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The above facility is inspected for compliance with Division 104, Part 14 of California Health and Safety Code (HSC). Registration HSC 117890 - No LQG shall generate medical waste unless El registered with the EA. HSC 117950 - LQG shall register with the EA prior to ❑ 2. generating medical waste. HSC 117903 - Permit from the EA is required prior to treating ❑ 3' medical waste. ❑ 4 HSC 117925 - SQG that treats medical waste onsite shall register with the EA. HSC 117900 - Shall not haul medical waste unless registered, ❑ 5. common carrier, trauma scene practitioner, or exempted under the MOT exemption. HSC 117928 - Common Storage Facility shall have permit El 6. fissured by the EA. ❑ 7 HSC 117890 - LQG shall notify EA 72 hours prior to participating in temporary event. F1 8 HSC 117895 - SQG shall notify EA 72 hours prior to Records/Documentation ❑ 19. I HSC 117935 - Registered SQG shall file MWMP with the EA ❑ 10. HSC 117943 - SQG required to register shall maintain treatment and shipping and tracking records for 3 years. ❑ 11. HSC 117945 - SQG not required to register shall maintain information document and transportation records for 3 years. ❑ 12. HSC 117960 - LQG shall file MWMP with the EA. ❑ 13. HSC 117975 - LQG shall maintain treatment and shipping and tracking documents for 2 years. Transportation [11 14. 1 HSC 117946 - MOT exemption requirements for SQG. I ❑ 115. I HSC 117976 - MOT exemption requirements for LQG. ❑ 116. 1 HSC 118032 - Pharmaceutical waste hauling exemption Received by: Print: Danielle Sherid Print: Sr REHS Treatment ❑ 17 HSC 118130 - All onsite medical waste treatment facilities shall be permitted by the EA. ❑ 18. HSC 118165 - All treatment records shall be kept for 3 years. ❑ 19 HSC 118215 - All medical waste shall be treated pursuant to this section. HSC 118220 - Pathology waste of a human nature shall be ❑ 20. disposed of by interment, incineration, or an approved HSC 118222 - Contaminated pathology waste, trace chemo ❑ 21. waste, or pharm waste from health care settings shall be treated by incineration or an approved alternative. ❑ 22 HSC 118225 - Sharps waste shall be treated pursuant to this section. Containment/Storage ❑ 23 HSC 117630 - Biohazard bag shall meet the standards set forth in this section. HSC 118275 - Medical, biohazardous, sharps, trace chemo, pathology, or pharmaceutical waste shall be segregated and El 24. contained pursuant to this section. The container shall be properly labeled. ❑ 25 HSC 118280 - Biohazard bags shall be containerized and stored pursuant to this section. ❑ 26 HSC 118285 - Sharps waste shall be containerized and stored pursuant to this section. ❑ 27 HSC 118295 - Containers shall be washed and decontaminated pursuant to this section. ❑ 28 HSC 118305 - Reuseable drums or conainters used for medical waste shall not be used for other storage. ❑ 29 HSC 118307- Intermediate storage area shall be secured and marked with proper signage. ❑ 30. HSC 118310 - Designated accumulation area shall be secured and marked with proper signage. Other ❑ 131. 0m Phone: (209) 451-9003 178 Reinspecion onlabout: A reinspection fee of $130 per hour may be charged. Page 1 of 2 EH -08/2015 MEDICAL WASIGNSPECTION REPORT `Date: g C I- 110 San Joaquin County Environmental Health Department Program COO -1 141 S 4 1868 E. Hazelton Ave., Stockton, CA 95205 Record: r"r (209) 468-3420 Program (, C "LJ www.siogv.org/ehd Element: Facility Name Address City Zip Code Gill Medical Center, LLC 1617 n. California st. Stockton 95204 Facility Contact Title Phone Number Email Inspection Type Danielle Sheridan Property Management (209) 451-9003 Routine The above facility is inspected for compliance with Division 104, Part 14 of California Health and Safety Code (HSC). Registration HSC 117890 - No LQG shall generate medical waste unless El registered with the EA. HSC 117950 - LQG shall register with the EA prior to ❑ 2. generating medical waste. HSC 117903 - Permit from the EA is required prior to treating ❑ 3' medical waste. ❑ 4 HSC 117925 - SQG that treats medical waste onsite shall register with the EA. HSC 117900 - Shall not haul medical waste unless registered, ❑ 5. common carrier, trauma scene practitioner, or exempted under the MOT exemption. HSC 117928 - Common Storage Facility shall have permit El 6. fissured by the EA. ❑ 7 HSC 117890 - LQG shall notify EA 72 hours prior to participating in temporary event. F1 8 HSC 117895 - SQG shall notify EA 72 hours prior to Records/Documentation ❑ 19. I HSC 117935 - Registered SQG shall file MWMP with the EA ❑ 10. HSC 117943 - SQG required to register shall maintain treatment and shipping and tracking records for 3 years. ❑ 11. HSC 117945 - SQG not required to register shall maintain information document and transportation records for 3 years. ❑ 12. HSC 117960 - LQG shall file MWMP with the EA. ❑ 13. HSC 117975 - LQG shall maintain treatment and shipping and tracking documents for 2 years. Transportation [11 14. 1 HSC 117946 - MOT exemption requirements for SQG. I ❑ 115. I HSC 117976 - MOT exemption requirements for LQG. ❑ 116. 1 HSC 118032 - Pharmaceutical waste hauling exemption Received by: Print: Danielle Sherid Print: Sr REHS Treatment ❑ 17 HSC 118130 - All onsite medical waste treatment facilities shall be permitted by the EA. ❑ 18. HSC 118165 - All treatment records shall be kept for 3 years. ❑ 19 HSC 118215 - All medical waste shall be treated pursuant to this section. HSC 118220 - Pathology waste of a human nature shall be ❑ 20. disposed of by interment, incineration, or an approved HSC 118222 - Contaminated pathology waste, trace chemo ❑ 21. waste, or pharm waste from health care settings shall be treated by incineration or an approved alternative. ❑ 22 HSC 118225 - Sharps waste shall be treated pursuant to this section. Containment/Storage ❑ 23 HSC 117630 - Biohazard bag shall meet the standards set forth in this section. HSC 118275 - Medical, biohazardous, sharps, trace chemo, pathology, or pharmaceutical waste shall be segregated and El 24. contained pursuant to this section. The container shall be properly labeled. ❑ 25 HSC 118280 - Biohazard bags shall be containerized and stored pursuant to this section. ❑ 26 HSC 118285 - Sharps waste shall be containerized and stored pursuant to this section. ❑ 27 HSC 118295 - Containers shall be washed and decontaminated pursuant to this section. ❑ 28 HSC 118305 - Reuseable drums or conainters used for medical waste shall not be used for other storage. ❑ 29 HSC 118307- Intermediate storage area shall be secured and marked with proper signage. ❑ 30. HSC 118310 - Designated accumulation area shall be secured and marked with proper signage. Other ❑ 131. 0m Phone: (209) 451-9003 178 Reinspecion onlabout: A reinspection fee of $130 per hour may be charged. Page 1 of 2 EH -08/2015