5601_ROSCANS_1973

NORTH CAROLINA STATE BOARD OF HEALTH
Inspection Form for Sanitary Landfills
Name of Site County
Location ®� Person s�ontacted
Weather Conditions
SIR: An inspection of your land disposal site has been made this date and you are
notified of the violations, if any, marked below with a cross W .
1. PLAN REQUIREMENTS
Site Plan Approved
Operational Plans Approved
Plans Being Followed
2. SPREADING & COMPACTING
Waste Restricted to the
Smallest Area Practicable
Waste Properly Compacted
Proper Slope on Working Face
3. COVER REQUIREMENTS
Six (6) Inches Daily Cover
Two (2) Foot Final Cover
Erosion Controlled
4. ACCESS
Attendant on Duty
Access Controls (Gate, Chains)
All Weather Road
Dust Controlled
5. WATER PROTECTION
Surface Drainage Controlled
Evidence of Leaching
Waste Placed in Ground Water
REMARKS:
DATE
6. BURNING
Evidence of Burning
Fire Control Equipment Available
7. SPECIAL WASTES
Spoiled Food Properly Handled
Animal Carcasses, Abattoir
Waste, Hatchery Waste, Etc.,
Properly Handled
8. HAZARDOUS WASTES NOT ACCEPTED
Pathological
Pesticides
Other
9. VECTOR CONTROL
Effective Rat Control
Effective Fly Control
Other. Vector(s) Controlled
10. MISCELLANEOUS
Blowing Paper Controlled
Directional Signs
Operational Signs (Procedures,
Hours, Etc.)
NAME A
Solid Waste & Vector Control Section
North Carolina State Board of Health
SBH FORM 1709 (2/73)
Solid Waste & Vector Control Section

NORTH CAROLINA STATE BOARD OF HEALTH
Inspection Form for Sanitary Landfills
Name of Site County
Location Person s '5—c6ntac ted
Weather Conditions
SIR: An inspection of your land disposal site has been made this date and you are
notified of the violations, if any, marked below with a cross W .
1. PLAN REQUIREMENTS
Site Plan Approved
Operational Plans Approved
V Plans Being Followed
2. SPREADING & COMPACTING
Waste Restricted to the
Smallest Area Practicable
Waste Properly Compacted
Proper Slope on Working Face
3. COVER REQUIREMENTS
Six (6) Inches Daily Cover
Two (2) Foot Final Cover
X. Erosion Controlled
4. ACCESS
Attendant on Duty
Access Controls (Gate, Chains)
All Weather Road
Dust Controlled
5. WATER PROTECTION
Surface Drainage Controlled
Evidence of Leaching
Waste Placed in Ground Water
REMARKS:
6. BURNING
Evidence of Burning
Fire Control Equipment Available
7. SPECIAL WASTES
Spoiled Food Properly Handled
Animal Carcasses, Abattoir
Waste, Hatchery Waste, Etc.,
Properly Handled
8. HAZARDOUS WASTES NOT ACCEPTED
Pathological
Pesticides
Other
9. VECTOR CONTROL
Effective Rat Control
Effective Fly Control
Other Vector(s) Controlled
10. MISCELLANEOUS
Blowing Paper Controlled
Directional Signs
Operational Signs (Procedures,
Hours, Etc.)
DATE NAME
Solid Waste &Vector Control Section
North Carolina State Board of Health
SBH FORM 1709 (2/73)
Solid Waste & Vector Control Section

N. C. STATE BOARD OF HEALTH
CHECK -OFF SHEET FOR PROPOSED SANITARY LANDFILL SITES
COUNTY LOCATION ACRES
PROPERTY OWNER PROPOSED OPERATOR
1. Is this site within the boundaries of a public water supply
watershed? Watershed
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
YES NO
Does
any portion of this site contain floodplain areas?
YES
Are
there public or private wells
nearby that could be affected?
YES
Nearest well in feet
(Elaborate in Comments Section)
Are
there springs present on the
site? Number
YES
Will
this site require dyking?
YES
Will
this site require piping of
surface drainage?
YES
Not precluding required boring information, does this site have
adequate cover material for the sanitary landfill development?
Will this site require diversion of surface water?
Receiving stream for surface drainage from site
Will this site require extensive preparation, such as clearing?
(Elaborate in Comments Section)
Will this site require a new all-weather access road?
(Elaborate in Comments Section)
Evaluate the following:
A. Surface soil conditions as related to cover requirements
B. Location as related tc population density
C. Accessibility to users
NO
NO
NO
NO
NO
YES NO
YES NO
YES NO
YES NO
POOR GOOD
EXCELLENT
12. Based on the observations made above and otherwise, do you recommend that the requestor
proceed with the requirements of Section IX of the North Carolina State Board of Health
"Rules and Regulations Providing Standards for Solid Waste Disposal"?
YES NO
13. COMMENTS: (Include any requirements noted by you for the sanitary landfill development
and operation)
14. Number of borings recommended for a representative sampling of the site
15. Percent of usable land Include sketch of site on back of this form.
(DATE) N. C. State Board of Health
District Sanitarian for Solid Waste
SBH FORM 1350 (1/72) or
Sanitary Engineering Sanitary Engineer