18E_ROSCANS_1985

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Weather Conditions N.C. DEPARTMENT OF HUMAN RESOURCES
DIVISION OF HEALTH SERVICES
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Permit Number
INSPECTION FORM FOR SANITARY LANDFILLS
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Name o.f Site _County
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Lo-:cation . Signature ·of P(rson(s) Receiving Report
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 REQUIREMENTS
Site plan approved
Construction plans approved
__ Plans being followed
2. SPREADING & COMPACTING
Waste restricted to the
smallest area practicable
__ Waste properly compacted
3. COVER REQUIREMENTS
Six inches daily cover
Two foot final cover
One foot intermediate cover
4. DRAINAGE CONTROLLED
On-site erosion
Off-site siltation
Erosion control devices
Seeding of completed areas
Temporary seeding
5, WATER PROTECTION
__ Off-site leaching
-~ Waste placed in water
__ Surface water impounded
__ Monitorin~ wells installed
'·DATE -.....-'---· =-~..:..\.•··•--':'-.:-''-.... _ .. "_·------c.~,
DHS FORM 1709 (7/82)
6. ACCESS
__ Attendant on duty
~ Access controls
All weather road
Dust controlled
BURNING
Evidence of burning
Fire control equipment available
8. SPECIAL WASTES
Spoiled food, animal carcasses,
abattoir waste, hatchery waste,
etc., covered immediately
9. UNAUTHORIZED WASTES ACCEPTED WITHOUT
WRITTEN PERMISSION
Type------------~
10. VECTOR CONTROL
Effective control measures
11. MISCELLANEOUS
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Blowing material controlled
__ . _ Proper signs posted
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NAME )f,,:~:./ / · >> >~'--,{ .,, ,i":__; ____ ;·:,,
. /Solid & Haiardoui .· Waste Management Branch ,/
Solid & Hazardous Waste Management Branch
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Weather Conditions N.C. DEPARTMENT .OF HUMAN RESOURCES
DIVISION OF HEALTH SERVICES Permi-t Number
INSPECTION FORM FOR SANITARY LANDFILLS
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Name of Site
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County ,'
Location Signature of :];>erson(s) Receiving Report
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 REQUIREMENTS
__ Site• plan approved·
__ Construction plans approved
__ Plans being followed
2. SPREADING & COMPACTING
Waste restricted to the
smallest area practicable
__ Waste properly compacted
3. COVER REQUIREMENTS
Six inches daily cover
Two foot final cover
One foot intermediate cover
4. DRAINAGE CONTROLLED
On-site erosion
Off-site siltation
Erosion control devices
__ Seeding of completed areas
__ Temporary seeding
5. WATER PROTECTION
__ Off-site leaching
__ Waste placed in water
__ Surface water impounded
__ Monitoring wells installed
DHS FORM 1709 (7/82)
6. ACCESS
Attendant on duty
Access controls
All weather road
Dust controlled
7. BURNING
Evidence of burning
Fire control equipment available
8. SPECIAL WASTES
Spoiled food, animal carcasses,
abattoir waste, hatchery waste,
etc., covered immediately
9. UNAUTHORIZED WASTES ACCEPTED WITHOUT
WRITTEN PERMISSION
__ Type -'--------------
10. VECTOR CONTROL
Effective control measures
11. MISCELLANEOUS
Blowing material controlled
Proper signs posted
.·:· 'NAME ... )::.''" ., .... ---·i·.· ,·.· •. ·•· -........ , . ···.-i.·'.:_._·_ ·.-.• ~.:,"'_ .. -,::. ...... ~·· . . . /,--~ .... I . ~~-< . < -.•• ,.,,_. ; , ...
· --·--soli¢t' & Hazardous Waste Management Branch
Solid & Hazardous Waste Management Branch