Hospital Waste Inspection Report Form
Document all aspects of your hospital waste inspection using this standardized form.
Inspection Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Inspector Name
*
First Name
Last Name
Hospital / Facility Name
*
Location/Area Inspected
*
Waste Handling Observations
*
Segregation and Storage Conditions
*
Compliant with protocols
Minor non-compliance
Major non-compliance
Staff Waste Handling Practices
*
Consistently follow procedures
Occasional lapses
Frequent non-compliance
Overall Compliance Status
*
Compliant
Partially compliant
Non-compliant
Issues Identified
*
Corrective Actions Recommended
*
Follow-up Actions / Notes
Submit Inspection Report
Should be Empty: