4401-INDUS-1979 Champion International SW020-0056 PARF & Invoice 5-8-20

PERMIT APPLICATION REVIEW FORM
Review Requested by: Allen Gaither
Date Requested: 5/6/2020
Facility Name and Permit ID Champion International, 4401-INDUS-1979
Applicant (Owner) Name Champion International
Description of Permit Request
[This is the action the applicant
is requesting in accordance with
NCGS 130A-294(a3)]
(1)a. New – New Facility
(1)b. New – Substantial Amendment
(1)c. New – Expand Waste Boundary
(1)d. New – Waste Category Change
(1)e. New – Permit Less than LoS Duration
(2)a. Amendment – Renewal/Review
(2)b. Amendment – Change in Ownership
(3)a. Modification – Change to Approved Plans (No CHR)
(3)b. Modification – Five-year Limited Review (No CHR)
Permitted Annual Tonnage N/A (Closed facility)
Permit Fee (New Only) N/A
Date Application Received 5/6/2020
Contact Name & Title Mr. Tom Richardson, Environmental Remediation Manager
Phone # [phone]
Email Address [e-mail]
Company International Paper Company
911 Address Beaverdam Road, Canton, NC 28716
Mailing Address 6400 Poplar Avenue
City/State/Zip Memphis, Tennessee 38197
Parent Company Unknown
Known Subsidiaries Unknown
Other known names business
has operated under
Unknown
Known Counties of Operation N/A (Closed facility)
Does the applicant have a past
or current solid waste permit?
Yes No Unknown
Facility Type: INDUS Permit #: 4401-INDUS-1979
Did the permit applicant submit
Financial Assurance cost
estimates?
Yes No Not Needed
Other notes Modification for stormwater repairs/improvements on the cap.
SW020-0056
P0074
North Carolina Department of Environmenal Quality
Division of Waste Management
Solid Waste Section
INVOICE
Invoice #:SW020-0056
Date:5/8/2020
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:Tom Richardson, Environmental Remediation Manager
International Paper Company
6400 Poplar Ave
Memphis, TN 38197-0001
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:
Champion International (4401-INDUS-1979)
Beaverdam Road
Canton, NC 28716
Permit Modification Application (Modification- Change to Approved Plans (NO CHR)) received
on 5/6/2020
$0.00
$0.00Total Amount Due
6/7/2020Date 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