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SANI Environmental Health Department <br /> ---C 0 U N T Y-------- <br /> GUIDELINES FOR THE MEDICAL WASTE MANAGEMENT PLAN <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 <br /> Department. The Medical Waste Management Plan shall contain the following information as <br /> appropriate for your facility: <br /> Business Name: W//J2 <br /> Business Address: Y�r <br /> 1�70/d <br /> City State Zip Code <br /> Phone Number: ) <br /> Contact Person: j' <br /> Type of Facility or Business: C <br /> Registration for: <br /> Small Quantity Generator with Onsite Treatment (Generates less than 200 lbs/month). <br /> Large 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: k- / - Title: <br /> Phone: 1 Date: <br /> 1. List the types of medical waste generated at your facility (i.e. laboratory wastes, blood or body <br /> fluids, sharps, contaminated animals, surgical specimens, trace chemo or isolation wastes): <br /> Do you generate any pharmaceutical waste (expired, spent, partials, patient returns)?,,VrYes ❑ No <br /> 6 of 11 <br />