N1101_FIRE_20220923

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Waste !Management
ENVIRONMENTAL QUALITY
SOLID WASTE MANAGEMENT FACILITY
FIRE OCCURRENCE NOTIFICATION
NCDEQ Division of Waste Management
Solid Waste Section
Notify the Section verbally within 24 hours and submit written notification within 15 days of the occurrence.
(If additional space is needed, use back of this form)
NAME OF FACILITY: Whitesides/T & L Grading, Inc. Notified LCID Landfill PERMIT # Nl 101
DATE AND TIlV1E OF FIRE: (g _ A,-[ _ J,E,4,4 00 an
IOW WAS THE FIRE REPORTED AND BY WHOM:
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LIST ACTIONS TAKEN:
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VHAT WAS THE CAUSE OF THE FIRE:
)ESCRIBE AREA, TYPE, AND AMOUNT OF WASTE INVOLVED:
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WHAT COULD HAVE BEEN DONE TO PREVENT THIS FIRE:
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DESCRIBE PLAN OF ACTIONS TO PREVENT FUTURE INCIDENTS:
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NAME �P� C' 1 i Ear TITLE: �u P C�Ya1\ DATE: Cl _ 4(D -ACI-- q
THIS SECTION TO BE COMPLETED BY SOLID WASTE SECTION REGIONAL STAFF
DATE RECEIVED
List any factors not listed that might have contributed to the fire or that might prevent occurrence of fixture fires:
FOLLOW-UP REQUIRED:
NO PHONE CALL SUBMITTAL MEETING RETURN VISIT BY: (DATE)
ACTIONS TAKEN OR REQUIRED: