8802_ROSCANS_1968

DEPARTMENT OF - Form Approved
HEALTH, EDUCATION, AND WELFARE Budget bureau No. 68S-67022
PUBLIC HEALTH SERVICE COMMUNITY SOLID WASTE PRACTICES
LAND DISPOSAL SITE INVESTIGATION REPORT
,. STATE
/ �4J� 2. a rLOCATION (Political J urisdiction) 3
5 /CN T
NAME OF SITE V DO0.ESS OF I l
s�A t. ; rl'] Rit A A,I M YL 4
fSc,SmaaL h'ej4*-e.e,,, 12 ..os /
6. D SURVEYDAY UANTW
7, NAME
F
PERSON COMPLETING FORM
B,TITI T'-
9.
ORGANIZATION ND
ADDRESS
10,
POLITICAL JURISDICTIONS SERVED BY LAND
DISPOSAL SITE
ESTIMATED
AVERAGE DISTANCE
NAMM OF
POLITICAL JURISDICTION
PERCENTAGE OF
JURISDICTION
SERVED BY SITE
OF SITE FROM
CENTER OF SOURCE
AREA (Miles)
SITE OP ER AT EO BY
PUB C AGENCY ❑
PRIVATE AGENCY 54
rpo
PUBLIC AGENCY - ❑
bb
0 PRIVATE AGENCY
FOA ADDITIONAL ENTRIES, C ECK fIERE [] (ssl AND MAKE ENTRIES TN ITEM #45
SOPERATION YES IF S, INDICATE LE OCOMMUNITY OSTATE LLJ
REGULATED BY w RIN PAL AUTHORITY
OF
/
ONO PRINCIPAL
one only) - UNYY OTHER
HEALTH AUTHORITY? (Snacify)
14, GENERAL CHARACTER OF SITE (Check me only) S. YEAR SITE PLACED IN OPERATION
00
a B QUARRY OR BORROW PIT HILLSIDE e. ANTICIPATED LIFE REMAINING (Years) S
O GULLY -CANYON OORFSH TIDELAND
PLAIND
0 LEVEL AREAS T. TOTAL AREA OF SITE (Acres)
6 87
OOTHER (Specif) Dot AREA TO BE USED FOR LAND
no5 DISPOSAL (Acres)
12, ZONING/ND USE SURROUNDING FA CILITY (Check Predominant type only)
LA RDZONING LAND USE
E INDUSTRIAL RESIDENTIAL AGRICULTURAL 72 Ts
ON
Q RESIDENTIAL Q AGRICULTURAL I O COMMERCIAL OTHER
Q COMMERCIAL OOTXER Spectty) 0INDUSTRIAL (Specl[y)
LIGHT
USE HOT
20• IS USE OFCOMPLETED
OYES IF YES, CHECK D MI T =AREA OR PARK =CONSTRUCTION =AGRICULTURE QDETERMINED ❑
—
SITE PLANNEDx ®'NO USE ONLY =PARKING LOT -yJ HEAVY CONSTRUCTION =OTHER (Specify) T4
S =NONE =OTHER
21 COMPLETED SITE USE? CON CONTROL �+1'E FDR COVER
USEDDTH m
0 NO (Check one only) (Spaclf) ]b 76
23. FREQUENCY 'O NONE ODAILY(Except face) SPREADING MP I�„E,§
D IN Ac LLaJJ.'!• o
(Ens of each eC OF COVER tJ. 4. I oP s HANDLED PP
(Check one Doty) DAILY End of each MOTHER ffy) IM AT ELY TWO -FOOT LAYERS OR LESS?
a79 So
25,
NUMBER of DAYS DISPOSAL SITE COULD NOT BE USED BECAUSE OF WEATHER CONNECTED CONDITIONS (EnlerPeer arage //��
year) yK THERE
2 OPERATION (Juditment evaluation -check appropriate ralagoriee) CONSIDERED TO
APPEARANCE
ROUTINE BURNING
CONTROLLED?
BE
GE
AOE
D-�N�O!•NE
PRO Si
EM
PO
O SIGHTLY
DYES
DYES
UUNCONTROLLED
OYES
YES
UNSIGHTLY
4-31Nv
PLANNED AND^
LIMITED
20

LAND DISPOSAL SITE INVESTIGATION REPORT (Page 2)
27. CONTROL PROGRAMS Do ❑
not 3. IS LOWEST PART OF FILL IN WATER TABLE? OYES FZ; `O
YES NOpas
80
NEEDED dQ 2 29. FIRE � E OWATER ❑
RODENT ROGRAhINTROL pqo TBc iloN OFIREBREAK QOTHER 3
PROVIDED O pacify)
36
NEEDED 0 so. NUMBER OF TIMES FIRE CONTROL EQUIPMENT
FLY CONTROL WAS REQUIRED AT SITE IN THE PAST YEAR
PROGRAM PROVIDED Q31.
' ❑
1 IS SALVAGING PERMITTED? Iy>.rEs NO33
NEEDED O IP
BIRD CONTROL
PROGRAM PROVIDED 32 IS SALVAGING PRACTICED? ©' ES ONO a]
NEEDED O �2? 3. ESTIMATED NUMBER OF LOADS DEPOSITED DAILY (Avers"
DUST CONTROL VEHICLES
PROGRAM O FROM PUBLIC FROM PRIVATE FRAM fi1TH�R COLL,+
PROVIDED '+�1'L^! 3^. G. fEtil.t_Z�
VEHICLES
COLLECTION
(specify)
NEEDED 0 �� (Enter
ODOR CONTROL (Enter E (Enter
rumba)Es umbel
PROGRAM PROVIDED O �, lanhe)
131
34. ARE
QUANTITATIVE NANY FORM? Mx RECORDS Do37, CHECK ANY ITEMS ARE
0
S YES O not EXCLUDED FROM THE DISPOSAL SITE 14
use
5. QUANTITIES OF SOLID WASTES RECEIVED ANNUALLY 4 ALL SEWAGE
0 PUTRESCIBLES SOLIDS [--]TIRES
27
TONS WEIGHE❑ "� 1 ALL JUNKED HAZARDOUS
. <: 48 49 to 51 52 53 54 O NON -COMBUSTIBLES 22 AUTOMOBILES OMATERIALS
TONS ESTIMATED 1116 ALL LARGE 20 OTHER (Specify)
y6 f�60 (1hl a COMBUSTIBLES APPLIANCES O
CUBIC YARDS Be� O "°^ tx 23 DEMOLITION 29
62 64 65 66 6x ea O GARBAGE El WASTES 30
36, GENERAL CLASSIFICATION []OTHER(Specify)
DISPOSALACCEPTED SITE (Chh�e..,,c.®kk those accepted) 6 DEAD CONSTRUCTION 31
�IOUSEHOLp T �'LND US- jSt STITUTIONAL O ANIMALS DEBRIS 3
TRIAL
TO 72 74 WASTE STREET OTHER (Specify)
AGRICUL- INCINERATOR OOIL OSWEEPI NGS 0 ❑
11T60MMERCIAL �TURAL O 3
5 RESIDUE ONLY 34
3 71 J3 NUMBER 33. TOTAL NUMBER OF EM PLOY EES ON SITE (Average dolly)
e. (Average utilized daily)LE yyRR�� FTO
DRAGLINE OR SHOVEL -TYPE EXCAVATORS 4J 0, HOURS OF DAILY
35 36 OPERATION BEGIN ® END
SCRAPERS (Self propelled) 0 (On a 24-how clock) 51 52
3] 36 F
41. NUMBER OF DAYS OPERATED PER WEEK
TRACTORS (Tract or Rubber Tire) 65
(Bulldozer at High Lift Leader) g 40
• 2. ANNUAL OPERATING COST $ FT
TRUCKS 1 (Including auparvmaintenalonnce)
end II II I 9 0 60 61 62
4 q2 equipment maintenalc� 56 57 6 6
Do
OTHER not (Specify use 43 43 45 OYES
Do 43, IS THIS A SANITARY LANDFILL? ❑
OTHER NO 63
(Specify) use q6 4
44. IF SOURCES OTHER THAN REPORTER DESIGNATED IN ITEM ] WERE UTILIZED IN COMPLETING THIS FORM, INDICATE BELOW
THE SOURCES USED AND ITEM NUMBERS
NAME OF,
PERSON
TITLE
ORGANIZATION
ITEM NUMBER(S)
PHS-99442 (467)