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FORWARD LANDFILL <br />DAILY PRE-A-PPLICATION INSPECTION FORM <br />Waste Discharge Requirements Order No. R5-2014-0006 <br />Weather conditions: <br />Temperature: <br />Wind direction: 19— Wind speed: - <br />Other relevant field conditions: <br />Evidenceof erosion ............................................................. : ......................�0 .............................. 13 Yes <br />Berdacondition .............................................................. I ............................ j2112rood ......................... o Needs attention <br />Soilsaturation ............................................................................................... RrNo .............................. 0 Yes <br />Pondink......................................................................................................... jpafqo ............................. : C1 Yes <br />Potential runoff to off-site areas .............................................................. PNO .............................. 0 Yes <br />Potential discharge to surface water ....................................................... plf,70 .............................. C) Yes <br />Actual discharge to surface water ............................................. ........................ 0 Yes <br />Accumulation of organic solids ...... ......................................................... M"N'o .............................. E3 Yes <br />clogging....................................... ........................................................... plfio .............................. Yes <br />Odors that have the potential to be objectionable at or <br />beyondthe property boundary ............................................................... JEf No .............................. 13 Yes <br />Vectors(insects, rodents) .................................................................. ............................... ®Yes <br />Documented observations requiring corrective action and corrective action taken (if applicable): <br />Note.- No valves are rewired axtatl of the land qo4cafien operation. <br />Date/time: lj2-/ - L11 An I & @ ' —L7 � Signatute-�a Title: Operations Maniger <br />Ruben Ramirez <br />