13. tracking documents for 2 years. ❑ 29' marked with proper signage. Trans Ortat�0 El30 HSC 118310-Designated accumulation area shall be secured p..=.r °r , and marked with proper signage. „k ❑ 14. HSC 117946-MOT exemption requirements for SQG. Other ❑ 15. HSC 117976-MOT exemption requirements for LQG. ® 31. HSC 117938-Records of training ❑ 16. HSC 118032-Pharmaceutical waste hauling exemption. ❑ 32. Received by: Print: Dr.Joseph Signature: meae Al Phone:(209)224-8104 Specialist: Print: Harprit Mattu,Sr REHS Signature: Phone: (209)468-3284 Reinspecion on/about: A reinspection fee of$130 per hour may be charged. Page 1 of 3 EH-08/2015