Controlled Substances Disposal Log DEA Registrant: DEA Registration #: Storage Cabinet Location: Schedule(s)1: Lot # or Drug and Amount Reason for DEA # of Returned Returned by Returned by Concentration Disposed Disposal Disposal Route2 or recipient4 Date name) (Signature) 3 1Disposal Logs for Schedule I & II must be maintained separately from Schedules III-V 2If disposal is conducted by any manner other than return to supplier or reverse distributor, circumstances should be fully described and documented 3RD = Reverse Distributor 4DEA number of the RD3 or supplier who will be accepting the substances for disposal Instructions: When substance has expired or is no longer usable or needed, add to this log and store separately from other inventory. Record disposal information when disposal occurs. Maintain completed form in records for at least two years from date of last transaction.
Controlled Substances Disposal Log DEA Registrant: DEA Registration #: Storage Cabinet Location: Schedule(s)1: Lot # or Drug and Concentration Amount Disposed Reason for Disposal Disposal Route2 or 3 DEA # of recipient4 Returned Date Returned by name) Returned by (Signature) 1Disposal Logs for Schedule I & II must be maintained separately from Schedules III-V 2If disposal is conducted by any manner other than return to supplier or reverse distributor, circumstances should be fully described and documented 3RD = Reverse Distributor 4DEA number of the RD3 or supplier who will be accepting the substances for disposal Instructions: When substance has expired or is no longer usable or needed, add to this log and store separately from other inventory. Record disposal information when disposal occurs. Maintain completed form in records for at least two years from date of last transaction.
disposal_log.docx