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U"it c SAN JOAQUIN COUNTY Date $ 3t) 1), <br /> ENVIRONMENTAL HEALTH DEPARTME PR hqc <br /> 1868 East Hazelton Ave., Stockton, CA 95205 <br /> (209)468-3420 <br /> P MEDICAL WASTE INSPECTION FORM <br /> FacilityName 0o(kur s k, oc o`V'af of �) cu, -FacilityAddress <br /> FacilityContact W�.�1r�al� Titl C,c-v Suv m s 1N3re,t)E0P Phone#OL31-831—_ <br /> INSPECTION TYPE: KRoutine ❑Complaint ❑Re-inspection <br /> VIOLATION(S) <br /> Registration THE ITEMS BELOW REPRESENT VIOLATIONS OF THE CALIFORNIA <br /> _1.HSC Section 117955-Large Quantity HEALTH & SAFETY CODE (HSC): <br /> Generator shall register with the enforcement <br /> agency prior to commencement of the generation of <br /> medical waste. ' Sal 5 <br /> _2.HSC Section 117903-Permit from the <br /> enforcement agency required to treat medical rvrtAV3, np Irwe. i\Yet_ <br /> waste. ( <br /> _3.HSC Section 117890-No large LQG shall 111 1b ®n t 1i - <br /> generate medical waste unless registered with the V �� <br /> enforcement agency. <br /> na <br /> _4.HSC Section 117895-SQG that treats medD Ml�- U11 14 tJ— <br /> waste shall register with enforcement agency. t <br /> _5.HSC Section 117900-Shall not haul med �,� ( „ ��jLo C.Q• <br /> waste unless registered or obtained LQHE. <br /> _6.HSC Section 117903-Shall not treat med <br /> waste without permit from enforcement agency. <br /> _7.HSC Section 117908-Common Storage <br /> facility shall be registered with local enforcement NoVeS° lkC® '� t4 L^vAA 66 S t) Kvx 1 <br /> agency. <br /> Procedures 22 w <br /> _8.HSC Section 117935-SQG MWMP <br /> _9.HSC Section 117943-SQG Shall keep <br /> records for 3 years. a. e r 1 lJV{f Li <br /> _10.HSC Section 117945-SQG not required to u` <br /> register shall keep records for 2 years. \'Gt;�� (� +13r f W1 u a <br /> 11.HSC Section 117960-LQG shall file MWMP <br /> with enforcement agency. <br /> _12.HSC Section 117975-LQG shall keep 3_ t <br /> records for 3 years. <br /> Transportation 1 of tw:,,IIAJ,� �uJ (Sgt'e,\,J <br /> _13.HSC Section 118030-LQHE application. <br /> Treatment/Storage <br /> _14.HSC Section 118135-Shall obtain a permit + Z lJ�a C CC c,t�mcrenAt,�il 1 <br /> from the enforcement agency to treat medical l�` , 001'!31-1S f•Y <br /> waste prior to treating the waste. e, til U^ 6A ULC(�.S s r <br /> _15.HSC Section 118765-All treatment records <br /> shall be kept for 3 years. <br /> Th—all <br /> Section 118215-All medical waste <br /> shall be treated pursuant to this section. <br /> _17.HSC Section 118220-Recognizable human <br /> anatomical parts shall be disposed of by interment <br /> unless otherwise hazardous. <br /> _18.HSC Section 118225-Treated sharps shall <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 118307-Interim storage labeled <br /> _24.HSC Section 118310-Enclosure labeled. <br /> _25.HSC Section 118305-Cannot reuse drums <br /> 26.HSC Section 117630-Approved biohazard <br /> ba—g used. !Z <br /> _,L,,27.HSC Section 118275(g)-Pharm label/store <br /> _28.HSC Section 118222-Incineration Required Insp for Signature Recei ed By ate <br /> 29 Other-Describe in narrative. <br />