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0 <br />SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />304 E. Weber Ave., Third Floor, Stockton, CA 95202 <br />(209) 468-3420 <br />MEDICAL WASTE INSPECTION FORM <br />Date <br />Record ID� C(7C,I <br />Prog Elern4 'Z Z <br />Facility Name Facility Address <br />Facility Contact CZLI+� Title . e,,j' Ione #--L4 L,) 1 --7-A I (n <br />INSPECTION TYPE: (Routine ❑Complaint ❑Reinspection <br />VIOLATION(S) <br />Registration <br />THE ITEMS BELOW REPRESENT VIOLATIONS OF THE CALIFORNIA <br />_ 1. HSC Section 117955 -Large Quantity <br />Generator shall register with the enforcement <br />HEALTH & SAFETY CODE (HSC): <br />agency prior to commencement of the generation <br />of medical waste. <br />HSC Section 117903 -Permit from the <br />< <br />1 2 _ �^ a r`c Oh c f y i car i 1 �� c n �, p((I ca c) ods <br />e.r <br />_2. <br />enforcement agency required to treat medical <br />waste. <br />_3. HSC Section 117890 -No large LQG shall <br />generate medical waste unless registered with <br />1+J, <br />the enforcement agency. <br />r ' ' �' '' C r_ C c) + i i ,\,7, � f- <br />_4. HSC Section 117895-SQG that treats med <br />waste shall register with enforcement agency. <br />h�a <br />1�.� ���IYl c� iCi :r �,:.� _ /� r� C �'r"waste <br />����.l�'�,- <br />_5. HSC Section 117900 -Shall not haul med <br />unless registered or obtained LQHE. <br />�,6.HSC <br />Section 117903 -Shall not treat med <br />waste without permit from enforcement agency. <br />7.HSC Section 117908 -Common Storagery"125 <br />f ,)h�� . �e- 4 <br />facility shall be registered with local enforcement <br />agency. <br />Procedures <br />gz - <br />8.HSC Section 117935-SQG MWMP <br />_9.HSC Section 117943-SQG Shall keep <br />records for 3 years. <br />_10.HSC Section 117945-SQG not required to <br />register shall keep records for 2 years. <br />_11.HSC Section 117960-LQG shall file <br />MWMP with enforcement agency. <br />_12.HSC Section 117975-LQG shall keep <br />records for 3 years. <br />Transportation <br />_13. HSC Section 118030-LQHE application. <br />Treatment/Storage <br />_14.HSC Section 118135 -Shall obtain a <br />permit from the enforcement agency to treat <br />medical waste prior to treating the waste. <br />_15.HSC Section 11 8765 -All treatment <br />re r shall be kept for 3 years. <br />16.HSC Section 118215 -All medical waste <br />shall be treated pursuant to this section. <br />_17.HSC Section 118220 -Recognizable <br />human anatomical parts shall be disposed of by <br />interment unless otherwise hazardous. <br />Section 118225 -Treated sharps shall <br />'6e --destroyed <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 118310 -Enclosure labeled. <br />_24.HSC Section 118305 -Cannot reuse drums <br />��✓ r <br />In4sptor ignature Ke6fved By <br />-6a-g- Section 117630 -Approved biohazard <br />bag used. <br />26. Other -Describe in narrative. <br />'r— <br />