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Page 7 of 12 <br /> HazardousWeekly • - • • • <br /> Inspection Date: 08/19/2018 Time: 10:17:14 AM <br /> Name of Inspector: Jon Alley Signature of Inspector: <br /> Retail Rx* <br /> *If your <br /> Check All Store location has a Yes Pharmacy,you Store Number: 9830 <br /> Operations Inspected: must inspect <br /> the Pharmacy <br /> N/A tote(s). <br /> #of totes inspected: 18 <br /> Retail Store Log <br /> Item/Condition to be checked Yes No N/A Observation Deficiency Corrective Actions and Date <br /> Are all bags storing hazardous waste X <br /> completely sealed? <br /> Are all totes in GOOD condition(NOT broken, <br /> leaking or otherwise in poor condition),including X <br /> the condition of the cover and handles? <br /> Do all totes containing waste have a Hazardous <br /> or Universal Waste label affixed to them?(AF, X <br /> OX,CA,CB,TX,UW or ToxicRx) <br /> Has the store address been written on all X <br /> labels? <br /> Has the accumulation start date been written on <br /> all labels for totes containing waste and are all X <br /> dates less than 90 days'*from today's date? <br /> Has the proper physical state been checked on X <br /> all labels? <br /> Have the proper checkboxes been checked on <br /> all labels to reflect the types of product placed in X <br /> each tote? <br /> Are all labels visible for inspection? X <br /> Is there enough aisle space(36")to allow <br /> inspections of and access to each tote in the X <br /> event of an emergency? <br /> Is the tote free of unidentified waste,leaks and X <br /> spills? <br /> Are leaking hazardous waste items being <br /> properly bagged and labeled,using absorbent X <br /> and double-bagged where applicable? <br /> Are hazardous waste items collected in the <br /> correct tote so different categories of waste X <br /> items are separate? <br /> Are damages/returns being processed daily and X <br /> moved to a tote if hazardous waste? <br /> Is the store's EPP Summary Poster completed, <br /> current(with present Store Manager),and <br /> posted next to out-dialing telephones(in the X <br /> break room,at out-dialing phones near <br /> hazardous waste storage areas,and in front <br /> office)? <br /> Are spill clean up supplies,including personal <br /> protective equipment(gloves,goggles,etc) X <br /> available and in good condition? <br /> For California Only.Is the store's Hazardous <br /> Material Business Plan(HMBP)completed, X <br /> current and available for review? <br /> • Hazardous waste totes have a 50-quart capacity. <br /> -*If date is greater than 90 days, call the CVS Environmental Hotline at 1-888-412-0287. <br />