Orange County NC Website
Browse       Search
41 <br /> U.S. Department of Agriculture <br /> Natural Resources Conservation Service Hazardous Materials Field Inspection Checklist <br /> HAZARDOUS MATERIALS FIELD INSPECTION CHECKLIST <br /> A. BACKGROUND INFORMATION Clear Form <br /> NRCS PROGRAM LANDOWNER NAME <br /> PROPERTY ADDRESS NUMBER OF ACRES <br /> NEST APPLICATION NUMBER COUNTY STATE <br /> FIELD INSPECTOR'S NAME&TITLE DATE INSPECTED <br /> B. INSTRUCTIONS: <br /> • For each question,indicate if you find any evidence of past or present hazardous materials. <br /> • For any suspected evidence found, display the location on the parcel map and attach photographic evidence as an <br /> addendum to this document. <br /> • If you need more room to explain your findings attach additional sheets. <br /> • When complete, attest that a field inspection has been completed and that to the best of your knowledge the <br /> information included is accurate. <br /> C. Field Conditions: Onsite Nearby None <br /> 1. Dumps or landfills(especially with drums/containers) ❑ ❑ ❑ <br /> 2. Other debris: household or farm waste ❑ ❑ ❑ <br /> 3. Fills(possible cover for dumps) ❑ ❑ ❑ <br /> 4. Unusual chemical odors ❑ ❑ ❑ <br /> 5. Above/below ground storage tanks ❑ ❑ ❑ <br /> 6. Buildings: chemical storage, equipment repair solvents ❑ ❑ ❑ <br /> 7. Structures: evidence of asbestos ❑ ❑ ❑ <br /> 8. Vegetation different from surrounding area for no apparent reason ❑ ❑ ❑ <br /> (e.g., stressed or dead,bare ground) <br /> 9. "Sterile" or modified water bodies ❑ ❑ <br /> 10.Oil seeps, stained ground, discolored stream banks ❑ ❑ ❑ <br /> 11.Unnatural characteristics of water: oil slicks,unusual color,etc. ❑ ❑ ❑ <br /> 12.Spray operation base: air strip,equipment parking area chemical ❑ ❑ ❑ <br /> staging, storage, and mixing areas <br /> 13.Machinery repair areas ❑ ❑ ❑ <br /> 14.Pipelines,power lines, gas lines ❑ ❑ ❑ <br /> 15.Oiled or formerly oiled roads ❑ ❑ ❑ <br /> 16.Mounted transformers -evidence of leakage ❑ ❑ ❑ <br /> 17.Any mining activity or mining residue: past,present, or future ❑ ❑ ❑ <br /> 18.Wastewater treatment equipment, septic system, sewage lagoons ❑ ❑ ❑ <br /> 1 <br />