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CONCLUSIONS, ACTION TAKEN OR REQUIRED
INFORMATION COPIES
TO:
EPA Form 1300-6 (7-72)
NC DEPARTMENT OF ENVIRONMENT, HEALTH AND NATURAL RESOURCES
Division of Solid haste Management
Solid Waste Section
SOLID WASTE MANAGEMENT FACILITY EVALUATION REPORT
Type of Facility! (". f Permit # County.
Name of Faci l i ty r r'+ ! Location
Date of Last Evaluation
[_ Permit Conditions Followed Yes No N/A
A. Specific Condition(s) Violated
II. Operational Requirements Followed Yes
15A N.C. Admin. Code 13B Section
A. Specific Violation(s) by number and letter.
III. Other Violations of Rule or Law
No
e7 /l i
IV. Evaluator's Comments
V. Continuation Page Required?
Yes No Receiving Signature
Evaluation Date Solid Waste Section
DEHNR 3793 (Part I White: Facility Part II Canary: Central office Part III Pink: Regional Office)
Solid Waste Section (Review 7/94)
KI
Prose: G.S. 130A-294 requires that an evaluation program be established for the
operation of solid waste management facilities on a statewide basis. The
Solid Waste Management Act and Solid Waste Management Rules codified at
15Pi NCAC 13B list requirements which must be followed by solid waste
facilities.
Tnst1rt-ion_s: Solid Waste Section personnel shall complete the evaluation form each
time they conduct official evaluations. The form shall be signed by
the person(s) receiving the report.
Part I White: facility ccpy
Part II Cmiary: Raleigh central office file copy
Part III Pink: Pagional office file copy
Disposition: This form may be retained in accordance with the Record Retention and
Disposition Schedule of the Solid Waste Section, Solid Waste Management
Division of the Department of Environment, Health and Natural Resources.
NC DEPARTMENT OF ENVIRONMENT, HEALTH AND NATURAL RESOURCES
Division of Solid waste Management
solid waste section
SOLID WASTE MAMAGE ENT FACILITY EVALUATION REPORT
Type of Facility..) Permit # ,, County
Name of Facility Y- �f% Location '
Date of Last Evaluation
I. Permit Conditions Followed Yes No N/A
A. Specific Condition(s) Violated _
II. Operational Requirements Followed Yes No
15A N.C. Actin. Code 13B Section
A. Specific Violation(s) by number and letter.
i A i
III. other Violations of Rule or Law
IV. Evaluator's Convents
V. Continuation Page Required? Yes No Receiving SignatureC-'�
Evaluation Date Solid Waste Section
DEHNR 3793 (Part I White: Facility Part II Canary: Central office Part III Pink: Regional Office)
Solid Waste Section (Review 7/94)
G.S. 130A-294 requires that an evaluation program be established for the
operation of solid waste management facilities on a statewide basis. 'The
Solid Waste Management Act and Solid. WasteManagement Rules codified at
15A NCAC 13B list requirements which must_ be followed by solid waste
facilities.
Instructias: Solid Waste Section personnel shall complete the evaluation form each
time they Conduct official evaluations. The form shall be signed by
the person(s) receiving the report.
Distribut-im:
Part ]a CD�: Raleigh central office file copy
Part III Pink: Regional office file copy
Disposition: This form may be retained in accordance with the Record Retention and
Disposition Schedule of the Solid Waste Section, Solid Waste Management
Division of the Department of Environment, Health and Natural Resources.
NC DEPARTMENT OF ENVIRONMENT, HEALTH AND NATURAL RESOURCES
Division of Solid Waste Management
Solid haste Section
SOLID WASTE MAMAGEIEMT FACILITY EVALUATION REPORT
Type of Facility. Permit * County.
Name of Facility. �t �'�"'l•�t 11 Location
Date of Last Evaluation
I. Penmit Conditions Followed Yes No N/A
A_ Specific Condition(s) Violated
II. Operational Requirements Followed Yes No
15A N.C_ Admin. Code 13B Section
A_ Specific Viotation(s) by number and letter.
III. Other Violations of Rule or Law
IV. Evaluator's Comments
V. Continuation Page Required? Yes No Receiving Signature
Evaluation Date Solid haste Section
DEHMR 3793 (Part I White: Facility Part II Canary: Central Office Part III Pink: Regional Office)
Solid haste Section (Review 7/94)
01
Pa pose: G.S. 130A-294 requires, that an evaluation program be established for the
operation of solid waste management facilities on a statewide basis. The
Solid Waste Management Act and Solid Waste Management Rules codified at
15A NCAC 13B list requirements which must be foliawed by solid waste
facilities.
Instructions: Solid Waste_ Section personnel shall earrplete the evaluation form each
time they conduct official evaluations. The form shall be signed by
the person(s) receiving the report.
Distrribut m: Part I mite: facility ccpy
Part II unary: Raleigh central office file copy
Part III Pink: Regional office file cPy
Disposition: This form may be retained in accordance with the Record Retention and
Disposition Schedule of the Solid Waste Section, Solid Waste Management
Division of the Department of Environment, Health and Natural Resources.