4903-HHW-2020 Iredell County Household Hazardous Waste SW020-0003 PARF, Data Sheet, Invoice 1-13-20

PERMIT APPLICATION REVIEW FORM
Review Requested by: Larry Frost
Date Requested: 7/9/2019
Facility Name and Permit ID 4903-HHW-2020, Iredell County Household Hazardous Waste
Applicant (Owner) Name Iredell 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 NA
Permit Fee $0.00
Date Application Received 10/25/2019
Contact Name, Title & Phone # David Lambert, Director of Solid Waste, 704.878.5430
Email Address
Company Iredell County
911 Address 354 Twin Oaks Road
Mailing Address 354 Twin Oaks Road
City/State/Zip Statesville, NC 28625
Parent Company NA
Known Subsidiaries NA
Other known names business
has operated under
NA
Known Counties of Operation Iredell
Does the applicant have a past
or current solid waste permit?
Yes No Unknown
Facility Type: INDUS Permit #:
Did the permit applicant submit
Financial Assurance cost
estimates?
Yes No Not Needed
Other notes This is a request for a new HHW permit.
SW020-0003
P0083
[e-mail]
1/13/2020
APPLICATION FOR NEW PERMIT DATA SHEET (Revised March 2012)
Data Field Description Data
Site_Name
M: name given to the facility. Name can permit name, but does
not have to.Iredell County Sanitary Landfill
Address1
M: first line of physical address assigned by local 911 service,
may be different than mailing address.354 Twin Oaks Road
Address2 M: second line of physical address, used when necessary.
City M: city, town or locality where facility is located.Statesville
State
M: two letter US postal service abbreviation for the state where
the facility is located.NC
Zip M: zip code for the location address.28625
County M: county name where facility is located.Iredell
Latitude M: decimal degrees, should be between 33 and 37.35.7702
Longitude M: decimal degrees, should be between -75 and -85.-80.8239
Horiz_Collection_Method
O: applies to how the coordinates were collected: 001=GPS or 002=geocode or 003=from map 001
Supplemental_Location
O: descriptive text for locating a facility when address is not
practical.NA
Geometric_Type
M: 001=Fixed or 002=Mobile, e.g. Facility is Fixed, a septage
pumper is Mobile 001
Reference_Point
O: description of point where coordinates were collected at the
facility, 001=front door, 002=permitted feature, 003=for mobile,
004=undefined point on facility 002
Status M: description of the overall facility; Open or Closed.Open
Owner
M: classification of the owner of the facility as either Public or
Private entities.Public
Start_Date
M: date on which the facility began to be of interest to the
program, Facility Registration Date; Facility's Original Permit
Issue Date; Facility's First Inspection Date; Program's Start Date;
Department's Creation Date (07/01/1989)10/25/2019
Start_Date_Qualifier
O: description of event represented by Start_Date field, e.g.
Facility's Original Permit Issue Date.NA
End_Date
O: date on which the facility ceased to be of interest to the
program.NA
End_Date_Qualifier
O: description of event represented by End_Date field, e.g. Date
of Final Closure.NA
PermitID M: unique id number used for permit 4903-HHW-2020 Proposed Permit No.
LocationID
M: id number used in location table to identify the facility or
environmental interest subject to this permit. This number is
assigned and is only needed if permit relates to an existing site.P0472Permit_Name M: Common Name used for this permit Iredell County Sanitary Landfill
Orig_PermitIssueDate M: Date when first permit issued.Proposed
PermitIssueDate M: Date MOST recent permit issued.NA
PermitExpDate M: Date when current permit expires.NA
PermitStatus
M: Active=Accepting/handling waste; Inactive=Not accepting
waste; Proposed=Application in-house for NEW permit;
Expired=Past Expiration date but not officially closed; Post-
Closure=Not taking waste but monitoring; Closed=Not accepting
waste and 'official' closure letter sent; Post-Closure
Complete=Not taking waste and monitoring complete;
County=Non-facility within a county Proposed
Rule
M: block of rules governing site e.g. .1600, .0500, .1100, .0800,
etc..300
EnvMonitoring
M: environmental monitoring required, yes is required or no is not
required.No
PrimaryWaste_Type
M: primary waste type handled under this permit: MSW, CD,
Indus, Tire, LCID, Medical, YW, Septage, HHW, WG HHW
PrimaryOperation_Type
M: primary operation when dealing with waste: LF, Trans,
LandAp, TP, Compost, MatRecovery, Incin, Hauler,
WasteToEnergy, Authorization, Notification, Collection, Detention TPOwner_Name M: name of owner as appears on the permit.Iredell CountyOperator_Name M: name of operator/facility manager.David Lambert, [e-mail]
North Carolina Department of Environmenal Quality
Division of Waste Management
Solid Waste Section
INVOICE
Invoice #:SW020-0003
Date:1/13/2020
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:David Lambert, Director of Solid Waste
Iredell County Household Hazardous Waste
354 Twin Oaks Road
Statesville, NC 28625
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:
Iredell County Household Hazardous Waste (4903-HHW-2020)
354 Twin Oaks Road
Statesville, NC 28625
New Application for Permit (New Facility) received on 10/25/2019
$0.00
$0.00Total Amount Due
2/12/2020Date 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