Home-Generated Sharps Consolidation Point Application Form

If pick-up from the consolidation point is to be less frequent than once every seven (7) days, this document will serve as a request that the Department approve less frequent service by the transporter. Department approval of this application is your authorization for extended storage.

For more information, the Medical Waste Management Act (California Health and Safety Code, Section 117600, et seq.) states the operational requirements for Home-Generated Sharps Consolidation Points in Sections 117904 and 118147.

If you are a registered medical waste generator, the Medical Waste Management Act, Section 118147, provides a mechanism for your facility to accept home-generated sharps.

Please e-mail any additional information or concerns to: [email protected]

Home-Generated Sharps Consolidation Point Application Form

Applicant Address
Frequency of Transporter Pick-up

If “varies”, please identify on facility information sheet(s) the frequency of collection at each location on Table A, attach more pages if needed. Use Table B to list mail-back locations. (See Tables A & B below)

Application Type
Type of Collection Unit

Use Table B to list mail-back locations

Is this consolidation point on your website?

If yes. Check Website box

Accept waste from

©2021 County of Santa Clara. All rights reserved.