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ENVIRONMENTAL HEALTH DEPARTMENT <br />SAN JOAQUIN COUNTY RECEIVED <br />1868 E. Hazelton Avenue <br />Stockton, California 95205 <br />Telephone: (209) 468-3420 <br />Fax: (209) 468-8392 <br />DEC 14 2015 <br />ENVIRONMENTAL !-HEALTH! <br />PERMT%SERVICES <br />GUIDELINES FOR THE MEDICAL WASTE MANAGEMENT PLAN <br />Small quantity generators that provide onsite treatment and all large quantity generators shall have a <br />Medical Waste Management plan on file with the San Joaquin County Environmental Health Department. <br />The Medical Waste Management Plan shall contain the following information as appropriate for your <br />facility: <br />, r , <br />Business Name: I , 3 (�� j <br />��,Q i� �d i ca ( � W1 r <br />Business Address: 00 1yr. Va-k f0 (0', a Stccelfi <br />city <br />/ L State Zip Code <br />Phone Number: ().61% <br />Type of Facility or Business: r I -e— a- l +h ��C �- <br />REGISTRATION EOR: <br />❑ Small Quantity Generator with Onsite Treatment (Generates less than 200 lbs/month). <br />❑ Large Quantity Generator Only (Generates 200 lbs or more/month). <br />M' Large Quantity Generator with Onsite Treatment (Generates 200 lbs or more/month). <br />Person responsible for implementation of the Medical Waste Management Plan: <br />Name: 30hn �4-7ndte, Title:S2fl10(' serv,ck- 'Ae3 0"reGt c <br />Phone: t`acg) Lf6? — L-41? i Date: I '"A / `'� ), C I c� <br />1 • List the types of medical waste generated at your facility (i.e. laboratory wastes, blood or body <br />a) Do you generate 4ny pharmaceutical waste (expired, spent, partials, patient returns)? [Yes ❑ No <br />If yes, describe the type of pharmaceutical waste (expired, spent, partials, patient returns): <br />And estimate the monthly amount of pharmaceutical waste generated at your facility: q 0 , <br />EHD 45-03 5 <br />2015 <br />