7202T-TRANSFER-1995 Perquimans-Chowan-Gates Transfer Station SW019-0020 PARF & Invoice 2-22-19

PERMIT APPLICATION REVIEW FORM
Review Requested by:Ethan Caldwell
Date Application Received:02/01/2019
Location ID (if known)P0599
Permit ID 7202-TRANSFER-1995
Permit Name
(aka Permit Applicant Name)
Perquimans Chowan Gates Landfill Commission (Owner)
Perquimans-Chowan-Gates Transfer Station
Facility Type Trans
Physical Street Address 759 Perrys Bridge Road
City, State, Zip, County Belvidere, NC 27919
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 LOS
(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
Permit Fee $0.00
Facility ContactMailing AddressContact Name, Title Angel White
Phone # [phone]
Email Address [e-mail]
Company Albemarle Regional Health Services
Facility Contact Street 759 Perrys Bridge Road
City, State, Zip Code Belvidere, NC 27919
Billing ContactMailing AddressContact Name, Title Angel White
Phone # [phone]
Email Address [e-mail]
Company Albemarle Regional Health Services
Facility Contact Street 759 Perrys Bridge Road
City, State, Zip Code Belvidere, NC 27919
Other notes Operated by Republic Services of NC
Permit Name – This is the name on the permit
Facility Contact Address – May not be the facility address.
For Facility and Billing Contact check Annual Facility Report and latest inspection on Laserfiche.
SW019-0020
P0599
North Carolina Department of Environmenal Quality
Division of Waste Management
Solid Waste Section
INVOICE
Invoice #:SW019-0020
Date:2/22/2019
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:Angel White
Perquimans-Chowan-Gates Transfer
759 Perry's Bridge Road
Belvidere, NC 27919
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:
Perquimans-Chowan-Gates Transfer Station (7202T-TRANSFER-1995)
759 Perrys Bridge Road
Belvidere, NC 27919
Permit Renewal Application (Amendment- Five-Year Renewal) received on 1/21/2019
$0.00
$0.00Total Amount Due
3/24/2019Date 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