Appendix B

LANDFILL EVALUATION FORM

                      Landfill No.


Landfill Name

Legal Descrip

Air Photo No.

Plat Book Pag

Soil Types 1)


tion:   1/4   1/4, Section   T__N, R__E

_      _     _DNR File No.

le                  Priority Ranking


2)


1) HGW

    BR

    Clay O-


ft.

in.

%


2 ) HGi

    BR

    Cla


1ft.
                in.

ly O-           %


%.


Perm 0-            in/hr    Perm 0-

                  in/hr

Surface Water Flow Direction

Groundwater Flow Direction

Distance & Direction to Surface Water

Homes within 1/4 mile radius of landfill.


1
2

3

4

5


)

)

)

)

)


Homes within 1/2 mile down gradient of landfill.

1)

2)

3)


in/hr
in/hr


Z)