88C_ROSCANS_1993

!vC DEPARTMENT OF ENVIRONMENT, HEALTH AND NATURAL RESOURCES
Division of Solid Waste Management
Solid Waste Section
SOLID WASTE MANAGEMENT FACILITY EVALUATION REPORT
Type of Facility a) ` ' t t s �It l Permit * 4.. Canty + MhSu IU r Y i L
Now of Facility4DIASI leii r r o� t � lfM G +�l�ii r° Location :� ►�� ►V) �'C()7Y
Date of Last Evaluation ! 1
a
I. Permit Conditions Followed i, Yes No N/A
A. Specific Condition(s) Vi
II. Operational Requirements Followed
15A N.C. Admin. Code 13B Section
_Yes No
A. Specific Violation(s) by nxmber and letter.
III. other Violations of Rule or Law
IV. Evaluator's Comments
V. Continuation Page Required%? Yes No Receiving Signature
Evaluation Date i 7 `:' Solid Waste Section
DEHNR 3793 (Part I bite: Facility Part II Canary: Central office Part Ill Pintas: Regional Office)
Solid Waste Section (Review 7/94)

�i
Purpose: G.S. 134A-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 requirmentts which mast be follawed by solid waste
facilities.
Instructions: Solid Waste Section personnel shall cctnplete the evaluation form each
time they conduct official evaluations. The form shall be signed by
the person(s) receiving the report.
f - ... .
Part IEE CWmry: Raleigh central office file copy
Part III Pink: Regional office file M
Di position: 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 KAKAGENENT FACILITY EVALUATION REPORT
Type of Facility. !L Per it # County
I L'nt Location
Name of Facility��...
Date of Last Evaluation
I. Permit Conditions Followed Yes No N/A
A. Specific Condition(s) Violated.
II. Operational Requirements Followed %4,—Yes No
15A N.C_ Admin. Code 138 Section () :";- r) —1
A. Specific Violation(s) by number and letter.
111. Other Violations of Rule or Law
IV. Evaluator's Comments Al + U I
V. Continuation Page Required? —Yes No Receiving Signature
Evaluation Date Solid Waste Section
DEHNR 3793 (Part I White: Facility Part 11 Camary. Central Office Part III Pink: Regional Office)
Solid Waste Section (Review 7/94)

Purpose: 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 followed by solid waste
facilities.
Instructions: 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.
Distribution: Part I mite: facility copy
Part II Canary: Raleigh central office file copy
Part III Pink: Regional office file copy
Dispositions: 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.