N0138 TOMMY CARTNER

DEED woK
417S Chin pfP% '.
.. rya C-44 0 91E
0308
,state, a .:J�y�f!T_orjh Carolina.;;..
Department of Env, ironmentf H alth, and,Natuaral-: esourees
- - P•J f{Jl4l1J8 7 f xtalelh�Ft-brth Carolina, 276114687"
.O.'r'i':r•?-�...r.•1-' k,K' - '
V11db8m, L. Meyer
Jaynes G. Martin, Governor ...t. • {i•'+ DIf CC�Or
William W. Cobcy,+ Jr., Secretary .
`. LAND CLEARING AND 'INtRT' DEBRIS LANDFILL NOTIFICATION
Pursuant to 15A NCAC 1 B .0663i21(a), the land owner(s) and operator(s) of any Land Clearing and
Inert Debris Land_ fill under two (2) acres in siie shall submit this notification form to the Division prior
to constructing or operating the landfill. This form must be filed for recordation in the Register of
Deeds' office. The register of Deeds shall record the notification under the name of the owner(s) of
the land in the county or countles In which the land is located. 'The Register's seal and the date, book,
and page number of recording must be inciuded on this form when submitted to. the Division. This
notification is not valid to authorize operation of -a landfill unless complete, accurate, and recorded as
required by •'I 5A' NCAC 136 .0563(2)(b).
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Facility Nam$:
Facility location Istreet address);
City: e— County: _r� g fi �
The land on which this landfill is located is described in the deed recorded in:
,r (�: '
deed book: V page:' county: ic.
:... ,'• C.C' 1',
Name of land owner.
Mailing address of land owner:
City: State.,
Telephone number of land owner:
If the land is owned by more than one person, attach. additional sheets,with the name, address,
and phone number of all additional land owners.
Name of operator:
Trade or business name of operator:
Mailing address of operator:w^ 9. L' X 4�K 1 ca -- -��
City: 090 r_A i.' State:_ I C Zip: C
Telephone number of operator: o
If the landfill is operated by more than one person, attach additional sheets with the name,
address, and phone number of all additional operators.
11, Projected use of land after completion of landfill operations:
An Equil oppmwunl(y M1mmdve Action Employer
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DEED BOOK PAGE.-22L
- '#.ti'-..ti. �� n• tiff �.1
The following are the applicabiky,,lsiti4 and' operating. criteria•,for Land Clearing and Inert Debris
Landfills,operating.uridtir•'rlot fi6`atlon, 1 :'+ _ y" .y# «y�I ;�1 ;►t.��. ;,;•
,0603 APPLICABILITY RE0UiREMF14TO FOR LAND CLEARING AND INERT ps*l3lllS' ILClfyj ANl7FILLS
Mannoarmant of lard clearing,ind inert„debris oill be �n.aced rden�e'ffh t�e.S anew $lerarcl�y far man rig solid waste as provided for under
IJ,C,C3.S. 5 130A-309.04(e1. gfapossl In *land fll��Is considered lobe 'the least desirable method of managing land clearing and inert debris. Where
landillling is necessary, the requirernonts of this Rule apply.
III An individual permit from the Division of Solid Waste Management 1s not required far Land Clearing and Inert 1]sbrls 1Ll+tD1 landfills that
meet all of the following candmans:
(a1
The facilityle to be operated for the dfsposel of land clearing waste. Inert debris, untreated wood, and yard treah. Operations
must be conslatent and In compliance with the local government solid waste mansgame' "t plan as approved by the Olvision
rsr 0i1d V1%este llilanargen+ent.
Ibf
ilia total dlspoasl eras is under two acres in size.
tort
The facility and practices comply with the siting criterfs under Rule..0504, and operational requlto+rients under Rule .0569.
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(d)
The rill sctivlty Is' not exempt from, an rnus c0-niply .with all other Fedotal, State. or Local laws. ordinances. pules.
regufatione, or orders, fncludlnp but snot limited to •`tonln resirlctions, flood plain raetrictlome. wetland reatrlalCdns,
sedirmentation and erosion control requirements. and mining repulatlons.' i -
121 Where
an individual permit is not required. the following appllos:. r,
IV)
The ownei of tl�a land where the landfill In located must notify the Division on a proscribed form, duty signed, notarized, and
recorded as per Rule .01at3312I161. The ppsrator of the landfill. If dliterent from 11+e land awnor: *hail also sign the notlflcatton
form. I
1bl
Trio owner must file the proscribed nottlicstton farm for recordation In the Register of Dead*' Office. The Register of Deeds
shalt Index the notification In the grantor Index under the name of the owner of the land In the county or countle■ Its which
the fend Is located. A copy of the recorded notification, affixed with. the Ravleter's seal and t6of Bats. book and page number
of recording shall be sent to the Division of Solid Waste Management.
I0
Whom the lend on which the Land Clearing and Inert Debris Landfill is sold, leased, conveyed, or tr¢rrraferred In any manner,
the dead or other Instrument of transfer shall contain In the description section In no smaller type than that used in the body
of the dead or Instrument a statement that the property has been used ss a Land Clearing and Inert Debris Landfill end ■
reference by book and page to the recordation of the notillostion.
.0604 SITING
CRITERIA FOR LAND CLEARING AND iNERT VEB1i19 iLCiDI LANDFiLLS
Is
1101
following ailing criteria shell apply for Land Cloartno and Inert Debris iLCIDi landfills:
Facilities or practices'. shell not be located in the 100-year floodplain.
Facilities or practices shell not cause or contribute to the taking of any endangered or, threatened species of plants. fish, or wildlife, .
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Fentities orprae:ttcas shall not rosult in the dastructlon or sdvbrse modification of the critical habitat of endangered or threatened speciess
as Identified in 50 CFR Part 17 which Is hereby Incorporated by reference Including any subsequent amendments end editions. This
material 1s evaiiable for inspection at the Department' of EnvironmeM, Wealth, and Natural Resource*, Dlvislon of Solid Waste
Management, 401 Oberlin Flood. Raleigh. North Csrolia& 27605 where copies can be obtained ■t no cost. =
Facilities or practices shell not damage or destroy err'srehaeoloolcal ear historleal site.
Facilities or practices shalt not cause an adverse Impoat,nn a state park, recreation or scenic area, or any other lands included In the
stele nature and historic preserve. '
Facliftles shall not be located In any wetland as defined in the Clean Water Act, Section 4041bl.
It must he shown that adequate suitable satla are avallehld for caner, either from an or off site.
Lend Clearing and Inert debris landfills shell meet the [allowing surface and ground water requirements:
1el Faciiitlee or practices shell not cause a discharge of pollutants Into waters of the state that Is In violation of the requirements
of the National Pollutant blecharge ElImInalton'System INPDESI, under Section 402 of the Clean Water Act, as amended.
Ibl Facilities or practises shill not cause a discharge of drodaod materials or fill material into waters of the state that Is In
violation of the requirementa under Section 404 of the Clean Water Act, as amended.
10 Fecilltion or practices shall not cause non•polnt iduroe poqution'of waters of the slate that violater nssipned water quality
standards.
(d) Waste In landfills with a disposal ores greater then two acres thall be placed a minimum of four feet atrove the seasonal high
wnIor table, except whore an alternative separation Is approved by the Division.
(oil West@ in landfills with a dtrrposal areas lass !hero two screi shall be placed above the seasonal high water table.
The facility shall meet the following minimum buffer requirements:
(a) 60 feet from the waste boundary to 611 surface waters of the stone as defined In a.$. 143-212.
(bl 100 feet from the disposal area to property lines, residential dwellings, commercial or public buildings, and wells.
ICI Buffer requirementa may be edjusted as m+cessery to Insure'edequate protection of pubile health end the environment.
The facility shall meet all requirements of any applicable toning ordinance.
.0608 OPEitATIONAL nEQUTAEMENTS FOR LAND CLEAniNa AND INERT DEBRIS (LCIDI LANDFILLS
Land Clearing and inert Ofibrle ILC101 landfills shall meat the following operational requirements:
Ili operational plane shall be approved and followod as specified for the Iscility.
(21 The facility shall only accept !hone solid wasta+r which It Is permitted to resolve,
131 Solid waste shall be restricted to the a nialtest aros feasible end compacted are densely as practical Into cells.
141 Adequate soil cover shall be applied monthly. or when the solve area teaches one acre In size, whichever occurs first.
2

DEED, A
.� ;bgI p •slender days ilia" eomplatlan`of any phase of die ogal o eralioria or Upon -
0 P P revocetfon of a permit, the disposal area •hail be
covered 'with e'minlmum of ens loot of suiRabfe soil covet sloped to allow.turface water runoff in a' controlled mariner. Tha Division
i"iv require lurtlrar action In order to correct any condilian which Nor may become Injurious to the public health, or a nuisance to the
community.
{a) Adaqurtn erosion control measures, structures, or davlces than bi utNised t' prevent elk front leaving the rite aril tv prevent excessive on site erosion,
l71 f'rbvlsibrrs for a ground caves sufficient to restraln qio*Ior4lnuat be accomplished within 30 working Jaya or 120 oalandarday* upon
,i xI ' Wharfs I, .r . a . ,.« , •.
compl i Jn of any phase of landfill development.
irsilbe Ode'+' , °v•° , .. .,� . :'
181 The �acillti s *;atelt• seaurid by insane of betes,'enalna, tieirrr►i' fericei qtC. t rav ... - ` ' ;
• , �- • ,+ p ant unauthoritad access except when
in operator is oir duly,':�1n tE te�rid sit shill �s on'9uty "fall timos'while'ihr landfill is open lot pubiia use to i1:sure compliance with
aperatlenal requlremertt* ind tit prevent accgptance.of unaulhori#ed wastds.
r reeds •hall o o� elf -weather canstfUctlon gird praperiy mialnirfnail +i ,
1101 Strrfaa� wati� •flails dlViriad frorft the wanting face" •nd sold not be" 1m'
poundid over waste'.
l I I1 solid waste @hall not be dlspoiod of in water. •
lt2l Open burning of solid waste Is prohibited.
1131 ` ti The conaerttratian of okplo'iive ga#ee generated l!y Ihs facility shetl not exceed: Tvr¢n�y=hvo percent01 the lower'gxploslve 0m' It for the gases in facility structures,
lb) :. . The lower explosive limit for the gases st the property boundary.
1141 r Leadha'ta shelf he properly managed on site through the use of current best management practices.,
111151 Should the f]ivtalon drenf it necessary, drounJ water,or surface water monitoring, or both, pray be required as provided for under Aule■
.0601 and .0002 of this Subchapter,
i1 B1 A sign shall be posted at the facility entrance ihowing the contact name and number In case of an ernergency and the permit number,
The permit number requirement Is not spplleable for facilities not tequiring an krdividual permit.
Certification by Land Owner: F.
certify that the information provided by me in this notification is true, accurate and
r complete to the
best of my knowledge. The facility siting and disposal operations of this landfill will comply with the
requirements of sections .0564 and .0566 of the Solid Waste Management Rules. The facility and operations of this landfill will also comply with all applicable Federal, State, and Local laws, rules,
regulations, and ordinances. Where the operator ' different from the land owner, 11 the mind owner,
have knowledge of the operator's plans to dispose of solid waste on the land and I specifically
grant
permission for the operation of the landfill. I understand that both the land owner and operator are
jointly and severally liable for improper operations and proper closure bf the landfill as provided for b
North Carolina General Statute -13OA-309.27, l further understand that North, Carolina,. General Statute.
• 130A- 2 provides for administrative penalties of ufito.,fi.ve hundred.dollars ($500.00) per da violation of the Solid Waste Management Rules. y Per each
g l further understand that the Solid Waste Management
Rules may be revised or amended in the future and that the facility siting and operations of this landfill
will be required to comply with all such r isions or amendments.
Print Nil Owner) Signature erf
Bate
North Carolina
1 County
l' , a Notary Public for said County and State, do hereby certify
that
personally appea•red before me this day and acknowledged the
.dr �e� ,eicw' cu i n... the foregoing instrument.
r, } !' 'fi_nd official a seal, this the day of
19
Notary Public A
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S ii� ex' ires `
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Certification by landfill Operator (if.different different ff
ins O�rYnerj: ,
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I certify that the information provided by me In
his'notifidation'Is; true; accurate,' and complete to the
best of my knowledge. The facility siting. and
posal "operiatip s `of this; lendfill�will.co'mply with the
requirements' of sections'.0564, and �.05 .6, f;} ' 8, olid Waste,":Management. Rules.,The facility and
- operations of this landfill will also comply'.`witl
I1,'appilcable'`-Federal;' tare i-end L-0cal,;..Iaws, rules,
regulations, and ordinances. I have info:rmdd't�
nd owner of my plans,todispo e+o solid waste on
the land and 'the land owner has specifically
rented permission for the operation of the landfill. I
understand that both the operator- and land .
w er,;: ' ,..-je': ' .
jointly end . severall�f',y.l1ab.l ,for improper
..:,.. f 4arez,
operations and proper closure of the landfill as ���t`ovid.ed„for.by North Carolina Ceheral Statute 1 OA-
309.7• !further understand that North Carotin
;enerStatute 130- provides for administrative
penalties of up to five hundred dollars ' 00
9) .:per. day per each 'violatio' n of. the : Solid Waste
Management Mules.' 1 further understaand that t
olid,.VYaste Management Rules may be revised or
amended in -the future and' that the facilit sit
a,nd. operations of 'this landfill will be required to
comply with all such revisions or amendm ,7r.
110021 ! tWasrr
North Carolina
due;x�
{
County
a Notar,
personal
�,n of the foregoing Instrument. ,
!tpbpe ator) Date
Public for:said County and State, do hereby certify
►,appeared •before me 'this day and acknowledged the
end -official 'seal;' this4 tie
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qd expires
4otary Public
R
For additional land owners and landfill operator. , attach separate notarized certifications for each
additional land owner and landfill operator. `
INS# UCTIONS
f urpose: Notification if Land Clearing and inert behriIr .Landfills under two 121 acres In file Is required under 16 NCAC 138
.05031211al. Contact the Solid Waste Section it the address below for further Information.
Distribution; Mail completed recorded orlglnal notification jl;!.�.tha following address:
+ Olvlslon of SqIId Wasto Management
Solid waste b'ectlon
Raleigh. Northparallna 27t111-7607
.191 el 733•06#2
of '
Disposition- This form will be transferred to the State Records Center when reference value ends. Records will be held for agency In the
State necerds Center live 151 additional years and then transferred to the custody of the Archives.
i�
NORTH CAROLINA, DAVIE COUNTY
The foregoing eertifleate (s) of.. , ..Tere;, ..X.- -Appe .sou ....................... ............. . ........... ..........................................
1
...............................................I.....,,.,,..,...I.......,.,,,,..,,,,,.,......,...Notary Public u .......Couiity
to re) certified to be correct. This instrument was presented for registration this ...... 2,8.......... day oL...............tune.............. I9..95,...,
at ..A-mm. P.M.. and duly recorded to the office of the register of Deeds of DAVIE COUNTY, North Carolina in Book...1.81...........
Page ........ 47.0......
This the ....... 2R........ day of.....................June.................... A. D.. 19.....9.5 -,.,,,
tz.4t ...................
y: 4% UI PUTY RE,GIS TER OF DEEDS
.............. �Z-to_e
Henry L. Shore
REGISTER OF DEEDS
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