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E <br />E <br />S A NJ 0 A 0 U I N <br />—COUNTY— Environmental Health Department <br />10,,,0%,1 Grootness grows here. <br />INFORMATION PACKET FOR MEDICAL WASTE GENERATORS <br />This packet contains the information and forms you will need to help you comply with <br />the Medical Waste Management Act. <br />Instructions <br />Please return the completed forms prior to medical 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 the <br />"Certification Statement" on Page 3 and return both complete forms to the mailing <br />address below. <br />2. If you are required to register as a medical waste generator, as indicated by <br />affirmative answers to questions 3 & 4 on the "Pre -Application Questionnaire", then: <br />a. Complete the "Registration for Medical Waste" form located on Page 4. <br />b. Complete a "Medical Waste Management Plan" following the guidelines starting <br />On Page 5. <br />c. Return the completed forms and management plan to the mailing address below. <br />Your cooperation in promptly registering and following the specified handling <br />requirements is greatly appreciated. <br />If you have any questions regarding registration or handling requirements, please <br />contact us at (209) 468-3420 and ask for assistance in the Medical Waste Program. <br />RETURN ALL COMPLETED FORMS TO: <br />San Joaquin County Environmental Health Department <br />1868 E. Hazelton Ave. <br />Stockton, CA 95205 <br />Attn: Medical Waste Program <br />1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />