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ENVIRONMENTAL HEALTH DEPARTMENT <br /> SAN JOAQUIN COUNTY <br /> 1868 E. Hazelton Avenue <br /> Stockton, California 95205 <br /> Telephone: (209)468-3420 <br /> Fax: (2 9)468-8392 <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 /> Business Name: <br /> -� a�X-Iiws <br /> Business Address: k2,OS- L- - <br /> A -IL n <br /> C- <br /> City State Zip Code <br /> Phone Number: Lzt)01 <br /> Type of Facility or Business: <br /> REGISTRATION FOR: <br /> El Small Quantity Generator with Onsite Treatment(Generates less than 200 lbs/month). <br /> 2 Large Quantity Generator Only(Generates 2001 s or more/month). <br /> El Large Quantity Generator with Onsite Treatment(Generates 2001 s or more/month). <br /> Person responsible for implementation of the Medical Waste Management Plan: <br /> Name: QAf A�\��-k - - <br /> gL �S�;ervi ceJ <br /> one 20-)) 1*301- $31,03 ate: it. jib-19 <br /> 1. List the types of medical waste generated at your facility(i.e. laboratory wastes,blood or body <br /> fluids, sharps,contaminated animals,surgical specimens,trace chemo or isolation wastes): <br /> a) Do you generate my pharmaceutical waste(expired,spent,partials,patient returns)?2 Yes F]No <br /> If yes,describe the type of pharmaceutical waste(expired,spent,partials,patient returns)- <br /> �0'v'�'a-ts 4-'* 'r&hArv,-,s <br /> And estimate the monthly amount of pharmaceutical waste generated at your facility: Loo [h_j_ <br /> EHD 45-03 <br /> 2015 5 <br />