Laserfiche WebLink
Jan, 31. 2012 10:32AM G0I LD MEDICAL ENGINEERING No. 5494 P. 2 <br />N ENTAL HEALTHtEPARTMENT <br />INFORMATION PACKET FORM DICALWASTE GENERA.'I'URS <br />This packet contains the information and farms you will )freed to Delp you comply with the <br />Medical Waste Management <br />SAN JOAQUIN COUNTY <br />Donna K. Heran, R.E.H.S. <br />Director 600 East Main Street <br />Latirie A. Cotulla, R.E.H.S. Stockton, California 95202 <br />Assistant Director Telephone: (209) 468-3420 <br />Fax: (209) 468-3433 <br />Unit Supervisors <br />Carl Borgmart, FLE RS. <br />Mike Huggins, R.E.H.S., R.D.I. <br />Margaret Lagorio, R.E.H.S. <br />Robert McClellon, R.E.H.S. <br />Jeff Carruesco, R.E.H.S, <br />Kasey Foley, KEE,& <br />Act. <br />Instructions <br />Please return the completed forms prior to medical <br />waste generation or treatment. <br />1. Complete the "Pre -Application Questionnaire" on Page 2. If your answers indicate <br />you are not required to register as a medical waste generator, then complete Ehe <br />"Certification Statement" on Page ? and return <br />both complete forms to the mailing <br />address below. <br />2. If you are required to register as a rrledical waste generator, as iidicated by affirmative <br />answers to questions 3 & 4 on the "Pre -Application QU,,,stiorAk <br />laire", thea: <br />a. Complete the "Registration for Medical <br />Waste" form located on <br />Page 4. <br />b. Complete a "Medical Waste Management Flan" following <br />the guidelines <br />provided on Page 5. <br />c. Return the completed forms and management plan <br />to the mailing address <br />below. <br />Your cooperation in promptly registering and following the specified handling requirements <br />is <br />greatly appreciated. <br />If you have any questions regarding registration or handling requirements, please contact (209) <br />458-3420 and ask for the Medical <br />Waste Pro <br />RETURN ALL COMPLETED FORMS 'l <br />Z <br />Attn: Medical Waste Program <br />San Joaquin County Environmental Health, Depart <br />ment <br />600 East Main Street <br />Stockton, C.A. 95202 <br />p 45-03 W1rg <br />04/18/08 <br />ER <br />