2304-TP-2020 Shelby, City of T & P Facility SW020-0105 PARF, Data Sheet & Invoice 9-2-2020

PERMIT APPLICATION REVIEW FORM
Review Requested by: Allen Gaither
Date Requested: 8/28/2020
Facility Name and Permit ID City of Shelby T&P, 2304-TP-2020
Applicant (Owner) Name City of Shelby
Description of Permit Request
[This is the action the applicant
is requesting in accordance with
NCGS 130A-294(a3)]
Amendment
(2)a. Amen newal/Review
(2)b. Amen
ange to Approved Plans (No CHR)
(3)b. Modification Five-year Limited Review (No CHR)
Permitted Annual Tonnage N/A
Permit Fee (New Only) $50
Date Application Received 8/27/2020
Contact Name & Title Mr. Justin S. Merritt, Assistant City Manager
Phone # [phone]
Email Address [e-mail]
Company City of Shelby
911 Address 1940 South Lafayette Street, Shelby, North Carolina 28150
Mailing Address P.O. Box 207
City/State/Zip Shelby, NC 28151
Parent Company N/A
Known Subsidiaries N/A
Other known names business
has operated under
N/A
Known Counties of Operation Cleveland
Does the applicant have a past
or current solid waste permit?
Yes No Unknown
Facility Type: Permit #:
Did the permit applicant submit
Financial Assurance cost
estimates?
Yes No Not Needed
Other notes Permit application for new Treatment & Processing Facility
SW020-0105
P1347
Data Field Description Data
Site_Name
M: name given to the facility. Name can permit name, but does not
have to.City of Shelby Treatment & Processing Facility
Address1
M: first line of physical address assigned by local 911 service, may
be different than mailing address.1940 South Lafayette Street
Address2 M: second line of physical address, used when necessary.
City M: city, town or locality where facility is located.Shelby
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.28150
County M: county name where facility is located.Cleveland
Latitude M: decimal degrees, should be between 33 and 37.35.244523
Longitude M: decimal degrees, should be between -75 and -85.-81.568818
Horiz_Collection_Method
O: applies to how the coordinates were collected: 001=GPS or
002=geocode or 003=from map 3
Supplemental_Location
O: descriptive text for locating a facility when address is not
practical. City of Shelby Waste Water Treatment Plant
Geometric_Type
M: 001=Fixed or 002=Mobile, e.g. Facility is Fixed, a septage
pumper is Mobile 1
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 4
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)8/27/2020
Start_Date_Qualifier
O: description of event represented by Start_Date field, e.g.
Facility's Original Permit Issue Date.Receipt of Permit Application
End_Date
O: date on which the facility ceased to be of interest to the
program.
End_Date_Qualifier
O: description of event represented by End_Date field, e.g. Date
of Final Closure.
PermitID M: unique id number used for permit
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.
Permit_Name M: Common Name used for this permit City of Shelby T&P Facility
Orig_PermitIssueDate M: Date when first permit issued.
PermitIssueDate M: Date MOST recent permit issued.
PermitExpDate M: Date when current permit expires.
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.0.03
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 LCID & YW
PrimaryOperation_Type
M: primary operation when dealing with waste: LF, Trans, LandAp,
TP, Compost, MatRecovery, Incin, Hauler, WasteToEnergy,
Authorization, Notification, Collection, Detention TP
Owner_Name M: name of owner as appears on the permit.City of Shelby
Operator_Name M: name of operator/facility manager.City of Shelby

North Carolina Department of Environmenal Quality
Division of Waste Management
Solid Waste Section
INVOICE
Invoice #:SW020-0105
Date:9/2/2020
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:Justin Merritt, Assistant City Manager
City of Shelby
1940 South Lafayette Street
Shelby, NC 28150
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:
Shelby, City of T & P Facility (2304-TP-2020)
1940 South Lafayette Street
Shelby, NC 28150
New Application for Permit (New Facility) received on 8/27/2020
$50.00
$50.00Total Amount Due
10/2/2020Date 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