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COMPLIANCE INFO_2012-2020
Environmental Health - Public
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EHD Program Facility Records by Street Name
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4500 - Medical Waste Program
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PR0526860
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COMPLIANCE INFO_2012-2020
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Last modified
2/7/2023 11:39:04 AM
Creation date
2/7/2023 10:19:47 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4500 - Medical Waste Program
File Section
COMPLIANCE INFO
FileName_PostFix
2012-2020
RECORD_ID
PR0526860
PE
4520
FACILITY_ID
FA0018191
FACILITY_NAME
SUTTER GOULD
STREET_NUMBER
2505
Direction
W
STREET_NAME
HAMMER
STREET_TYPE
LN
City
STOCKTON
Zip
95209-2839
APN
08227003
CURRENT_STATUS
01
SITE_LOCATION
2505 W HAMMER LN
P_LOCATION
01
P_DISTRICT
003
QC Status
Approved
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SJGOV\cfield
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EHD - Public
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CJ <br />`'` SAN.l0A0UIN <br />—COUNTY <br />1u,,,0— Greatness grows here. <br />E <br />a ! � <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: Sutter Gould Medical Foundation — SMP <br />Business Address: 2505 W. Hammer Lane <br />Stockton CA 95209 <br />City State Zip Code <br />Phone Number: ( 209) 524-1211 (24 Hour Operator) <br />Contact Person: Dwain Baughman Phone Number (if different from above): (209 ) 524-1211 <br />Type of Facility or Business: Medical Office Building <br />Registration for: <br />❑ Small Quantity Generator with Onsite Treatment (Generates less than 200 lbs. /month). <br />5Large Quantity Generator Only (Generates 200 lbs or more/month). <br />❑ Large Quantity Generator with Onsite Treatment (Generates 200 lbs or more/month). <br />Person responsible for implementation of the Medical Waste Management Plan: <br />Name: Dwain Baughman Title: Environmental Services Manager <br />Phone:_( 209) 521-6097 Ext 2306 Date: 3-11-19 <br />1. List the tvpes of medical waste aenerated at vour facility (i.e. laboratory wastes. blood or bodv fluids <br />sharps, contaminated animals, surgical specimens, trace chemo or isolation wastes): <br />Sharps; used/new needles, syringes w/o drugs, tubing w/needles, sutures & scalpels, lancets & blades. <br />Non -sharps -soaked, dripping bloody dressings, ventilator tubing, culture plate, bloody tubing, barium <br />opened and unused. <br />Do you generate any pharmaceutical waste (expired, spent, partials, patient returns)? Yes❑ No <br />If yes, describe the type of pharmaceutical waste (expired, spent, partials, patient returns): <br />Expired, partials, spent pharmaceuticals <br />And estimate the monthly amount of pharmaceutical waste generated at your facility: N/A <br />2. Estimate the monthly amount of medical waste (excluding waste pharmaceuticals) generated at your <br />facility: 800 lbs. per month. Use combination Pharmaceuticals & Sharps Container <br />3. Describe the medical waste handling procedures utilized by and applicable to your facility, including, <br />But not limited to the following: <br />
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