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FORWARD LANDFItL <br />DAILY PRE -APPLICATION INSPECTION FORM <br />Waste 13ischarge Re eats order No. R-5-2014-0006 <br />Weather conditions: <br />0, <br />TerpLperatLike:. <br />Wind direction: ction: Wind speed. <br />Other relevant field conditions: <br />Evidence of erosion ....................................................... <br />9rGood ......................... E3 Needs attention <br />Ponding........................................................................................................'ATO.............................. 0 Yes <br />Potential runoff to off-site areas ............................................................. ;rNo .............................. 0 Yes <br />Potential discharge to surface water ...................................................... PrIN"o .............................. 0 Yes <br />Actual discharge to surface water ........................................... ........................ 0 Yes <br />Accumulation of organic solids ............................................................... O'No .............................. C3 Yes <br />clogging ................................................................................................ <br />-Xf40 .............................. 13 Yes <br />Odors that have the potential to be objectionable at or <br />beyond the property boundary ............................................................... 7(No .............................. 0 Yes <br />Vectors(insects, rodents) ................................................................. ........... : .................... El Yes <br />Documented observations requiring corrective action and corrective action taken (if applicable): <br />Note No valves are required axparl of the land appfitadon operation. <br />Date/time: 1-11LIMIL- @ lAtS7— Signature: .�a Title: Operations ex <br />Ruben Ramirez <br />