0403-MSWLF-2010 Chambers Development MSWLF (Anson Landfill) SW019-0089 PARF & Invoice 8-28-19

Modified on 8.28.2019 
Revision #4 
PERMIT APPLICATION REVIEW FORM
Review Requested by: Donna Wilson Date Requested: 8/27/2019
Facility Name and Permit ID Chambers Development MSWLF (Anson Landfill), 0403-
MSWLF-2010
Applicant (Owner) Name Chambers Development of North Carolina, Inc.
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 – Five-year Renewal
☐(2)c. Amendment – Change in Ownership
☐(3)a. Modification – Change to Approved Plans (No CHR)
☐(3)b. Modification – Subsequent Permit to Operate (No CHR)
Permit Fee $875
Date Application Received 12/21/2018
Contact Name, Title & Phone
No. Nelson Breeden, Regional Engineer
Contact Email Address [e-mail]
Company Name Waste Connections of North Carolina, Inc.
911 Address 375 Dozer Drive, Polkton NC 28135
Mailing Address 265 Brookview Centre Way, Suite 205
City/State/Zip Knoxville TN 37919
Parent Company Waste Connections, Inc.
Known Subsidiaries N/A
Other Known Related or
Associated Business Names N/A
Known Counties of Operation Anson
Does the Applicant have a Past
Or Current Solid Waste Permit?
Yes ☒ No ☐ Unknown ☐
Facility Type: MSWLF Permit No.: 0403
Did the Permit Applicant Submit
Financial Assurance Cost
Estimates?
Yes ☒ No ☐ N/A☐ Not Needed ☐
Other Notes Phase 5 expansion. PTC applic was submitted before site suitability
has been documented, and the application has to be split out.
SW019-0089
P0976
North Carolina Department of Environmenal Quality
Division of Waste Management
Solid Waste Section
INVOICE
Invoice #:SW019-0089
Date:8/28/2019
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:Tyler Fitzgerald
Chambers Development MSWLF (Anson County)
265 Brookview Centre Way, Suite 205
Knoxville, TN 37919
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:
Chambers Development MSWLF (Anson Landfill) (0403-MSWLF-2010)
375 Dozer Road
Polkton, NC 28135
New Application for Permit (Expand Waste Boundary) received on 12/21/2018
$875.00
$875.00Total Amount Due
9/27/2019Date 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