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f <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> PQ u'N <br /> SAN JOAQUIN COUNTY Unit Supervisors <br /> 2 .er--s4 ,?�G?� Donna K.Heran,R.E.H.S. Carl Borgman,R.E.H.S. <br /> N:. < 304 East Weber Avenue, Third Floor Mike Huggins,R.E.H.S.,R.D.I. <br /> Director <br /> " Al Olsen,R.E.H.S. Stockton, California 95202-2708 Douglas W.Wilson,R.E.H.S. <br /> ., P• Program Manager Telephone: (209) 468-3420 Margaret Lagorio,R.E.H.S. <br /> Laurie A.Cotulla,R.E.H.S. Robert McClellon,R.E.H.S.. <br /> Program Manager Fax: (209) 464-0138 Mark Barcellos,R.E.H.S. <br /> INFORMATION PACKET <br /> FOR MEDICAL WASTE GENERATORS <br /> This packet contains the information and forms you will need to help you comply with <br /> the Medical Waste Management Act. <br /> INSTRUCTIONS <br /> Please return the completed forms prior to medical waste generation or treatment. <br /> 1. Complete the "Pre-Application Questionnaire" on Page 2. If your answers <br /> indicate you are not required to register as a medical waste generator, then <br /> complete the "Certification Statement" on Page 3 and return both completed <br /> forms to the mailing address listed below. <br /> 2. If you are required to register as a medical waste generator, as indicated by <br /> affirmative answers to questions 3 & 4 on the "Pre-Application Questionnaire", <br /> then: <br /> a. Complete the "Registration For Medical Waste" form located on Page 4 <br /> and <br /> b. Complete a "Medical Waste Management Plan" following the <br /> guidelines provided on Page 5 and <br /> C. Return the completed forms and management plan to Kasey Foley at <br /> the mailing address below. <br /> Your cooperation in promptly registering and following the specified handling <br /> requirements is greatly appreciated. <br /> If you have any questions regarding registration or handling requirements, please <br /> contact Kasey Foley at (209) 468-3451. <br /> RETURN ALL COMPLETED FORMS : <br /> Kasey Foley, REHS, Medical Waste Program <br /> San Joaquin County Environmental Health Department <br /> 304 E Weber Avenue, 3rd Floor <br /> Stockton, CA 95202 <br /> 1 • <br />