First Environment conducted multi-media environmental compliance audits at seven medical centers. The size of the facilities included in the review ranged from 500,000 – 1,150,000 sq ft. We audited each facility’s compliance with all applicable federal, state, and local environmental regulations and EOs using U.S. TEAM Guide audit protocols. The operational scope of the compliance audits included hazardous waste management, including universal and pharmaceutical wastes; storage tanks (both ASTs and USTs); drinking water wells; laboratories; patient care facilities, in/outpatient pharmacies, sterile supply and materials management, recycling operations; and biomedical waste disposal practices. Our approach included a pre-audit document review, on-site kick-off meeting, employee interviews, on-site observations, and records review. Following the audits, we entered our findings into the VA’s electronic database, CP-Track, and provided the facilities with an opportunity to review and comment on the findings.