4403_ROSCANS_1985

P6
■
N. C. DEPARTMENT OF HUMAN RESOURCES
DIVISION',OF HEALTH SERVICES
STATE LABORATORY OF PUBLIC HEALTH
P. 0. BOX 28047 - 306 N. WILMINGTON ST., RALEIGH 27611
Site Number . Field Sample Number pQ l5? 9
Name of Site ,AND/=/1_4- Site. Location .5) R6,2)
Collected By fR►h� }� rSr�� IDS %.'7 Date Collected � Time /$ l ?iY
Type of.Sample:;
Environmental Concentrate
Gr undwater Comments
Solid D�l✓n/ //�Di �/T"i S��t�tl��x
urface Water i uid � •- • , - > ....,.
Soil _!L�
Sludge �- c �•
Other Other S- 17��
Extractables
Total.
A= a
rcrc}
arameter Results mg/1
Parameter
Results mg/1
Parameter',Results
mg/1
_ Arsenic
_-Arsenic
cam.
hloride--
— Barium,
'Aarium
_
Conductivity
Cadmium
adai
— ium
:j:=
Copper
_ Chromium
ium
`�. _��. ;, /
c/Fluoride
Lead
�iead .- ...
,.
Iron
_ Mercury
y
-'-I
C
Manganese
_ Selenium
lenium
C, z)�'
t/_Nitrate
,p•"
1�
— Silver
Silver
_
r, C? _
H
VSulfate6
—
,//TDS
'l
ORGANTC CWF.MTSTRV
M UKUBIULUGY RAnTnr14FMT4.ZTI2V .
Parameter>;
Coliform Colonies/100mis
(MPN) Coliform:Colonies/100mis
Date Received
Date Extracted r
Reported By
a
AtPR 10 jg,lb'-7
.
DHS 3191 (Revised; 2/84)
Solid and Hazardous Waste OG`rWARTI! UAP
i

Weather Conditions N.C. DEPARTMENT OF HUMAN RESOURCES Permit Number
DIVISION OF HEALTH SERVICES
INSPECTION FORM FOR SANITARY LANDFILLS
Name of Site
County
Location
Signature of Person(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
6. ACCESS
Site plan approved
Attendant on duty
Construction plans approved
Access controls
Plans being followed
All weather road
Dust controlled
2. SPREADING & COMPACTING
Waste restricted to the
BURNING j
smallest area practicable
Evidence of burning
Waste properly compacted
Fire control equipment available
3. COVER REQUIREMENTS
8. SPECIAL WASTES
Six inches daily cover
i
Spoiled food, animal carcasses,
Two foot final cover
abattoir waste, hatchery waste,
etc., covered immediately
One foot intermediate cover
9• UNAUTHORIZED WASTES ACCEPTED WITHOUT
4. DRAINAGE CONTROLLED
WRITTEN PERMISSION
On -site erosion
Type
Off -site siltation
Erosion control devices
Seeding of completed areas
10. VECTOR CONTROL
Temporary seeding
Effective control measures
5. WATER PROTECTION
11. MISCELLANEOUS
Off -site leaching
Blowing material controlled
Waste placed in water
Surface water impounded
Proper signs posted
Monitoring wells installed
REMARKS:
i
1
DATE NAME
1
Solid & Hazardous Waste Management Branch
1
DHS FORM 1709 (7/82)
j
Solid & Hazardous Waste Management Branch

Weather Conditions N.C. DEPARTMENT OF HUMAN RESOURCES
DIVISION OF HEALTH SERVICES
INSPECTION FORM FOR SANITARY LANDFILLS
Permit Number
Name of Site County
Location gignature of Person(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 6. ACCESS
Site plan approved Attendant on duty
Construction plans approved Access controls
Plans being followed All weather road
nest controlled
2. SPREADING & COMPACTING
't, Waste restricted to the
smallest area practicable
Waste properly compacted
3. COVER REQUIREMENTS
s' Six inches daily cover
Two foot final cover
One foot intermediate cover
4. DRAINAGE CONTROLLED
On -site erosion '
Off -site siltation
_. r'1
�L .
Erosion control devices YI�rltf lf Seeding of completed areas ll.;f,
Temporary seeding
5. WATER PROTECTION
Off -site leaching
Waste placed in water
Surface water impounded
Monitoring wells installed
REMARKS:
DATE
BURNING
Evidence of burning
Fire control equipment available
8. SPECIAI. 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 Z,t/ j',�ox�,->5
Proper signs posted P""A'm-g
6,'
NAME
Solid & Hazardous Waste Management Branch
L
DHS FORM 1709 (7/82)
Solid & Hazardous Waste Management Branch

Weather Conditions N.C. DEPARTMENT OF HUMAN RESOURCES Permit Number
DIVISION OF HEALTH SERVICES
INSPECTION FORM FOR SANITARY LANDFILLS
Name of Site
Goun
Location Siignatu e of Person(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
1. PLAN REQUIREMENTS 6. ACCESS
Site plan approved _Y Attendant on duty
Construction plans approved Access controls
Plans being followed All weather road
Dust controlled
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'900
Off -site siltation
a
Erosion control devices15Yf4rA/P'PSC.V
Seeding of completed areas
Temporary seeding
5. WATER PROTECTION
Off -site leaching
Waste placed in water
Surface water impounded
Monitoring wells installed
REMARKS:
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
DATE NAMEY1i,�a ''� I
Solid & Hazardous Waste
DHS FORM 1709 (7/82)
Solid & Hazardous Waste Management Branch
agement branch