56A_ROSCANS_1992

NC DEPARTMENT OF ENVIRONMENT, HEALTH AND NATURAL RESOURCES
Division of SoLid Waste Nanaganart
Solid Haste Section
SOLID WASTE MANAGEMENT FACILITY EVALUATION REPORT
Type of Facility Permit
Name of Facility Location
Date of Last Evaluation '
I. Permit Conditions Followed yes No N/A
A. Specific CoMition(s)
II. Operational Requi rarnts Followed Yes No
15A N.C. Admin. Code 138 Section
A. Specific Violations) by nuber and Letter.
Ili. Other Violations of Rule or Law
IV. Evaluator's Comments
V. Continuation Page Required? _Yes _No Receiving Si
Evaluation Date Solid Haste Section
DEHNR 3793 (Part I White: Facility Part II Canary: Central Office Part III Pink: Regional Office)
Solid Haste Section (Review 7/94)

Repose: 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 White: facility copy
Part II Canary: 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.