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Inspection Date and Time: <br /> Name and Signature of Inspector: <br /> Retail Photo Rx <br /> Yes o o a <br /> Check All Store Operations Inspected: N/A 0 1:3 ❑ Store Number: <br /> a of <br /> containers F1 ❑ FJ <br /> 1.Are all self-sealing bags storing hazardous waste <br /> completely sealed? <br /> 2.Are all collection containers in GOOD condition(NOT <br /> leaking or otherwise poor condition)? <br /> 3.Do all collection containers have a Hazardous or <br /> Universal Waste label?(AF,OX,CA,CB,TX,UW,PH,or <br /> ToxicRx) <br /> 4.Has the store number and address been written on <br /> all labels? <br /> 5.Has the proper date been written on all labels? <br /> i <br /> 6.Has the proper physical state been checked on all <br /> labels? <br /> 7.Have the proper checkboxes been checked on all <br /> labels to reflect the types of product placed in each <br /> container? <br /> 8.Are all labels visible for inspection? <br /> 9.Are all dates less than 180 days from today's date? <br /> 10.Is there enough aisle space to allow inspections of <br /> and access to each collection container? <br /> 11.Is each collection container free of spills,leaks,or <br /> other wastes not bagged? <br /> 12.Are hazardous waste items being properly bagged <br /> and labeled,using absorbent and double-bagging <br /> where applicable? <br /> 13.Are hazardous waste items collected in the correct <br /> container so different categories of waste items are <br /> separate? <br /> 14.Are damages/returns being processed daily and <br /> moved to a waste collection container if hazardous <br /> waste? <br /> 15.Are all routes clear such that collection containers <br /> are accessible by emergency personnel in the event of <br /> an emergency? <br /> 16.Is the store's Emergency Information Poster <br /> completed,current,and posted next to out-dialing <br /> telephones? <br /> 17.Are spill clean up supplies,including PPE(gloves, <br /> goggles,etc)available and in good condition? <br /> 18.Is the store's Hazardous Material Business Plan <br /> (HMBP)completed,current,and available for review? <br /> Maintain completed inspection logs in your EH&S Program Binder for at least 3 years. <br /> 0 CVS/pharmacy <br />