8606-MSWLF-1998 SW018-0105 Surry County MSWLF PARF & Invoice 11-13-18

PERMIT APPLICATION REVIEW FORM
Review Requested by: Allen Gaither
Date Requested: 11/13/2018
Facility Name and Permit ID Surry County MSWLF, 8606-MSWLF-1998
Applicant (Owner) Name Surry County
Description of Permit Request
[This is the action the applicant
is requesting in accordance with
NCGS 130A-295.8(b)]
(1)a. New – New Facility
(1)b. New – Expand Facility Boundary
(1)c. New – Expand Waste Boundary
(1)d. New – Substantial Amendment
(2)a. Amendment – Next Phase of the Approved Facility Plan
(2)b. Amendment – Renewal/Review 5YR 10YR
(2)c. Amendment – Change in Ownership
(3)a. Modification – Change to Approved Plans (No CHR)
(3)b. Modification – Subsequent Permit to Operate (No CHR)
(3)c. Modification – Five-year Limited Review
(4) Major Permit Modification
Permitted Annual Tonnage <100,000 TPY
Permit Fee $0.00 LoS
Date Application Received 11/13/2018
Contact Name, Title & Phone # Mr. Dennis Bledsoe, Public Works Director, [phone]
Email Address [e-mail]
Company Surry County
911 Address 237 Landfill Road, Mount Airy, NC 27030
Mailing Address P.O. Box 342
City/State/Zip Dobson, NC 27017
Parent Company N/A
Known Subsidiaries N/A
Other known names business
has operated under
N/A
Known Counties of Operation Surry
Does the applicant have a past
or current solid waste permit?
Yes No Unknown
Facility Type: MSWLF, CDLF Permit #: 86-02, 03, 06
Did the permit applicant submit
Financial Assurance cost
estimates?
Yes No Not Needed
Other notes Plans to relocate scales and scalehouse within facility.
SW018-0105
P0913
North Carolina Department of Environmenal Quality
Division of Waste Management
Solid Waste Section
INVOICE
Invoice #:SW018-0105
Date:11/13/2018
Payment Options:
Division of Waste Management
Solid Waste Section
1646 Mail Service Center
Raleigh, NC 27699-1646
phone: [phone] fax: [phone]
email: [e-mail]
To:Dennis Bledsoe, Public Works Director
Surry County
PO Box 342
Dobson, NC 27017
More information available on the web:
North Carolina Department of Environment and Natural Resources (DENR) - http://portal.ncdenr.org/
North Carolina Solid Waste Program - http://portal.ncdenr.org/web/wm/sw
North Carolina Electronics Management Program - http://portal.ncdenr.org/web/sw/electronics
E-check -Available online at http://go.ncdenr.gov/swpay
Requires bank account and routing information. You will need to use the zip code in the description box and the invoice number
shown on this invoice to access your account. If a zip code is not listed, use the code: 99999 along with the invoice number.
Credit Card -Available online at http://go.ncdenr.gov/swpay
Accepts MasterCard, Visa, and Discover cards. You will need to use the zip code in the description box and the invoice number
shown on this invoice to access your account. If a zip code is not listed, use the code: 99999 along with the invoice number.
*Convenience Fee of 2.65% added to amount invoiced.]
Paper check -Make checks payable to N.C. Division of Waste Management, Solid Waste Section, include Permit Number and invoice number
on check. If you are paying by electronic transfer, include the invoice number with your electronic transfer. Please return a copy
of this invoice with your payment.
[G.S. 25-3-506: A $25.00 processing fee will be charged on all returned checks.]
Remit paper checks to:
N.C. Division of Waste Management
Solid Waste Section
1646 Mail Service Center
Raleigh, NC 27699-1646
Description Amount Due
Facility-Application:
Surry County MSWLF (8606-MSWLF-1998)
237 Landfill Road
Mount Airy, NC 27030
Permit Modification Application (Modification- Change to Approved Plans (NO CHR)) received
on 11/13/2018
$0.00
$0.00Total Amount Due
12/13/2018Date Due
Pursuant to North Carolina General Statute 130A-295.8 you are required to pay fee(s) based on your solid waste management activities. The fee(s)
shall be used to support the solid waste management program. An application is deemed incomplete until all fees are received.
Explanation of Invoice Amount is Based on Facility's Current Permit Application:
Billing process:
Mary H. Johnson [phone]
Ed Mussler [phone]
Solid Waste Contacts:
Regulations and Technical Assistance:
Ed Mussler [phone] Landfills, Transfer Stations
Adam Ulishney [phone] Land Application Sites, Compost Facilities
NC Solid Waste Invoice Form I-2014