IOWA DEPARTMENT OF NATURAL RESOURCES SINGLE USE LANDFARM (PCS)

iowa department of natural resources single use landfarm (pcs) permit inspection form permit no.: -sdp- - p-pcs county:  f

IOWA DEPARTMENT OF NATURAL RESOURCES
SINGLE USE LANDFARM (PCS) PERMIT INSPECTION FORM
Permit No.: -SDP- - P-PCS
County: 
Facility Name: 
Phone Number: 
Facility Address:
 
 
 
Responsible Official: 
Phone Number: 
Person(s) Present:
1) 
2) 
3) 
Mailing Address:
 
 
 
Date of This Inspection: 
Date of Last Inspection: 
*Be advised your facility may require, due to either SIC code or
onsite management practices, an NPDES General Permit #1 (Stormwater
permit).
PCS Analysis
IAC 567 Chapter 120.6: Petroleum Contaminated Soil (PCS) Analysis
Yes
No
NA
120.6(2)“c”
Was the PCS analyzed for the following constituents:
*
BTEX Testing – benzene, toluene, ethylbenzene, and xylene (OA-1)
*
TEH-diesel Testing – total extractable hydrocarbons (OA-2)
*
MTBE Testing – methyl tertiary-butyl ether must be analyzed for
unless prior analysis has shown MTBE is not present in soil or
groundwater
*
Total RCRA Metals Testing – Resource Conservation and Recovery Act
Metals must be analyzed for if the history of the petroleum
contaminated site included solvents, batteries, leaded fuel, waste
oil, or a gas station in operation prior to 1985
Comments: 
Site Suitability Requirements
IAC 567 Chapter 120.7: Site Exploration and Suitability Requirements
Yes
No
NA
120.7(1)
Does the single use landfarm applicator have written confirmation from
the site owner for one of the following:
*
That any other landfarm created in the past three years within 15
feet of the proposed operating area has been closed pursuant to
rule 567 – 120.12(455B)
*
That no area within 15 feet of the proposed operating area has
been used as a landfarm in the past three years
(Note: This rule does not apply for a landfarm utilized prior to
October 20, 2004)
120.7(2)
Has PCS been stored or landfarmed within 500 feet from a well
(including agricultural drainage wells)? (Note: Groundwater monitoring
wells installed pursuant to paragraph 120.8(2)“c” and extraction wells
as part as a remediation system are exempt from this requirement)
120.7(3)
Has PCS been stored or landfarmed within 500 feet of a sinkhole?
120.7(5)
Has PCS been stored or landfarmed within 200 feet of a stream, lake,
pond, wetland, or other surface water of the state? (Note: The setback
requirement may be waived if the surface water has been constructed
for pollution control purposes)
Site Suitability Requirements
IAC 567 Chapter 120.7: Site Exploration and Suitability Requirements
(Cont’d)
Yes
No
NA
120.7(6)
Has PCS been stored or landfarmed within 200 feet of a tile line
surface intake?
120.7(7)
Has PCS been stored or landfarmed within 200 feet of an occupied
residence, recreational area, child care facility, educational
facility, or health care facility?
120.7(8)
Has PCS been stored or landfarmed within the 100 year flood plain?
120.7(9)
Has PCS been stored or landfarmed on slopes greater than 5 percent?
120.7(10)“a”(2)
Do the soils in the operating area of the single use landfarm consists
one or more of the following:
*
Clay, sandy clay, sandy clay loam, sandy loam, silty clay, silt
clay loam, clay loam, loam, or silt loam as classified by USDA
Textural Classification Chart for soils
120.7(10)“b”
Are soils in the operating area free of stones and debris larger than
4 inches in diameter?
120.7(10)“c”
Do soils in the operating area have a pH greater than or equal to 6
and less than or equal to 9?
120.7(10)“d”
Does the landfarm operating area have a minimum of 6 feet of soil over
bedrock?
Comments: 
Landfarm Design
IAC 567 Chapter 120.8(1): Landfarm Design Requirements
Yes
No
NA
120.8(1)“a”
Have PCS storage areas (if any) been constructed in compliance with
the following requirements:
*
Over an impervious surface (e.g., tarp, concrete pad, plastic
sheeting)
*
Under a roof or tarp to minimize the infiltration of precipitation
*
In an area with minimal potential for stormwater run-on
120.8(1)“b”
Have the landfarming plots being utilized been flagged pursuant to the
following requirement:
*
Landfarming plots being utilized shall be flagged for one year
after land application or until landfarm is closed, whichever is
shorter
Comments: 
Landfarm Operating Requirements
IAC 567 Chapter 120.9: Landfarm Operating Requirements
Yes
No
NA
120.9(1)
Has only “Standard PCS” been landfarmed (unless a permit amendment is
issued) on the plot being utilized as a single use landfarm? (Note:
Standard PCS – soil contaminated with gasoline, diesel fuel, kerosene,
jet fuel, motor oil, hydraulic fluid, or some combination thereof)
120.9(2)
Has PCS that is in a saturated, slurry, or in a flammable condition
been landfarmed at the single use landfarm?
120.9(3)
Was PCS stored (if applicable) for seven days or less during landfarm
season (April 1 – October 31)?
120.9(4)
If PCS was landfarmed outside of landfarming season, was it part of an
emergency cleanup supervised by the department or did the following
conditions exist:
*
The operating area is free of snow
*
The slope of the operating area is less than 3 percent
*
The PCS is incorporated into the soil as soon as site conditions
allow
120.9(5)
When the landfarming plot was utilized, was only one application of a
particular source and type landfarmed? (Note: A single use landfarm
may apply a subsequent application of PCS to the previously utilized
landfarm plot if the plot has been closed pursuant to subrule
120.12(2).)
120.9(6)
Did the PCS application rate comply with the following table?
The average concentration of benzene shall be calculated from all soil
borings test results within the PCS excavation area.
Table 1
Average concentration of benzene (mg/kg)
Ft2 of landfarm area per yd3 of PCS applied
Maximum thickness of unincorporated PCS
Yd3 of PCS per acre of landfarm
0 < mg/kg < 10
81 ft2
4 inches
537 yd3
10 < mg/kg < 20
162 ft2
2 inches
268 yd3
20 < mg/kg
324 ft2
1 inch
134 yd3
(Note: PCS from an emergency cleanup supervised by the department may
be land applied at a rate of 2 inches thick or at a rate of 162 ft2 of
landfarm area per cubic yard of PCS. PCS that is not contaminated with
benzene or MTBE, but is contaminated with toluene, ethylbenzene,
xylene, TEH-diesel, or some combination thereof, shall be land applied
at a rate of 81 ft2 of landfarm area per cubic yard of PCS)
120.9(8)
Has solid waste that is not PCS (e.g., pipe) been removed and properly
disposed of? (Note: This includes all rubble, stones, debris larger
than 4 inches in diameter, or anything that interferes with
incorporating and turning of the PCS)
120.9(9)
Was the PCS incorporated into the soil by tilling, disking, or other
suitable means within 48 hours after it was land applied or before a
precipitation event, whichever was sooner? (Note: PCS must not be
incorporated deeper than 12 inches)
120.9(10)
After incorporation, was the PCS turned by tilling, disking, or other
suitable means at least once per month for the first three months
during landfarming season?
120.9(11)
Were crops for human or livestock consumption grown within 15 feet
from the utilized landfarm plot? (Note: Crops for human and livestock
consumption may be grown at a single use landfarm after the landfarm
plot is no longer required to be flagged pursuant to subrule
120.9(7).)
Landfarm Operating Requirements
IAC 567 Chapter 120.9: Landfarm Operating Requirements (Cont’d)
Yes
No
NA
120.9(13)
Has PCS been removed from a single use landfarm before the landfarm
was closed or the following conditions were met:
*
One sample from each 2,500 ft2 (e.g., 50 foot x 50 foot area) of
landfarm plot is analyzed pursuant to subparagraphs 120.6(2) “c”
(1), (2), (3). A minimum of one sample per landfarm plot shall be
obtained. All samples shall be obtained from between the top 2 to
6 inches of soil.
*
The results of the tests in paragraph 120.12(1) “a” demonstrate
that petroleum constituent concentrations for benzene, toluene,
ethylbenzene, TEH-diesel, and MTBE are below the detection limits
required by 567 - Chapter 135.
*
Records of the lab results, amount of PCS removed, and the exact
final location of the PCS shall be maintained by the landfarm.
Comments: 
Reporting & Record-Keeping Requirements
IAC 567 Chapter 120.10 and 120.11: ERRAP Requirements
Yes
No
NA
120.10(1)
Is an Emergency Response and Remedial Action Plan (ERRAP) readily
available? (Note: Single use landfarm applicators shall have employees
carry a copy of the ERRAP document to each site where operations are
taking place)
120.10(3)
At a minimum, have all employees received annual training sufficient
to understand and utilize ERRAP documents?
120.11(1) ”a” and “b”
Has a complete Landfarming and Storage Notification Form(s) been
submitted to the department central office as well as the department
field office with jurisdiction over the landfarm before receipt of PCS
for storage and land application events?
120.11(2)
Has the single use landfarm agency maintained records of all
information related to compliance with this chapter and the permit
throughout the life of the landfarm and for three years after landfarm
closure?
*
Permit application information
*
PCS analysis and characterization
*
Site suitability information
*
Specific design requirements
*
Operation information
*
ERRAP documents
*
Reports that were submitted to IDNR
*
Closure information
Comments: 
Landfarm Closure
IAC 567 Chapter 120.12: Single Use Landfarm Closure
Yes
No
NA
120.12(2)
If a landfarm is considered closed by the landfarming agency, has it
been 3 years after the PCS was land applied or at least 6 months and
the following was documented:
*
One sample from each 10,000 ft2 (e.g., 100 x 100 foot area) of a
landfarm plot is analyzed pursuant to subparagraphs 120.6(2) “c”
(1), (2), and (3) (BTEX, TEH-diesel, MTBE). A minimum of one
sample per landfarm plot shall be obtained. All samples shall be
obtained from between the top 2 to 6 inches of soil.
*
The results from the previous paragraph demonstrate that petroleum
constituent concentrations are less then 0.54 mg/kg for benzene,
42 mg/kg for toluene, 15 mg/kg for ethylbenzene, 3800 mg/kg for
TEH-diesel and 0.02 mg/kg for MTBE.
Comments: 
Summary of Requirements:
Compliance Date:
1) 
 
2) 
 
3) 
 
4) 
 
5) 
 
Summary of Reminders:
1) 
2) 
3) 
4) 
5) 
Summary of Recommendations:
1) 
2) 
3) 
4) 
5) 
Inspector: 
Date: 
Reviewer: 
Date: 
Facility Photographs (if applicable)
DNR SINGLE USE LANDFARM (PCS) PERMIT INSPECTION Page 6 of 6
IAC 567 Chapter 120. Iowa Code Chapters 455B & 455D. Revised 12/3/2007
DNR Form 542-0362