Title Page

  • Conducted on

  • Prepared by

  • Location
  • Number of containers in cage:

  • Signature

Hazardous Waste Containers

Container condition

  • Are any open?

  • Are any severely rusted?

  • Are any container heads bulging?

  • Are any leaking?

  • If any of these questions were marked yes, comments:

  • Describe actions taken to correct situation:

Container Marking

  • Accumulation start date marked on container:

  • Hazardous waste warning marking on container:

  • Contents marked on containers:

Accumulation Point

  • Is the accumulation point free of severe structural deterioration?

  • Is adequate aisle space present between drums to allow unobstructed movement for emergency response?

  • If any of these questions were marked no, comment:

  • Describe actions taken to correct situation:

Emergency Response Equipment

Emergency Horn

  • Is it easily accessible in case of an emergency?

  • Is it in working order?

Spill Control

  • Is an empty salvage drum nearby?

  • Is unused absorbent material nearby?

  • Is all PPE nearby?

Fire Protection

  • Is fire extinguisher readily accessible?

  • Is the fire extinguisher fully charged?

  • Is the fire extinguisher seal intact?

  • If any of these questions were marked NO, comment:

  • Describe actions taken to correct situation:

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