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Date <br /> SAN JOAQUIN COUNTY <br /> 'Soo- <br /> ENVIRONMENTAL HEALTH DEPARTMENT PR b'A a(zi <br /> 1868 East Hazelton Ave., Stockton, CA 95205 <br /> (209)468-3420 <br /> MEDICAL WASTE INSPECTION FORM <br /> FacilityName (we,b Rant -(.esker- FacilityAddress V110 G ms�1,�Ootk hvrnj 11k tr-c4k' <br /> FacilityContact Title A", �p, - Phone# <br /> INSPECTION TYPE: KRoutine EiComplaint EiRe-inspection <br /> VIOLATION(S) <br /> Registration THE ITEMS BELOW REPRESENT VIOLATIONS OF THE CALIFORNIA <br /> 1.HSC Section 117965-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. <br /> 2.HSC Section 117903-Permit from the <br /> -e-n-forcement agency required to treat medical <br /> waste. <br /> —3.HSC Section 117890-No large LQG shall *\R,W wjfc- Qnakii)a <br /> generate medical waste unless registered with the <br /> enforcement agency. 1 <br /> —4.HSC Section 117895-SQG that treats med 0.)a 4q, �CM L� 0Ak 1,M vV_ tklo- C�, U CA 0 n '�+ oy)�2 t 0� Wl-u-r' <br /> waste shall register with enforcement agency. --A <br /> —5.HSC Section 117900-Shall not haul med cru-ti Im. oN\U;b t&j rX I k lei(A'e- S-Vf- LA)�4 <br /> waste unless registered or obtained LQHE. Ij , - <br /> 6.HSC Section 117903-Shall not treat med �91g'L�e2 OA �221c-%. tLO+U.4R/� t <br /> waste without permit from enforcement agency. <br /> THSC Section 117908-Common Storage <br /> facility shall be registered with local enforcement <br /> agency. <br /> Procedures baA 0161A,l M r ze, L&'k&S+C-,k <br /> 8.HSC Section 117935-SQG MVVMP M L 1 \-A!&k MIALA 61Q lr\�t) Tr-n- <br /> -9.HSC Section 117943-SQG Shall keep <br /> records for 3 years. <br /> 10.HSG Section 117945-SQG not required to <br /> register shall keep records for 2 years. utvs, Cne)(Xijir Q, <br /> 11.HSC Section 117960-LQG shall file MWMP <br /> �ith enforcement agency. LAt r\-%rA (1�'-V\Y\I,e, is"Mj- - 'j <br /> -L4-fALf) <br /> —12.HSC Section 117975-LQG shall keep <br /> records for 3 years. LAI j <br /> Transportation <br /> 13.HSC Section 118030-LQHE application. <br /> Treatmentisto rage <br /> 14.HSC Section 118135-Shall obtain a permit tj <br /> from the enforcement agency to treat medical <br /> waste prior to treating the waste. <br /> I 5.HSC Section I I 8765-All treatment records 1A LX�\A 1'5 i2AL (Aj, <br /> shall be kept for 3 years. <br /> 16.HSC Section 11 8215-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. tt�.CXV.C4L 1J6j A 4 Q, 12 Z <br /> 18.HSC Section 118225-Treated sharps shall Ij <br /> Jbe-­destroyed or somehow prevent public access. ilm 01,1' 24 31 1 L62 <br /> —19.HSC Section 118275-MVV red bags,path, <br /> Ghjemo shall be labeled properly. <br /> V <br /> .,20.HSC Section 118280-MW label&conta6) <br /> —21.HSC Section 118285-Sharps label/contain <br /> —22.HSC Section 11 8295-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 /> bag used. <br /> 2S27.HSC Section 11 8275(g)-Pharm label/store <br /> —28.HSC Section 118222-Incineration Required Insp4dtor Signature Received By 'Dat6 <br /> 29 Other-Describe in narrative. <br />