2010 California Code
Health and Safety Code
Chapter 8. Treatment

118215.  (a) Except as provided in subdivisions (b) and (c), a
person generating or treating medical waste shall ensure that the
medical waste is treated by one of the following methods, thereby
rendering it solid waste, as defined in Section 40191 of the Public
Resources Code, prior to disposal:
   (1) (A) Incineration at a permitted medical waste treatment
facility in a controlled-air, multichamber incinerator, or other
method of incineration approved by the department which provides
complete combustion of the waste into carbonized or mineralized ash.
   (B) Treatment with an alternative technology approved pursuant to
paragraph (3), which, due to the extremely high temperatures of
treatment in excess of 1300 degrees Fahrenheit, has received express
approval from the department.
   (2) Steam sterilization at a permitted medical waste treatment
facility or by other sterilization, in accordance with all of the
following operating procedures for steam sterilizers or other
sterilization:
   (A) Standard written operating procedures shall be established for
biological indicators, or for other indicators of adequate
sterilization approved by the department, for each steam sterilizer,
including time, temperature, pressure, type of waste, type of
container, closure on container, pattern of loading, water content,
and maximum load quantity.
   (B) Recording or indicating thermometers shall be checked during
each complete cycle to ensure the attainment of 121 Centigrade (250
Fahrenheit) for at least one-half hour, depending on the quantity and
density of the load, to achieve sterilization of the entire load.
Thermometers shall be checked for calibration annually. Records of
the calibration checks shall be maintained as part of the facility's
files and records for a period of three years or for the period
specified in the regulations.
   (C) Heat-sensitive tape, or another method acceptable to the
enforcement agency, shall be used on each biohazard bag or sharps
container that is processed onsite to indicate the attainment of
adequate sterilization conditions.
   (D) The biological indicator Bacillus stearothermophilus, or other
indicator of adequate sterilization as approved by the department,
shall be placed at the center of a load processed under standard
operating conditions at least monthly to confirm the attainment of
adequate sterilization conditions.
   (E) Records of the procedures specified in subparagraphs (A), (B),
and (D) shall be maintained for a period of not less than three
years.
   (3) (A) Other alternative medical waste treatment methods which
are both of the following:
   (i) Approved by the department.
   (ii) Result in the destruction of pathogenic micro-organisms.
   (B) Any alternative medical waste treatment method proposed to the
department shall be evaluated by the department and either approved
or rejected pursuant to the criteria specified in this subdivision.
   (b) A medical waste may be discharged to a public sewage system
without treatment if it is not a biohazardous waste of a type
described in either subdivision (a) or (b) of Section 117635, it is
liquid or semiliquid, and its discharge is consistent with waste
discharge requirements placed on the public sewage system by the
California regional water quality control board with jurisdiction.
   (c) (1) A medical waste that is a biohazardous waste of a type
described in subdivision (a) of Section 117635 may be treated by a
chemical disinfection if the medical waste is liquid or semiliquid
and the chemical disinfection method is recognized by the National
Institutes of Health, the Centers for Disease Control and Prevention,
or the American Biological Safety Association, and if the use of
chemical disinfection as a treatment method is identified in the site'
s medical waste management plan.
   (2) If the waste is not treated by chemical disinfection, in
accordance with paragraph (1), the waste shall be treated by one of
the methods specified in subdivision (a).
   (3) Following treatment by chemical disinfection, the medical
waste may be discharged to the public sewage system if the discharge
is consistent with waste discharge requirements placed on the public
sewage system by the California regional water control board, and the
discharge is in compliance with the requirements imposed by the
owner or operator of the public sewage system. If the chemical
disinfection of the medical waste causes the waste to become a
hazardous waste, the waste shall be managed in accordance with the
requirements of Chapter 6.5 (commencing with Section 25100) of
Division 20.


118220.  Recognizable human anatomical parts, with the exception of
teeth not deemed infectious by the attending physician and surgeon or
dentist, shall be disposed of by interment or in accordance with
paragraph (1) or paragraph (3) of subdivision (a) of Section 118215,
unless otherwise hazardous.


118222.  (a) Biohazardous waste that meets the conditions of
subdivision (f) of Section 117635 shall be treated pursuant to
paragraph (1) or paragraph (3) of subdivision (a) of Section 118215
prior to disposal.
   (b) Biohazardous waste that meets the conditions specified in
subdivision (g) of Section 117635 shall be treated pursuant to
paragraph (1) or paragraph (3) of subdivision (a) of Section 118215
prior to disposal.



118225.  (a) Sharps waste shall be rendered noninfectious prior to
disposal by one of the following methods:
   (1) Incineration.
   (2) Steam sterilization.
   (3) Disinfection using an alternative treatment method approved by
the department.
   (b) Sharps waste rendered noninfectious pursuant to this section
may be disposed of as solid waste if the waste is not otherwise
hazardous.
   (c) Onsite medical waste treatment facilities treating sharps
waste pursuant to paragraph (2) or (3) of subdivision (a) shall
ensure that, prior to disposal, the treated sharps waste is destroyed
or that public access to the treated sharps waste is prevented.




118230.  An operator of a hazardous waste incinerator permitted
pursuant to Section 25200 may also accept medical waste for
incineration.


118235.  Each medical waste treatment facility issued a medical
waste permit shall provide the enforcement agency with an emergency
action plan that the facility shall follow to ensure the proper
disposal of medical waste in the event of equipment breakdowns,
natural disasters, or other occurrences.



118240.  Notwithstanding Section 9141 of the Food and Agricultural
Code, animals that die from infectious diseases shall be treated in
accordance with Section 118215 if, in the opinion of the attending
veterinarian or local health officer, the carcass presents a danger
of infection to humans.



118245.  (a) The department shall charge an application fee for
evaluation of an alternative treatment technology pursuant to
subdivision (d) of Section 118215 of two thousand five hundred
dollars ($2,500) and shall charge an additional fee equal to one
hundred dollars ($100) per hour for each hour which the department
spends on processing the application, but not more than a total of
five thousand dollars ($5,000), or as provided in the regulations
adopted by the department.
   (b) The department shall charge an application fee of one thousand
dollars, ($1,000) for evaluation and approval of the use of a
medical waste mail back system, which sends medical waste generated
in this state to an out-of-state facility for treatment and disposal
pursuant to subdivision (f) of Section 118040.