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Medical Waste


Medical Waste Program

IMPORTANT: Environmental Health Services is transitioning to an online portal in 2024 to streamline the process of managing permits and billing. If you did not already respond to the postcard mailer or email that went out in November and December, please review the email (click here) for further instructions. It is critical that we collect contact information to designate someone as a primary user who will be responsible for managing your business’ online account.


The San Mateo County Medical Waste Program has been managed by Environmental Health Services (EHS) since 1991. EHS is responsible for the regulation of medical waste generation, storage, transport and disposal. The Program is authorized by California’s Medical Waste Management Act passed by the California Legislature in 1990. EHS enforces these regulations and additional requirements adopted by the County, such as Medical Waste Management Plans and closure requirements.

Businesses located within or that provide services in San Mateo County MUST register for the program regardless of the volume or frequency of medical waste generated.

Residents that generate medical waste DO NOT have to register but must dispose of their waste sharps and waste medicine properly.  The County has numerous free drop-off locations for used sharps and unwanted or expired medicine generated by residents.


Dawson Coblin
(650) 208-8989

Belmont, Foster City, East Palo Alto, Menlo Park, Portola Valley, Redwood City, San Carlos, San Mateo, Woodside, and South of Pacifica (Half Moon Bay, El Granada, La Honda, Loma Mar, Moss Beach, Pescadero, Princeton, San Gregorio)

Lucas Willis
(650) 207-7269

Brisbane, Burlingame, Colma, Daly City, Millbrae, Pacifica, San Bruno, South San Francisco, SFO

What is Medical Waste?

There are five (5) categories of Medical Waste as defined in The Medical Waste Management Act (California Health and Safety Code Sections 117600-118360).

1. Biohazardous: Red bag waste and infectious contaminated solids

2. Sharps: Needles, syringes, blades, and broken glass capable of cutting or piercing

3. Pathology: Human body parts, specimens, animals body parts and tissues

4. Trace chemotherapeutic waste: Items previously containing chemotherapeutic agents

5. Medicine or pharmaceuticals

The Registration Process

Note: Users must have Adobe version 9.0 or higher to make edits to the registration form. 

1. Complete the Medical Waste Registration Form

2. Complete the Medical Waste Management Plan

The Medical Waste Management Plan is a template form.  Businesses may use the form provided or another format, as long as it contains all of the information required on the Medical Waste Management Plan form.

The Medical Waste Registration Form and the Medical Waste Management Plan may be emailed, faxed, or mailed to:

  • Email to :
  • Fax to (650) 627-8244
  • Mail to: 

    San Mateo County, Environmental Health Services
    2000 Alameda de las Pulgas, Suite #100
    San Mateo, CA 94403

San Mateo County categorizes medical waste generators into three categories called Tiers. The Tier a business is assigned to determines the following:

  • Fee structure
  • Payment frequency
  • Permit distribution
  • Frequency of inspections
  • Closure requirements
  • Overall potential risk to the County

Tier I: Private doctors and dentists, acupuncturists

Small private doctors and dentist offices, acupuncturists, and some businesses with cosmetology services. All Tier I businesses are Small Quantity Generators (SQG), pay a one-time fee* with registration, and may be inspected intermittently.

*Registration Exception: Tier I businesses MUST send their one-time payment with registration documents. EHS will NOT process a registration form until payment is received.  You may mail, call in or deliver in person your payment at the numbers and addresses above. Note, fees are subject to change annually. It is the responsibility of a program participant to ensure the payment amount is correct upon submittal.

Tier II: Small Quantity Generators (SQG) (generates < 200 lbs. per month)

Typical SQGs may be:

Veterinary clinics, veterinary offices, veterinary hospitals, biotechnology companies, pet shops, pharmacies, medical offices of corporations (if not registered as a building), medical or dental corporation practices (Big 4), skilled nursing facilities (SNFs), specialty medical practices, and home health care providers. 

SQGs pay an annual fee and are inspected biennially.      

Tier III: Large Quantity Generators (LQG) (generates > greater than or equal to 200 lbs. per month)

Typical LQGs are:

Hospitals, biotechnology companies, dialysis units, laboratories, corporate MOBs, skilled nursing facility surgery centers, research laboratories, and urgent care centers

LQGs pay an annual fee and are inspected annually

Additional or supplemental fee categories are:

  • Common storage areas
  • Skilled nursing facilities 
  • Onsite treatment
  • Home-generated sharps collection location

An account will be created 1-2 weeks after registration forms are submitted. A form submittal will prompt an unannounced initial inspection 1-2 weeks after an account is created where compliance is assessed, and fee category and Tier assignment are finalized.  The first fee invoice and permit will be mailed post-inspection.

Additional Information

If you have any questions, please contact the Medical Waste Program Specialist, Darrell Cullen at or (650) 372-6200.