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L <br />1 <br />1 <br />fi <br />1 <br />1 <br />r__� <br />LJI <br />Inspector's Initials <br />Everett Landfill/Tire Fire Site Date <br />Figure 5-1 <br />Inspection Form <br />Visual Inspection of Site Features <br />related to Environmental Control Objectives <br />Date of Inspection (D/M/Y): <br />Name of Inspector: <br />Title: <br />Employer: <br />The purpose of periodic site inspections is to ensure that: <br />covers of both developed and undeveloped areas are maintained to prevent <br />contact with landfilled materials, <br />access controls to undeveloped areas are effective, <br />stormwater is not allowed to infiltrate to groundwater, and <br />the leachate collection system is in good repair. <br />1. Interview site personnel. Inquire about conditions of pavement, landscape cover, <br />undeveloped area soil cap, utility corridors and building subbasements, including location(s) <br />of any penetrations, significant cracks, exposed hydraulic barrier and exposed sal in <br />developed non -landscaped areas. Inquire about condition of security fencing and <br />effectiveness of security measures. Inquire about stormwater management systems and <br />areas of potential infiltration into landfilled materials. Summarize information obtained from <br />site personnel interviews in the space below along with name, job title, and daytime <br />telephone number of the interviewee(s). <br />FAprojects\COEvBR Everett Landfill\PDF maker- final Page 1 of 5 Compliance Monitoring and <br />docs\Compliance Monitoring Plan15-1 Inspection <br />Form.doc Contingency Plan <br />FINAL - March 2001 Figure 5-1 <br />