8803_ROSCANS_1999

NC DEPARTMENT OF ENVIRONMENT, HEALTH AND NATURAL RESOURCES
Division of Solid Waste Management
Solid Waste Section
SOLID WASTE KAXAGENENT FACILITY EVALUATION REPORT
Type of Facility. Permit # Countxal_
Name of Facility, location on
TT
Date of Last Evaluation
I. Permit Conditions Followed Yes No N/A
A. Specific Candition(s) Violated
11. Operational Requirements Followed
Yes No
15A N.C. Admin. code 138 section
A. Specific Violation(s) by number and Letter.
Zi42
I I ,
9 -
111. other Violations of Rule or Law
IV. Evaluator's Comments o e", A h 1ji, 11
V. Continuation Page Required? -Yes
No Receiving Signature
Evaluation Date
Solid Waste Section
DEHUR 3793 (Part I White: Facility Part II Canary: Central Office
Part III Pink: Regional office)
Solid Waste Section (Review 7/94)

Phase: 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.
Distributicn: Part I Mute: facility copy
Part III Canary: Raleigh central office file copy
Part III P-uk: Regional office f ile copy
Diqpositian: 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 Envirorment, Health and Natural Resources.

NC DEPARTMENT OF ENVIRONMENT, HEALTH AND NATURAL RESOURCES
Division of Solid Waste Management
Solid Waste Section
SOLID /WASTE KAMAG0ENT FACILITY EVALUATION REPORT
Type of Facility��/ Permit # " County
Name of Foci L i ty/ +, ,. , �, ,. �+ )� �.+., ` d?H '- c` Ftr;-. / I l % Location
Date of Last Evaluation
I. Permit Conditions Followed Yes No N/A
A. Specific Condition(s) Violated
II. Operational Requirements Followed Yes No
15A N.C. Admin. Code 13B Section
A. Specific Violation(s) by number and letter.
III. Other Violations of Rule or Law
IV. Evaluator's Comments f ? 1�. . - -1 < // ,,,. +,.'�: < !.7 _'y-
V. Continuation Page Required? Yes No Receiving Signature
Evaluation Date Solid Waste Section
DEHNR 3793 (Part I White: Facility Part II Canary: Central Office Part III Pink: Regional Office)
Solid Waste Section (Review 7/94)

K
lkzp,m—e.- G.S. 130A-294 retpims that an evaluation pro9mm be estab:Li--,'W for the
(--e tion of sol-id wast nnana :ode b,-as-L---,. The
-gerent, fracd)ities on a statew
Solid WastF- Mmgr,-xo,-nt Act and Solid Was MaiWAare--riL RuIL—.. codified at
I tda., mj"7t �&),e followed bv solid waste
27VA Nr-'A.0 13B List �xxg�drements w -r
x -e - J011 pm,-sonnej- sinall c",q?lete tIje twalucition foxin eaCII
a solid Wast- Sect
4U.mim tbey corgiuct. official. eva:jim-
xtions. The form r4iall be signed by
Ow. receivirg the report.
WjF,,�tzibL*Jm� Pawt T MAte: facility capy,
j,drt fj oarwy:' Iedgh cxxxty-al office file CXW
p,vrt, -m - Regixg-nI office .file coW
I-Asp,w4ti C.M., Ibis form indy be retained in ac"-irdam-,e with the Ramid Retentioin andl
1).U�pcx,iLion �khe:IW.e of the Solid Waste. Seat on, Solid Waste PlariacXnexit
Uhli,SdOD Of the- Utanmt of Envirormimt, Health and Natural Resources.
16