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<br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjcehd.com <br />Environmental Health Department <br /> <br />INFORMATION PACKET FOR MEDICAL WASTE GENERATORS <br /> <br /> <br />This packet contains the information and forms you will need to help you comply with the <br />Medical Waste Management Act. <br /> <br />Instructions <br /> <br />Please return the completed forms prior to medical waste generation or treatment. <br /> <br />1. Complete the “Pre-Application Questionnaire” on Page 2. If your answers indicate you <br />are not required to register as a medical waste generator, then complete the “Certification <br />Statement” on Page 3 and return both complete forms to the mailing address below. <br /> <br />2. If you are required to register as a medical waste generator, as indicated by affirmative <br />answers to questions 3 & 4 on the “Pre-Application Questionnaire”, then: <br /> <br />a. Complete the “Registration for Medical Waste” form located on Page 4. <br /> <br />b. Complete a “Medical Waste Management Plan” following the guidelines starting <br />on Page 5. <br /> <br />c. Return the completed forms and management plan to the mailing address below. <br /> <br />Your cooperation in promptly registering and following the specified handling requirements <br />is greatly appreciated. <br /> <br />If you have any questions regarding registration or handling requirements, please contact us <br />at (209) 468-3420 and ask for assistance in the Medical Waste Program. <br /> <br /> <br /> <br /> <br /> <br />RETURN ALL COMPLETED FORMS TO: <br /> <br />San Joaquin County Environmental Health Department <br />1868 E. Hazelton Ave. <br />Stockton, CA 95205 <br />Attn: Medical Waste Program <br /> <br /> <br />