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Monday Date: <br /> Address: WEEKLY MATERIALS INSPECTION FORM Inspected by: <br /> City/State: Signature: <br /> m N Notes&Resolution <br /> O M Y <br /> V <br /> d d p <br /> d i -10O w H W m <br /> u u. o o = ° m ` V O Examples: <br /> DRUM STORAGE INSPECTION •e fl ,c '�° c H o` *contacted waste vendor for pick-up; <br /> VQ a h a 'mo a �o *replaced missing bung/cap; <br /> y 0S a� F N w u *put new label on drum. <br /> z 3 ® 0 z <br /> Yes No Yes No Yes No Yes No Yesl No Yes No Yes No <br /> Are all wastes stored in a clearly labelled <br /> drum? <br /> D <br /> Are the drums located in a secure place E <br /> not accessible by the public? o y <br /> m N <br /> Is the drum completely closed,including: x <br /> c <br /> d FM <br /> closed lid? v a, c <br /> M LL <br /> metal band with secured bolt? o c <br /> securely closed bungs/caps? a c d0 <br /> 0. <br /> No funnels or other devices attached? c R y <br /> Is there a Hazardous Waste Label on the <br /> drum? NIA N/A m az, <br /> r <br /> Is the Hazardous Waste Label completely m m <br /> filled out? N/A NIA v� <br /> d <br /> Does the drum have Secondary <br /> containment? a <br /> If yes to the above,is secondary <br /> containment free of liquid? <br /> BATTERY STORAGE INSPECTION <br /> Yes No <br /> Are all used batteries stored indoors on an Battery Notes <br /> impervious surface: <br /> &Resolution: <br /> Are all new batteries stored indoors? <br /> file:Environmental Law/Forms/Hazardous Materials Weekly Inspection Form REV 07/2011 <br />