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Home My WebLink About8803_ROSCANS_1987N.C. DEPARTMENT OF HUMAN RESOUlc�,cS WEATHER CONDITIONS DIVISION OF HEALTH SERVICES PERMIT NUMNR INSPECTION FOR SANITARY LANDFILLS NAME OF SITE COUNTY LOCATION SIGNATURE OF PERSQN(S) RECEIVING REPORT`" SIR: AN INSPECTION OF YOUR LAND DISPOSAL SITE HAS BEEN MADE THIS DATE AND YOU ARE NOTIFIED QF THE VIOLATIONS, IF ANY, MARKED BELOW WITH A CROSS (X). (1) PLAN AND PERMIT REQUIREMENTS (a) Construction plans shall be approved and followed. — (b) Specified monitoring and reporting requirements shall be met. (2) SPREADING AND COMPACTING REQUIREMENTS — (a) Solid waste shall be restricted into the smallest area feasible. (b) Solid waste shall be compacted as densely as practical into cells. (3) COVER REQUIREMENTS (a) Solid waste shall be covered after each day of operation, with a compacted layer of at least six inches of suitable cover or as specified by the division. — (b) Areas which will not have additional wastes placed on them for 12 months or more shall be covered with a minimum of one foot of intermediate cover. (c) After final termination of disposal operations at the site or a major part thereof or upon revocation of a permit, the area shall be covered with at least two feet of suitable compacted earth. (4) EROSION CONTROL REQUIREMENTS — (a) Adequate erosion control measures shall be practiced to pre- vent silt from leaving the site, (b) Adequate erosion control measures shall be practiced to pre- vent excessive on -site erosion. IJ� ' - mrh (9) SIGN REQUIREMENTS (a) Signs providing information on dumping procedures, the hours during which the site is open for public use, the permit number and other pertinent information shall be posted at the site entrance. (b) Signs shall be posted stating that no hazardous or liquid waste can be received without written permission from the division. — (c) Traffic signs or markers shall be provided as necessary to pro- mote an orderly traffic pattern to and from the discharge area and to maintain efficient operating conditions. (10) SAFETY REQUIREMENTS — (a) Open burning of solid waste is prohibited. — (b) Equipment shall be provided to control accidental fires or arrangements shall be made with the local fire protection agency to immediately provide fire -fighting services when needed. — (c) Fires that occur at a sanitary landfill shall be reported to the division within 24 hours and a written notification shall be submitted within 15 days. — (d) The removal of solid waste from a sanitary landfill is prohibited unless the owner/operator approves and the removal ?s not performed on the working face. — (e) Barrels and drums shall not be disposed of unless they are empty (5) DRAINAGE CONTROL REQUIREMENTS - and perforated sufficiently to ensure that no liquid or hazard- - (a) Surface water shall be diverted from the operational area. ous waste is contained therein. (b) Surface water shall not be impounded over or in waste. � ff -(c) Completed areas shall be adequately sloped to allow Sur aSg----- (11) WASTE ACCEPTANCE AND DISPOSAL REQUIREMENTS water runoff in a controlled manner. (a) Asiteshall only accept those solid wastes which itispermittedto receive. (6) VEGETATION REQUIREMENTS (b) No hazardous, liquid, or infectious waste shall be accepted or — (a) Within six months after final termination of disposal operations disposed of in a sanitary landfill except as may be approved by at the site on a major part thereof or upon revocation of a the division. permit, the area shall be stabilized with native grasses. (c) Spoiled foods, animal carcasses, abattoir waste, hatchery waste, — (b) Temporary seeding will be utilized as necessary to stabilize the and other animal waste delivered to the disposal site shall be site. covered immediately. — (d) Asbestos waste that is packaged in accordance with 40 CFR 61, as 7 WATER PROTECTION REQUIREMENTS REMENTS () Q amended through January 1,1985, may be disposed of separate (a) The separation distance of four (4) feet between waste and and apart from other solid wastes at the bottom of the working water table shall be maintained unless otherwise specified by face or in an area not contiguous with other disposal areas, in the division in the permit. either case, in virgin soil. Separate areas shall be clearly marked (b) Solid waste shall not be disposed of in water. so that asbestos is not exposed by future land -disturbing activi- - (c) Leachate shall be contained on site or properly treated prior to ties. The waste shall be covered immediately with soil in a discharge. An NPDES permit may be required prior to the dis- manner that will not cause airborne conditions. Copies of 40 charge of leachate to surface waters. CFR 61 may be obtained and inspected at the Solid and Hazard- (8) ACCESS AND SECURITY REQUIREMENTS ous Waste Management Branch, Division of Health Services, (a) The site shall be adequately secured by means of gates, chains, P. O. Box 2091, Raleigh, NC, 27602. berms, fences, and other security measures approved by the (12) MISCELLANEOUS REQUIREMENTS division, to prevent unauthorized entry. — (a) Effective vector control measures shall be applied to control (b) An attendant shall be on duty at the site at all times while it is flies, rodents, and other insects or vermin when necessary. open for public use to ensure compliance with operational (b) Appropriate methods such as fencing and diking shall be pro - requirements. vided within the area to confine solid waste subject to be blown (c) The access road to the site shall be of all-weather construction by the wind. At the conclusion of each day of operation, all and maintained in good condition. windblown material resulting from the operation shall be col- - (d) Dust control measures shall be implemented where necessary. lected and returned to the area by the owner or operator. REMARKS: _r DATE: NAME: and Hazardous Waste Management Branch DHS 1709 (Revised 4/85) Solid & Hazardous Waste Management Branch (Review 4/86) (white — Raleigh Office yellow — Facility green — Preparer) Purpose: G.S.130A-294 requires that an inspection program be established for the operation of solid waste management facilities on a statewide basis. The N.C. Solid Waste Management Rules codified 10 NCAC 10G, Section .0505 list specific operational requirements which must be followed by sanitary landfills. Preparation: Solid and Hazardous Waste Branch personnel shall complete the inspection form each time they conduct an official inspection. The form shall be signed by the person(s) receiving the report. Distribution: 1. White copy to Raleigh office 2. Yellow copy to facility 3. Green copy to preparer Disposition: This form may be destroyed in accordance with Standard 7, Inspection Records, of the Records Disposition Schedule published by the N.C. Division of Archives and History. Order additional forms from: Solid and Hazardous Waste Management Branch Division of Health Services P. O. Box 2091 Raleigh, NC 27602-2091 WEATHER CONDITIONS A.C. DEPARTMENT OF HUMAN RESOURL DIVISION OF HEALTH SERVICES INSPECTION FOR SANITARY LANDFILLS NAME OF SITE COUNTY LOCATION SIGNATURE OF PERSON(S) RECEIVING REPORT' I I PERMIT NUMBER SIR: AN INSPECTION OF YOUR LAND DISPOSAL SITE HAS BEEN MADE THIS DATE AND YOU ARE NOTIF)ED,OF THE VIOLATIONS, IF ANY, MARKED BELOW WITH A CROSS (X). (1) PLAN AND PERMIT REQUIREMENTS (a) Construction plans shall be approved and followed. (b) Specified monitoring and reporting requirements shall be met. (2) SPREADING AND COMPACTING REQUIREMENTS (a) Solid waste shall be restricted into the smallest area feasible. (b) Solid waste shall be compacted as densely as practical into cells. (3) COVER REQUIREMENTS (a) Solid waste shall be covered after each day of operation, with a compacted layer of at least six inches of suitable cover or as specified by the division. (b) Areas which will not have additional wastes placed on them for 12 months or more shall be covered with a minimum of one foot of intermediate cover. — (c) After final termination of disposal operations at the site or a major part thereof or upon revocation of a permit, the area shall be covered with at least two feet of suitable compacted earth. (4) EROSION CONTROL REQUIREMENTS (a) Adequate erosion control measures shall be practiced to pre- vent silt from leaving the site. (b) Adequate erosion control measures shall be practiced to pre- vent excessive on -site erosion. (5) DRAINAGE CONTROL REQUIREMENTS (a) Surface water shall be diverted from the operational area. —(b) Surface water shall not be impounded over or in waste. —(c) Completed areas shall be adequately sloped to allow surface. -- water runoff in a controlled manner. (6) VEGETATION REQUIREMENTS — (a) Within six months after final termination of disposal operations at the site on a major part thereof or upon revocation of a permit, the area shall be stabilized with native grasses. — (b) Temporary seeding will be utilized as necessary to stabilize the site. (7) WATER PROTECTION REQUIREMENTS (a) The separation distance of four (4) feet between waste and water table shall be maintained unless otherwise specified by the division in the permit. (b) Solid waste shall not be disposed of in water. (c) Leachate shall be contained on site or properly treated prior to discharge. An NPDES permit may be required prior to the dis- charge of leachate to surface waters. (9) SIGN REQUIREMENTS (a) Signs providing information on dumping procedures, the hours during which the site is open for public use, the permit number and other pertinent information shall be posted at the site entrance. (b) Signs shall be posted stating that no hazardous or liquid waste can be received without written permission from the division. — (c) Traffic signs or markers shall be provided as necessary to pro- mote an orderly traffic pattern to and from the discharge area and to maintain efficient operating conditions. (10) SAFETY REQUIREMENTS — (a) Open burning of solid waste is prohibited. (b) Equipment shall be provided to control accidental fires or arrangements shall be made with the local fire protection agency to immediately provide fire -fighting services when needed. — (c) Fires that occur at a sanitary landfill shall be reported to the division within 24 hours and a written notification shall be submitted within 15 days. (d) The removal of solid waste from a sanitary landfill is prohibited unless the owner/operator approves and the removal is not performed on the working face. — (e) Barrels and drums shall not be disposed of unless they are empty and perforated sufficiently to ensure that no liquid or hazard- ous waste is contained therein. (11) WASTE ACCEPTANCE AND DISPOSAL REQUIREMENTS — (a) A site shall only accept those solid wastes which it is permitted to receive. — (b) No hazardous, liquid, or infectious waste shall be accepted or disposed of in a sanitary landfill except as may be approved by the division. (c) Spoiled foods, animal carcasses, abattoir waste, hatchery waste, and other animal waste delivered to the disposal site shall be covered immediately. (d) Asbestos waste that is packaged in accordance with 40 CFR 61, as amended through January 1,1985, may be disposed of separate and apart from other solid wastes at the bottom of the working face or in an area not contiguous with other disposal areas, in either case, in virgin soil. Separate areas shall be clearly marked so that asbestos is not exposed by future land -disturbing activi- ties. The waste shall be covered immediately with soil in a manner that will not cause airborne conditions. Copies of 40 CFR 61 may be obtained and inspected at the Solid and Hazard- (8) ACCESS AND SECURITY REQUIREMENTS ous Waste Management Branch, Division of Health Services, (a) The site shall be adequately secured by means of gates, chains, P. O. Box 2091, Raleigh, NC, 27602. berms, fences, and other security measures approved by the (12) MISCELLANEOUS REQUIREMENTS division, to prevent unauthorized entry. (a) Effective vector control measures shall be applied to control (b) An attendant shall be on duty at the site at all times while it is flies, rodents, and other insects or vermin when necessary. open for public use to ensure compliance with operational (b) Appropriate methods such as fencing and diking shall be pro - requirements. vided within the area to confine solid waste subject to be blown — (c) The access road to the site shall be of all-weather construction by the wind. At the conclusion of each day of operation, all and maintained in good condition. windblown material resulting from the operation shall be col- - (d) Dust control measures shall be implemented where necessary. lected and returned to the area by the owner or operator. REMARKS: ! 21 Z �� DATE: NAME: Solid and Hazardous Waste Management Branch DHS 1709 (Revised 4/85) Solid & Hazardous Waste Management Branch (Review 4/86) (white — Raleigh Office yellow — Facility green — Preparer) Purpose: G.S.130A-294 requires that an inspection program be established for the operation of solid waste management facilities on a statewide basis. The N.C. Solid Waste Management Rules codified 10 NCAC 10G, Section .0505 list specific operational requirements which must be followed by sanitary landfills. Preparation: Solid and Hazardous Waste Branch personnel shall complete the inspection form each time they conduct an official inspection. The form shall be signed by the person(s) receiving the report. Distribution: 1. White copy to Raleigh office 2. Yellow copy to facility 3. Green copy to preparer Disposition: This form may be destroyed in accordance with Standard 7, Inspection Records, of the Records Disposition Schedule published by the N.C. Division of Archives and History. Order additional forms from: Solid and Hazardous Waste Management Branch Division of Health Services P. O. Box 2091 Raleigh, NC 27602-2091 N.C. DEPARTMENT OF HUMAN RESOUR. WEATHER CONDITIONS DIVISION OF HEALTH SERVICES PERMIT NUMBER INSPECTION FOR SANITARY LANDFILLS NAME OF SITE t COUNTY 0 h/ LOCATION SIP NATURE OF/P RSON(S) RECEIVING REPORT SIR: AN INSPECTION OF YOUR LAND DISPOSAL SITE HAS BEEN MADE THIS DATE AND YOU ARE WOT�FIED OF THE VIOLATIONS, IF ANY, MARKED BELOW WITH A CROSS (X). (1) PLAN AND PERMIT REQUIREMENTS — (a) Construction plans shall be approved and followed. — (b) Specified monitoring and reporting requirements shall be met. (2) SPREADING AND COMPACTING REQUIREMENTS — (a) Solid waste shall be restricted into the smallest area feasible. (b) Solid waste shall be compacted as densely as practical into cells. (3) COVER REQUIREMENTS (a) Solid waste shall be covered after each day of operation, with a compacted layer of at least six inches of suitable cover or as specified by the division. — (b) Areas which will not have additional wastes placed on them for 12 months or more shall be covered with a minimum of one foot of intermediate cover. — (c) After final termination of disposal operations at the site or a major part thereof or upon revocation of a permit, the area shall be covered with at least two feet of suitable compacted earth. (4) EROSION CONTROL REQUIREMENTS (a) Adequate erosion control measures shall be practiced to pre- vent silt from leaving the site. — (b) Adequate erosion control measures shall be practiced to pre-,,,/ vent excessive on -site erosion. _-- (5) DRAINAGE CONTROL REQUIREMENTS f t V — (a) Surface water shall be diverted from the operational area. — (b) Surface water shall not be impounded over or in waste. (c) Completed areas shall be adequately sloped to allow surface water runoff in a controlled manner. (6) VEGETATION REQUIREMENTS (a) Within six months after final termination of disposal operations at the site on a major part thereof or upon revocation of a permit, the area shall be stabilized with native grasses. (b) Temporary seeding will be utilized as necessary to stabilize the site. (7) WATER PROTECTION REQUIREMENTS (a) The separation distance of four (4) feet between waste and water table shall be maintained unless otherwise specified by the division in the permit. (b) Solid waste shall not be disposed of in water. — (c) Leachate shall be contained on site or properly treated prior to discharge. An NPDES permit may be required prior to the dis- charge of leachate to surface waters. (8) ACCESS AND SECURITY REQUIREMENTS — (a) The site shall be adequately secured by means of gates, chains, berms, fences, and other security measures approved by the division, to prevent unauthorized entry. — (b) An attendant shall be on duty at the site at all times while it is open for public use to ensure compliance with operational requirements. — (c) The access road to the site shall be of all-weather construction and maintained in good condition. — (d) Dust control measures shall be implemented where necessary. REMARKS: DATE: NAME: (9) SIGN REQUIREMENTS (a) Signs providing information on dumping procedures, the hours during which the site is open for public use, the permit number and other pertinent information shall be posted at the site entrance. (b) Signs shall be posted stating that no hazardous or liquid waste can be received without written permission from the division. (c) Traffic signs or markers shall be provided as necessary to pro- mote an orderly traffic pattern to and from the discharge area and to maintain efficient operating conditions. (10) SAFETY REQUIREMENTS — (a) Open burning of solid waste is prohibited. (b) Equipment shall be provided to control accidental fires or arrangements shall be made with the local fire protection agency to immediately provide fire -fighting services when needed. —(c) Fires that occur at a sanitary landfill shall be reported to the division within 24 hours and a written notification shall be submitted within 15 days. — (d) The removal of solid waste from a sanitary landfill is prohibited unless the owner/operator approves and the removal is not performed on the working face. — (e) Barrels and drums shall not be disposed of unless they are empty and perforated sufficiently to ensure that no liquid or hazard- ous waste is contained therein. (11) WASTE ACCEPTANCE AND DISPOSAL REQUIREMENTS (a) A site shall only accept those solid wastes which it is permitted to receive. — (b) No hazardous, liquid, or infectious waste shall be accepted or disposed of in a sanitary landfill except as may be approved by the division. — (c) Spoiled foods, animal carcasses, abattoir waste, hatchery waste, and other animal waste delivered to the disposal site shall be covered immediately. — (d) Asbestos waste that is packaged in accordance with 40 CFR 61, as amended through January 1,1985, may be disposed of separate and apart from other solid wastes at the bottom of the working face or in an area not contiguous with other disposal areas, in either case, in virgin soil. Separate areas shall be clearly marked so that asbestos is not exposed by future land -disturbing activi- ties. The waste shall be covered immediately with soil in a manner that will not cause airborne conditions. Copies of 40 CFR 61 may be obtained and inspected at the Solid and Hazard- ous Waste Management Branch, Division of Health Services, P. O. Box 2091, Raleigh, NC, 27602. (12) MISCELLANEOUS REQUIREMENTS (a) Effective vector control measures shall be applied to control flies, rodents, and other insects or vermin when necessary. (b) Appropriate methods such as fencing and diking shall be pro- vided within the area to confine solid waste subject to be blown by the wind. At the conclusion of each day of operation, all windblown material resulting from the operation shall be col- lected and returned to the area by the owner or operator. Solid and Hazardous Waste Management Branch DHS 1709 (Revised 4/85) Solid & Hazardous Waste Management Branch (Review 4/86) (white — Raleigh Office yellow — Facility green — Preparer) Purpose: G.S.130A-294 requires that an inspection program be established for the operation of solid waste management facilities on a statewide basis. The N.C. Solid Waste Management Rules codified 10 NCAC 10G, Section .0505 list specific operational requirements which must be followed by sanitary landfills. Preparation: Solid and Hazardous Waste Branch personnel shall complete the inspection form each time they conduct an official inspection. The form shall be signed by the person(s) receiving the report. Distribution: 1. White copy to Raleigh office 2. Yellow copy to facility 3. Green copy to preparer Disposition: This form may be destroyed in accordance with Standard 7, Inspection Records, of the Records Disposition Schedule published by the N.C. Division of Archives and History. Order additional forms from: Solid and Hazardous Waste Management Branch Division of Health Services P. O. Box 2091 Raleigh, NC 27602-Z091 WEATHER CONDITIONS .,.C. DEPARTMENT OF HUMAN RESOURCEb DIVISION OF HEALTH SERVICES INSPECTION FOR SANITARY LANDFILLS NAME OF SITE COUNTY LOCATION SIGNATURE OF PERSON(S) RECEIVING REPORT 15 PERMIT NUMBER 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 (X). (1) PLAN AND PERMIT REQUIREMENTS — (a) Construction plans shall be approved and followed. (b) Specified monitoring and reporting requirements shall be met. (2) SPREADING AND COMPACTING REQUIREMENTS (a) Solid waste shall be restricted into the smallest area feasible. (b) Solid waste shall be compacted as densely as practical into cells. (3) COVER REQUIREMENTS — (a) Solid waste shall be covered after each day of operation, with a compacted layer of at least six inches of suitable cover or as specified by the division. (b) Areas which will not have additional wastes placed on them for 12 months or more shall be covered with a minimum of one foot of intermediate cover. (c) After final termination of disposal operations at the site or a major part thereof or upon revocation of a permit, the area shall be covered with at least two feet of suitable compacted earth. (4) EROSION CONTROL REQUIREMENTS — (a) Adequate erosion control measures shall be practiced to pre- vent silt from leaving the site. (b) Adequate erosion control measures shall be practiced to pre- vent excessive on -site erosion. (5) DRAINAGE CONTROL REQUIREMENTS — (a) Surface water shall be diverted from the operational area. (b) Surface water shall not be impounded over or in waste. — (c) Completed areas shall be adequately sloped to allow surface water runoff in a controlled manner. (6) VEGETATION REQUIREMENTS — (a) Within six months after final termination of disposal operations at the site on a major part thereof or upon revocation of a permit, the area shall be stabilized with native grasses. (b) Temporary seeding will be utilized as necessary to stabilize the site. (7) (8) (9) SIGN REQUIREMENTS — (a) Signs providing information on dumping procedures, the hours during which the site is open for public use, the permit number and other pertinent information shall be posted at the site entrance. — (b) Signs shall be posted stating that no hazardous or liquid waste can be received without written permission from the division. — (c) Traffic signs or markers shall be provided as necessary to pro- mote an orderly traffic pattern to and from the discharge area and to maintain efficient operating conditions. (10) SAFETY REQUIREMENTS (a) Open burning of solid waste is prohibited. — (b) Equipment shall be provided to control accidental fires or arrangements shall be made with the local fire protection agency to immediately provide fire -fighting services when needed. (c) Fires that occur at a sanitary landfill shall be reported to the division within 24 hours and a written notification shall be submitted within 15 days. (d) The removal of solid waste from a sanitary landfill is prohibited unless the owner/operator approves and the removal is not performed on the working face. (e) Barrels and drums shall not be disposed of unless they are empty and perforated sufficiently to ensure that no liquid or hazard- ous waste is contained therein. (11) WASTE ACCEPTANCE AND DISPOSAL REQUIREMENTS — (a) A site shall only accept those solid wastes which it is permitted to receive. (b) No hazardous, liquid, or infectious waste shall be accepted or disposed of in a sanitary landfill except as may be approved by the division. (c) Spoiled foods, animal carcasses, abattoir waste, hatchery waste, and other animal waste delivered to the disposal site shall be covered immediately. (d) Asbestos waste that is packaged in accordance with 40 CFR 61, as amended through January 1,1985, may be disposed of separate and apart from other solid wastes at the bottom of the working face or in an area not contiguous with other disposal areas, in either case, in virgin soil. Separate areas shall be clearly marked so that asbestos is not exposed by future land -disturbing activi- ties. The waste shall be covered immediately with soil in a manner that will not cause airborne conditions. Copies of 40 CFR 61 may be obtained and inspected at the Solid and Hazard- ous Waste Management Branch, Division of Health Services, P. O. Box 2091, Raleigh, NC, 27602. (12) MISCELLANEOUS REQUIREMENTS (a) Effective vector control measures shall be applied to control flies, rodents, and other insects or vermin when necessary. (b) Appropriate methods such as fencing and diking shall be pro- vided within the area to confine solid waste subject to be blown by the wind. At the conclusion of each day of operation, all I' 11 windblown material resulting from the operation shall be col- lected and returned to the area by the owner or operator. REMARKS: /jN S /% (:(,)VirA 21147--12elltG /1li'1F7'"/.1 CO)I�k ///ha.@//rd WATER PROTECTION REQUIREMENTS (a) The separation distance of four (4) feet between waste and water table shall be maintained unless otherwise specified by the division in the permit. (b) Solid waste shall not be disposed of in water. (c) Leachate shall be contained on site or properly treated prior to discharge. An NPDES permit may be required prior to the dis- charge of leachate to surface waters. /;//, /,?J-EC,,li'l;f'i �'.'LUD/—l-�r %/'/'/')IJ/ ACCESS AND`SURITY REQUIREMENT`S' — (a) The site shall be adequately secured by means of gates, chains, berms, fences, and other security measures approved by the division, to prevent unauthorized entry. — (b) An attendant shall be on duty at the site at all times while it is open for public use to ensure compliance with operational requirements. (c) The access road to the site shall be of all-weather construction and maintained in good condition. — (d) Dust control measures shall be implemented where necessary. 1-19 -11h O brkh hA4, /64-s AKA / Div, DATE: f "A — X7 NAME:. �f Solid and Hazardous Waste Management Branch DHS 1709 (Revised 4/85) Solid & Hazardous Waste Management Branch (Review 4/86) (white — Raleigh Office yellow — Facility green — Preparer) r Purpose: G.S.130A-294 requires that an inspection program be established for the operation of solid waste management facilities on a statewide basis. The N.C. Solid Waste Management Rules codified 10 NCAC 10G, Section .0505 list specific operational requirements which must be followed by sanitary landfills. Preparation: Solid and Hazardous Waste Branch personnel shall complete the inspection form each time they conduct an official inspection. The form shall be signed by the person(s) receiving the report. Distribution: 1. White copy to Raleigh office 2. Yellow copy to facility 3. Green copy to preparer Disposition: This form may be destroyed in accordance with Standard 7, Inspection Records, of the Records Disposition Schedule published by the N.C. Division of Archives and History. Order additional forms from: Solid and Hazardous Waste Management Branch Division of Health Services P. O. Box 2091 Raleigh, NC 27602-2091 NORTH CAROLINA DEPARTMENT OF HUMAN RESOURCES INTER OFFICE MEMORANDUM DATE to S TO , tpA1LIAIA �FJSLOG .5hLlD w)}srr warms-rgiciO Alg.cla &—tffA str� FROM -71`m 'PniteL6&rti r C;6 `F1' 1:Zbw7)N0 Ly9Y1Dt I1L J45p✓q1D/J rtlo �"!iE T�i�NS�bVNt�lF9 cpt ),ry ,LFwpF -LJ-- Ohl lz��"1, G COISFfi VN14,mll )1%4 411 AOJ'A4 cow i-rzo cA 4v-96s►k. DHR Form 2 (8/75) NORTH CAROLINA DEPARTMENT OF HUMAN RESOURCES INTER OFFICE MEMORANDUM DATE 616187 UmimmTRIN 1: 6�A 1A 0NMD VI" =NVVVTadd b't' THr- CW0.►15QI,V1oA4L19 cvtory LYi>bpw- ot4 b 1 `f I %1. rt1415 GOY ER Mp v' vp L. r r Ti4Is LAY)pp" i1TE �AYtS 13£v-li pV-F49j-r=p Pr1dD GDW-X Yrim11tt IS ?Tt, ~ 5CAWLY 7/WZ4-vD 7d 2' 511T DHR Form 2 (8/75)