‘TENNESSEE DIVISION OF SOLID WASTE MANAGEMENT Initial Inspection CLASS | FACILITY INSPECTION DOCUMENT sire DATE fine 12/14/2022 |11:00 EO IBF Middle Point Landfill SNL750000219 750 East Jefferson Pike Rutherford ICHAT EE DISCCRIMER DNTAST PAGE VIOLATION REGULATION litt aoe eve BUFFER ZONE STANDARDS FOR SITING LANDFILLS 8310 PUFFERZONESTANDARD VioLATED (0400-11-01-.04(3Xa) ooo comments, COLLECTED LEACHATE 2330 | ACHATEIMPROPERLY MANAGED [0400-11-01-.04(4)a)8(-1i) 7TBq ooo Jcomments 8340 | NADEQUATE LEACHATE COLLECTION SYSTEM [0400:11-01-04%(0)7 ? wooo comments ‘COMMUNICATIONS 8130 [NO COMMUNICATION DEVICES [0400-17-01-0412x) ? Booo comments COVER MATERIAL 8160 _[UNAVAILABILITY OF COVER MATERIAL. [0400-17-01-.04(2)(h) ? Ronn comments DEAD ANIMALS 8250. [PEAD ANIMALS IMPROPERLY HANDLED (0400-11-01--04(2)(05.(i) (HIM) ? Booo comments DUST CONTROL 8190 _ | NADEQUATE DUST CONTROL (0400-17-01-04(2)0) comments, DUTY TO PROVIDE INFORMATION Page 1 of7 VERSION pare 51082023,{SEE DISCLAIMER ON LAST PAGE ‘VIOLATION REGULATION ‘OBSERVATION fuvo aoc vi v2 DUTY TO PROVIDE INFORMATION UNSATISFACTORY RECORDS OR REPORTS [SEE CITATION LIST LAST PAGE 8530 000 comments 8590 PERMITS: PLANS. OPERATING MANUAL NOT }0400-11-01-.02(5)(aX7) ? oO oo comments FIRESAFETY 8080 JEVIDENCE OF OPEN BURNING }0400-11-01-,04(2\(c)1 ? & o 00 comments, 8090 INADEQUATE FIRE PROTECTION }0400-11-01-,04(2\(c)2 ? Bq Oo o O comments GAS MIGRATION CONTROL STANDARDS 8380 Ivor ate GAS MIGRATION CONTROL }0400-11-01-,04(5\(a) ? RX] o rm o comments INADEQUATE MAINTENANCE OF GAS 0400-1 1-01-,04(5\(a) 8390 [micRATION CONTROL SYSTEM Icommens GENERAL FACILITY STANDARDS go19 | NADEQUATEVECTOR CONTROL (0400-11-01-04(2yay1 "ooo comments |ACCESS NOT LIMITED TO OPERATING HOURS | 0400-11-01-.04(2)(a)4 8020 comments INADEQUATE ARTIFICIAL OR NATURAL BARRIER] 0400-1 1-01-.04(2)(b)1 8030 comments Pa ge 2 of 7 VERSION oare 95/03/2023SEE DISCLAIMER ON LAST PAGE VIOLATION. REGULATION ‘OBSERVATION Invo aoc vi v2 (GENERAL FACILITY STANDARDS: INADEQUATE INFORMATION SIGNS [0400-11-01-.04(2\(o)2 8040 TCA 68-211-703(%) ‘mooo comments 8050 [UNSATISFACTORY ACCESS ROADISYPARKING "0400-11-07. 0401013 ain poo |coMMENTS |CERTIFIED PERSONNEL NOT PRESENT [0400-11-07--04(20)5 8060 [purine opeRATING HouRS [comments 8070 |UNAPPROVED SALVAGING OF WASTE 0400-11-01 -,04(2)(b)6_ ? & Oo oo lcomments LITTER CONTROL 110 [UNSATISFACTORY LITTER CONTROL (0400-11-07-,04(aNa) comments ‘OPERATING EQUIPMENT 8140 _ [INADEQUATE OPERATING EQUIPMENT (0400-11-01-.04(2)g) ooo comments, 8150. [UNAVAILABILITY OF BACKUP EQUIPMENT [0400-17-01-.0472%8) Moo oO comments OVERALL PERFORMANCE STANDARD 8270 [EXPOSED SOLID WasTE [0400-11-01-,04(2)a)3) ? Sooo comments, INADEQUATE MAINTENANCE OF LEACHATE MANAGEMENT [)400-11-01--04(2\ay@) 8320 RS ee any nacorm sscisrs }0400-11-01-.04(4)(a)7 X oOo oH COMMENTS Page 30f7 VERSION parE g5/03/202$5EE DISCLAINER ON LAST PAGE VIOLATION REGULATION ‘OBSERVATION vo aoc vi v2 ‘OVERALL PERFORMANCE STANDARD. LEACHATE OBSERVED AT THE SITE J0400-11-07-,04(ayania) 8350 lo4oo-t 1-01-04¢4ya)6, ? RoOoo comments 8360 |LEACHATE ENTERING RUN-OFF aoa: Tieoeoanyeer ? & oO oo comments 8370 _ [PACHATE ENTERING A WATER COURSE pourra "Wooo comments [POTENTIAL FOR EXPLOSIONS OR (0400-11-07-04(2Ka)2 8420 [uNcONTROLLED FIRES }0400-11-01-.04(5Xa) [comments 3490 _ |PXCESSIVE POOLING OF WaTER FELOEUREPOSTOIOO TF-OT-OAZTRS Jacrive) 0400-11-01-04/9y) (9 Jcomments [DUMPING OF WASTE INTO WATER 0400-11-01 -.04 (2)(a)3 8520 comments PERMANENT BENCHMARK 8280 [NO PERMANENT BENCHMARK (0400-11-01-,04(2K0) "I ooo conmenrs PERSONNEL SERVICES 8120 INADEQUATE EMPLOYEE FACILITIES }0400-11-01-.04(2)(e) ? B o Oo Oo [COMMENTS PROPER OPERATION AND MAINTENANCE 8540 Iicnoreety Meamaraines S SYSTEM 10400-11-01-.02(5\(a)4 ? ® o oO Oo [comMENTS Page 4 of 7 VERSION DATE. 95372021S5EE DISCLAIMER ONIASTPAGE ‘OBSERVATION viouaTion REGULATION vo an ON RANDOM INSPECTION PROGRAM INADEQUATE RANDOM INSPECTION PROGRAM [0400-11-01-.04(2)5) 8290 comments [F#*00r inspections are ateched RECORDS OF ORIGIN AND AMOUNT OF SOLID WASTE INO OPERATING SCALES AND/OR FAILURE TO [TCA 68-211-862(a)\1)12) ? 8610 _|uaivrain waste RECORDS NOOO comments RUN-ON, RUN-OFF, AND EROSION CONTROL INADEQUATE MAINTENANCE OF RUN-ON/ —_[0400-17-01-042\i)1-5 8170 run-oFF system(s) lo400-11-01-.04(8)(c)4ti) comments INADEQUATE EROSION CONTROL 0400-1 1-01-.04(2)()6 8180 jo400-11-01-.04(8\(c)4(i) commen ‘SPECIAL WASTE APPROVAL PROCESS |MISHANDLING OF SPECIAL WASTE }0400-11-01-.01(4\0)1 8300 [comments UNLAWFUL METHODS OF DISPOSAL [OPERATION DOES NOT CORRESPOND WITH ENGINEERING [TCAG8-211-104(3) 8570 pans evatuare ao Recono THE APPROXIMATE {rca 68-211-105(b) INTERIOR AND EXTERIOR SLOPE OF THE LANDFILL) comments [OPERATION DOES NOT CORRESPOND WITH | TCAG8-211-104(3) 8580 permit conDiTIONS 0400-11-01-.02(5)ay1) O00 comments WASTE HANDLING AND COVER STANDARDS JWASTE NOT CONFINED TOA MANAGEABLE [0400-11-01-.04(6\ayi 8430 area O00 comments Pages ot? VERSION pare 05/03/2021SEE DISCLAIMER ON LAST PAGE WASTE HANDLING AND COVER STANDARDS agg | MPROPER SPREADING OF WASTE [0400-11-01-.04(6)1a)2 ooo comments, 450 _|MPROPER COMPACTING OF WasTE [0400-17-01-04(6y@)2 ? wooo lcomments JUNSATISFACTORY INITIAL COVER Jo400-17-07-.04(6ya)3 8460 [0400-1 1-01-.04(6a)5 comments 8470 [UNSATISFACTORY INTERMEDIATE COVER OH00-179F- oui ? wooo comments UNSATISFACTORY FINAL COVER }400-11-01-.04(6a)6 8480 1400-1 1-01-.04(8(c)3(i) comments. 2510 [UNSATISFACTORY STABILIZATION OF COVER [0400-17-07-.046N0)56 ? mooo comments ‘WASTE RESTRICTIONS 219 UNAUTHORIZED waste accePTED [p400-1 0%. Baz ? wooo comments [UNAPPROVED SPECIAL WASTE ACCEPTED Jo400-17-01-01(4)(6) 8220 0400-1 1-01-.01(4)(c)5 comments Page 6 of? VERSION DATE o5ms/2021{SEE DISCLAIMER ON LAST PAGE TASTE RESTRTCTONS 8230 TIRES IMPROPERLY HANDLED 0400-1 1-01-.04(2)(k)3(i) Bb 5 oO 3240 |MEDICAL WASTE IMPROPERLY HANDLED 0400-1 1-01-.04(2\(k)4(i-iv) Oo 0 oO LEACHATE LEVELS: [Sump level readings are attached, "Disclaimer The information contained in these documents (checklsts/notes, etc.) snot intended tobe al inclusive ad is subject to change. These documents are intended solely for use by DSWM tof. These documents are not o substitute for evaluation of compliance in accordance with epplicable laws and regulotions. These documents are not intended fr, nor can they be relied upon, to create ary rights, substantive ar procedural, enforceable ar useable by ary partyin lngation withthe State of Tennesse or its employees. SAVE FORM Follow-Up Inspection Date Keith May Digtaly signed by Kosh May Inspector Name Dato, 2002 12.1611 10.06-0500 Page 7 of 7 VERSION oarE 95/03/2021ADDITIONAL COMMENTS Photographs of Jefferson Pike atthe lanl enirance ae attached fo illustrate that mug from the lanl 's being managed properly, [The sweeper and wheel wash were both operating to ensure that mud is not being tracked out onto jefferson Pike. Photographs of Bubba Spring/Outtall #2 and the stream that flows into the Stones River illustrates visually that no leachate was found tobe in the spring. Stormwater from the landiil flows through 2 separate ponds prior to discharge into the Stones River. Please note that Republic Services collects both groundwater and stormwater samples so that appropriate constituents can be tested. |Photograph of working face was taken to document that itis properly sized and managed property. [ue to a week of rain totaling 6 inches, soil was used for daily cover and not the Atmos ADC foam. Several employees were seen picking up blown litterSent from my iPhoneSy CRW) 7 or eee IM Ufe jester} = iw S ar + a eS o (a)Des 14, 2022 a 1 12:00:05 PM Murfreesboro T) | 37 United Sent from my iPhone¢ [5 of asp] Sis : Checked by yp (State inspector)5 meray Date: [JY 22 SPECIAL WASTE INSPECTION SHEET Te: 13) C1 intist Xf Random [1] Susplclous [] Recertification Disposal Facttty: WPL _ Waste Profie# _ Slob ¥.31790 ap Swe P3770 __ Ganerator Neme: \ |. Cone Name of Waste: Lact i ‘Transporter Namé Nee ‘Transporter Phone Number __ A - _ DriverNamo: Soro : { _ = ‘Vehicle License Plate Number and State: 1 Phy INDICATE YES OR NO FOR EACH OF THE FOLLOWING TESTS AND NOTE ANY DESCREPANCIES. 00 THE CHARACTERISTICS OF THE WASTE MATCH THE PROVIDED INFORMATION ON THE SPECIAL WASTE PROFILE? haracorntoe rofile es ‘Comments andlor Observations: Color ogie Odor WA 4 nt oes Prystalsite __‘rc\. wa 's a Photograph Attached? Qa {Intl Load Must include Photograph IF WASTE FAILS ONE OR MORE OF THE PHYSICAL SCREENING TESTS, THE WASTE IS DEEMED UNACCEPTABLE FOR DISPOSAL AND SHOULD BE REJECTED. Froe Liquids Wim Was! tod Ree alpen © 8) ayer Wispector Signature. { Baie Waste Rejected (If Rejected then a Photograph MUST be attached.) Reasons for Rejection C1 Extrancous andor Unauthorized Material [_] Suspected Hazardous Waste [} Suspected PCB Waste Gi Suspected PCB Waste CG Free Liquids {Z] Dove Not Match Profle Comments Inspector Signature Date a ‘General Manager or Designee t Date ‘Apt 2018fpmnme | SPECIAL WASTE INSPECTION SHEET C2 tnittat { Random CO Suspicious (] Recertification Dioposal Factity: Waste profes _S/vé II /0§30 Gonerator Name: al | Name of Waste: oud 4 ‘Transporter Name: S __ ‘Transporter Phone Number: orverName: _ |X, Weck Vehicle License Piate Number and State: _ Physical Screening INDICATE YES OR NO FOR EACH OF THE FOLLOWING TERTS AND NOTE ANY DESCREPANCIES. DO THE ‘CHARACTERISTICS OF THE WASTE MATCH THE PROVIDED INFORMATION ON THE SPECIAL WASTE PROFILE? unaeoces_e ‘gf comma am Color dg Fi or = Yord tao \ = Pryolel state _ Qe tao } Free Liquids Noa: ts a Photograph Attached? OF ode {tat Load Must Include Photograph IF WASTE FAILS ONE OR MORE OF THE PHYSICAL. ENING TESTS, THE WASTE IS OEEMED UNACCEPTABLE FOR DISPOSAL AND SHOULD BE REJE Recaol eu (As) Y-22 signature) Date Waste Rejected (If Rejected then a Photograph MUST te attached.) Reasons for Rejeotion 1D] Extransous andor Unauthorized Material [1] Suspected Hezardous Waste [1] Suspected PCB Waste 1G) Suspected PCB Waste CE) Free Liquids Doss Not Match Profle ‘Comments Thspector Signature General Manager OF Designee ‘Ag 2018<> REPUBLIC: Dete: 12 bu Be enecs i si ‘SPECIAL WASTE INSPECTION SHEET time: Guy C initia! (X| Random [1] Stispictous [] Recertification Disposal Facitty: OF i Waste Profle# S10 1% 13 ec7 Generator Name: g \. ss Se aS inc _———_—_—— Nam of Weate: 2c ve “raneportar Name: yu 5 - ‘Transporter Phone Number: Driver Name: _Dasor x i | - ‘Vehicle License Plate Number and Stato: Physical Sereening INDICATE YES OR NO FOR EACH OF THE FOLLOWING TESTS AND NOTE ANY DESCREPANCIES. DO THE CHARACTERISTICS OF THE WASTE MATCH THE PROVIDED INFORMATION ON THE SPECIAL WASTE PROFILE? A : oo Aen oE ee 8) me Physical Stato eves + lust 40-0 Freotiquds = _ None | sa Photograph Attached? q A jinltal Load Must include Photograph IF WASTE FAILS ONE OR MORE OF THE PHYSICAL S¢ NING TESTS, THE WASTE IS DEEMED UNACCEPTABLE FOR DISPOSAL AND SHOULD BE REJECTED. ee ae (ts ) lap Waste Rejected (If Rejected then a Photograph MUST Ho mtached) Reasons for Rpjection C1 Extraneous endior Unauthorized Material (-] Suspected Hazardous Waste C] Suspected PCB Waste a 1B Suspected PCB Wasto Free Liquids Gi Does Not Match Profte ‘Comments | “Tnspector Signature : Dats ‘General Manager or Designee i Date ‘Ap 2019LANDFILL INCOMING WASTE RANDOM INSPECTION CHECKLIST Use checklist for all suspicious Toads and for 5% of all incoming loads of solid waste brought into the ‘aility for disposal. is records are required by the Rules 04 psa Random inspections and are by Promulgatod “tt i Wars Managoment Act ot Rolp 400 11. 2X) Customer eo 3095. Vehicle License Plato # ‘Type Waste: 1 Municipal / County ‘H commercia industriat [1] Construction / Demo ‘Aro there any unauthorized wastes? automobile batteries (CO unuuthorized hazardous waste whole tires (corrosive, ignitable, reactive, TCLP Toxic bull Tiquia or listed hazardous waste) CI] peb’s C1 Other. C1 unauthorized special waste ‘Waste accepted? / ys = [] m0 Inspector's Name (Pring) Bale (@riat) Conn Qu Day {uo Neeru _ Inspector's Signature / Date Driver's Signature) ‘Notification of unauthorized waste: (1 TN Division of Solid Waste Managoment ee ‘Name /Date C1 Waste Hauler bea = ‘Nemo /Dato ppa073: Revision 1 Previous: August 1995 28LANDFILL INCOMING WASTE RANDOM INSPECTION CHECKLIST Uso checklist for all suspicious loads and for 3% of all incoming loads of solid wasto brought into the fability for disposal. Random and records are required by tho Rules inspections fromulgated under fhe Sod Waste Management Act at Ral 04991-10420) Customer}, E Vehicle License Plate # C0 ‘Municipal /County [[] Commercial [] Industrial [] Construction /Demo ‘Aro there any unauthorized wastos? automobile batteries 2 unsuthorized hazardous waste whole tres (comrosive, ignitable, reactive, TCLP Toxic ‘bulk Liquid or listed hazardous waste) C1 pet's 1 Other (unauthorized special waste Waste ace 7 yes Comments: jame (Print) _ Driver’ aoe @riat) siya — Nuk tal ye ‘Notification of unauthorized waste: [1 tN Division of Solid Waste Management —o Dy Waste Hasler ‘Name /Date 0 Waste Generator New /Das pad73: Revision ovis: Kogan 1995 28LANDFILL INCOMING WASTE RANDOM INSPECTION CHECKLIST Use checklist for all suspicious toads and for 5% of all incoming loads of solid waste brought Foc aa Random inspections and records are required by the Rules pment wid te Sid Wane Management Act at X at Bo g0Q1-01- 04K) Date ‘Customer ep Vehicle Lioenae Plate # ‘Type Waste: (1 Municipal / County [2 commercial Industrial [1] Construction / Demo Are there any unauthorized wasted? automobile batteries unauthorized hazardous whole tres (comrosive, ignitablo, ronal, TCLP Toxic bulk liquid or listed hazardous waste) pob’s C1 Otter unauthorized special waste ‘Waste accepted? yes [J 00 ta eens. inspector's Name (Print) Driver’s‘Name (Print) ‘ : - \ Inspector's Signature /Date Drive sua Morl ~ Sa ‘Name / Date © Waste Hasler Nazae [Bais ~ (1 Waste Generator ni pn073: Revision 1 Previous: August 1995 28LANDFILL INCOMING WASTE RANDOM INSPECTION CHECKLIST Uso checklist for all suspicious loads and for 3% of all incoming loads of solid waste Grought into the facility for disposal. Random inspeotions end records are required by the Rules we re ‘Promulgated under the Solid Waste Management Act at Rule 1-01-.04(2)(8) NaS time pe Customer Rep ae a Vehicle License Plate # ok Type Waste: 1 Musicipal / County Commercial 1 Industiat © [] Construction / Demo ‘Are there any unauthorized wastes? automobile batteries 0 imouthorized hazardous waste whole ti (corrosive, ignitable, reactive, TCLP Toxic (1 bulk liquid or listed hazardous waste) OO pet's 1 Other ‘unauthorized special waste ‘Waste accopted? yes [] mo e AP Ee inspector's Name (Print) Driver’s Name (Print) “ ‘Noiification of unauthorized waste: 11 TN Division of Solid Waste Management Name /Dato 1D Waste Hauler Res oas 1 Waste Generator muses ppn073: Revision 1 Previous: August 1995 28LANDFILL INCOMING WASTE RANDOM INSPECTION CHECKLIST Use checklist for all suspicious Toads ad aad Ee 395 of a incoming ods Sf solid waste rought into the fability for disposal. records are required bythe Rules promulgated under he Sli Meetings fae .04(2K6) Customer Vehicle License Plate # Type Waste: C1 Manipal Cousty {2/ Commercial [] tndustial [] Construction / Demo ‘Aro there any tmauthorized wasted? automobile batteries unauthorized hazardous waste whole tres (comosive, ignitable, reactive, TCLP Toxic bulk liquid or listed hazardous waste) pob’s OF Otter ‘unauthorized special waste Waste accepted? TY es O Comments: ___ wos "a Name (Print) eee @rint) peak fell Oxy — Wotfication of unauthorized waste: (1: TN Division of Solid Waste Management =e OC Waste ‘Name / Date OO Waste Generator Nae pn073: Revision 1 Provious: August 1995 28LANDFILL INCOMING WASTE RANDOM INSPECTION CHECKLIST eo cheat for all sesiou lode and Yr 3% ofall incoming Toads of aod ware ‘brought into the fability for disposal. Random inspections and records are required by the Rules Promulgated under th Hed iat Menapeenoet Act at Ralo 0490-11-01 .04(2K8) \2. ye Time (o\D3 Customer Lap SorS, Vehicle License Plate # Type Waste: 1 Municipal / County 2 conmersa 1 Industrial [] Construction / Demo ‘Aro there any unauthorized wastes? automobilo batteries unauthorized hazardous waste whole tires (corrosive, ignitable, reactive, TCLP Toxic ‘bulk liquid or listed hazardous waste) pob’s C1 Other (1 unauthorized special waste ‘Waste accepted? ‘4 O w ’ ‘Red Tuspector’s Name (Print) Driver's Name (Print) Sys Dee SoM — jignat \Date ‘Driver's Signature Notification of unauthorized waste: tN Division of Solid Waste Management Neme7Bas CO Waste Hsuler Nes7Bas Waste Generator mle pn073: Revision 1 Provious: August 1995LANDFILL INCOMING WASTE RANDOM INSPECTION CHECKLIST Use checkist for all suspicious aed oa 55% of aT incoming tule GE soi waste brooght into the fibility for dis and records are required by the Rules under = promulgsted unde jel Managemsat Act ‘At ot Bale oana. Hot 042K) Customer Iy< Vehicle License Plate #__ ‘Type Waste: (1 Municipal / County Co commerce Industrial [J Construction / Demo ‘Are there any unauthorized wastes? automobile batteries 1 unauthorized hazardous waste | whole tires (Corrosive, ignitable, reactive, TCLP Toxic bulk Higuid or listed hazardous waste) pob’s O Otter unauthorized special waste Wasto sett / ys [] m0 Comments: Coron Waid Inspector's Name (Print) Driver’s Name @rint) i} ) ok \ ‘a Signature / Date Driver's Signature /Date Notification of unauthorized waste: C1: TN Division of Solid Waste Mainigesiact ya 0 Wase ‘Name/Date ~ C1 Waste Genertor 7 pn073: Revision 1 Previous: August 1995LANDFILL INCOMING WASTE RANDOM INSPECTION CHECKLIST Use checklist for all suspicious Toads and for 5% of all incoming loads of solid waste brought into the fibility for disposal. Random inspections and racords are required by-the Rules promulgated under the Solid Waste Management Act at Rul O1- Ernst tam nena aaa Oe” Customer Veo 30 Vehicle License Plato# Type Waste: (1 Municipal / County [ commeria 1 Industiat [] Construction /Demo Are there any unauthorized wastes? automobile batteries 1 unauthorized hazardous waste . whole tres (Corrosive, ignitable, reactive, TCLP Toxic bulk fiqui or listed hazardous waste) 1 pob's Other, C1 anauthorized special waste Waste el ys OC) no ‘Comments: “ Al {aspector’s Name (Pret) rerename eee 00 Mud ‘apecior's Signature /Date Driver's Signature /Daio [SIN Dion of Sold Wars Managemen Name /Date (O Waste Hauler Saws DO Woste Generator Name /Daio pa0T3: Revision 1 Previous: August 1995 28LANDFILL INCOMING WASTE RANDOM INSPECTION CHECKLIST i he eet aa apne eas ad for 39% of ll incoming oud Of solid waste brought into the fability for disposal. Random inspections and records are required by the Rules Ba eens fe Salis Want Management Acta Rte 11-01-.04(2)(s) Date Qo Time 5: Customer yp ‘30. Vehicle License Plate # Type Waste: C1 Municipal Cousty (C/ Commercial [] industial [] Construction /Demo Are there any unauthorized wastes? automobile batteries (C1 unauthorized hazardous waste . whole tires (corrosive, ignitable, reactive, TCLP Toxic bulk Liquid or listed hazardous waste) pob's CO Otter Inspector's Name (Print) _Driver’s Name (Print) - wu i Date river's Signature / Dato Teint Pewee [1 'TN Division of Solid Wavte Management ‘Name /Dae C1 Wont Hi Name/Dato 1 Waste Generator Name /Dato pn073: Revision 1 Previous: August 1995 28LANDFILL INCOMING WASTE RANDOM INSPECTION CHECKLIST Use chieoklt for all suapioions loads and for 3% of all inconah ong Toads of solid waste brought into the facility for disposal. Random inspections and records are required by the Rules Pomlgted under Sli Waste Managemeot Act at Rule (400-1-01- 04) fine LBS Customer Y Vehicle License Plate # ‘Type Waste: Municipal County (C]-~Commereia C1 industrial =] Construction / Demo Are there any unauthorized wastes? ‘automobile batteries C1 unauthorized hazardous waste ‘whole tires (Corrosive, ignitablo, reactive, TCLP Toxic boll Kiquid or listed hazardous waste) CI pet's C1 Other (C1 unauthorized special waste Waste accepted? Wm Ow Comments: Iaspector’s Name (Print) Cag anne Cri “pe ites — Cig gg of unauthorized waste: (1: TN Division of Solid Waste Management ‘Name /Dato Waste Hauler o Name/Date (Waste Generator nS Name 7 Date ‘pn073: Revision 1 Provious: August 1995 28LANDFILL INCOMING WASTE RANDOM INSPECTION CHECKLIST Use checklist for all suspicious Toads and for $¥% of all incoming loads of solid waste brought into the fiility for dispossl. Random inspections and records are required by the Rulos a E Promulgeted mein fasts Medogheeat Act tate 1 Be -04(2\(8) Customer A 20 2055 ‘Vehicle License Plato # ‘Type Waste: C1 Municipal / County (1 Commercial industrial ©] Construction / Demo Are there any unauthorized wastes? 1 automobile batteries C1 unauthorized hazardous waste H whole tires (Corrosive, ignitable, reactive, TCLP Foxic boll liquid or listed hazardous waste) Gl pas 0 Otter (1 unauthorized special waste Waste accepted? ra C1 w Comments: fs Si 7Daie a Da ‘Noiification of unauthorized waste: [1 TN Division of Solid Waste Mangement eeasTbae O Waste Houler —s<—————— C1 Waste Generator ESE pn073: Revision 1 Previous: August 1995 28hg pamanoy “ABuip10238| 3s pue mainas oy s2BeueW suorresedo “yu s2ue)Kw09 anoge Bulpees duuns Aue Jo 1eBeUeWN suONeIado Ajflou ysnul uonzedsuI BuRWIO}Fad Ue pal [saxon 7331] sDNvngINOD