8202_SampsonCoMSWLF_20191011_PARFInvoice_SW019-0100

PERMIT APPLICATION REVIEW FORM
Review Requested by: Ethan Caldwell
Date Application Received: 10/03/2019
Location ID (if known) P0131
Permit ID 8202-MSWLF-2000
Permit Name
(aka Permit Applicant Name) Sampson County Disposal, LLC
Facility Type MSWLF
Physical Street Address 7434 Roseboro Hwy
City, State, Zip, County Roseboro, NC 28382, Sampson County
Description of Permit Request (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 ModificationPermit Fee $0.00 Facility Contact Mailing Address Contact Name, Title Bryan Wuester
Phone # [phone]
Email Address [e-mail]
Company Waste Industries
Facility Contact Street PO Box 640
City, State, Zip Code Roseboro, NC 28382 Billing Contact Mailing Address Contact Name, Title Rita Wurschum
Phone # [phone]
Email Address [e-mail]
Company Waste Industries
Facility Contact Street PO Box 640
City, State, Zip Code Roseboro, NC 28382
Other notes
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.
SW019-0100
North Carolina Department of Environmenal QualityDivision of Waste ManagementSolid Waste Section
INVOICE
Invoice #:SW019-0100
Date:10/11/2019
Payment Options:
Division of Waste ManagementSolid Waste Section1646 Mail Service CenterRaleigh, NC 27699-1646phone: [phone] fax: [phone]email: [e-mail]
To:Rita WurschumSampson County Disposal, LLCPO Box 640Roseboro, NC 28382
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/swNorth Carolina Electronics Management Program - http://portal.ncdenr.org/web/sw/electronics
E-check -Available online at http://go.ncdenr.gov/swpayRequires 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/swpayAccepts 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 ManagementSolid Waste Section1646 Mail Service CenterRaleigh, NC 27699-1646
Description Amount Due
Facility-Application: Sampson County Disposal, LLC (8202-MSWLF-2000)7434 Roseboro HighwayRoseboro, NC 28382Permit Modification Application (Modification- Change to Approved Plans (NO CHR)) received on 10/3/2019
$0.00
$0.00Total Amount Due
11/10/2019Date 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