N0740 MACEDONIA DUMP SITE

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State of North Carolina
`�- - Department of Environment,
Health and Natural Resources
Division of Solid Wcste Management
James B. Hunt, Jr., Governor
Jonathan B. Howes, Secretary
William L Meyer, Director
LAND CLEARING AND INERT DEBRIS LANDFILL NOTIFICATION
Pursuant to 15A NCAC 138 .0563(2)(a), the land owners) and operator(sl of any Land Clearing and
Inert Debris Landfill under two (2) acres in size 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 index the notification under the name of the owner(s) of the
land in the county or counties in which the land is located. The Register's seal and the date; book, and
page number of recording must be included on this form �when..oubmjtted. to. the Division. This
notification Is not valid to authorize operation of a landfill unless complete, accurate, recorded, and
submitted to the Division as required by 15A NCAC 138 .0583(2)(bte
1. Facility Name: yAf A c A. 14S' : ��--
2. Facility location (street address):
city: •� Ae d a / county: e e/vs'o.1 Z;p:
3. Directions to Site: t "' ° � + '
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4. The land on which this landfill is located is described in the deed recorded in:
deed book: 7.?J % t page: county:, ✓� S'r �' ✓' .e o !�
5. (7mlaffing
a of land ownern ^h._�oy, 2
6. address of Ian d w e • �� ��tiQ_9�
cityt�C2 .� Dr c4 Q. State: n t C • Zip: 4F17 3
76 Telephone number of land owner:�20 1 `J`� g� �Z
11.
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: � 4V o
Trade or business name of operator: jo. E
Mailing aid/dress of operator: lJ . S ep- � /x � t
city: /Ty �rIE f tn.�- o�/if+$taLe: /�' � � � Zip: �• O � jf- 9 .
Telephone number of operator:( d* 4% 9' ^ j �? S" %F I
If the landfill is operated by more than one person, attach additional sheets with the name,
address, and phone number of all additional operators. ,.Qp
12. Projected use of Iand after completion of landfill operations: J i4
P.O.6ox 27b87. Rcteigh. North Caroru�a 27b11-7687 Telephone 914-733-a996 FAX [phone]
An �cu� Cccc'::nity A`�mative Acflon Employer SC%recycled/ 10°b pcst-cons.• �.er pacer
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�UFiThe following are the applicability, siting, and operating criteria for Land Clearing and Inert Debris .--_.
Landfills operating under notification.
1721 *Land Clearing waste* means solid waste which is generated solely tram land clearing activities such as srjmos. trees, limps. brush,
grass$ and other naturally c"cumaill vegetative materiale
1731 : Lend clewing and inert asons landifillo means a facility for Me land duipasal of land clearing waste, comets, bricko comets block,
u an
174) Mud trash* means good Waste resulting tram larmcapoll ana yard maintenance such as brush, graiss, tres Drops, and similar vegetative
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130A*309*04taL
Disposal in a lancris is considered to be the tam desirable method of martagin land Clearing and Intent debris& Where
Is necessary,
the requirements at this Rule apply.
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An individuial
permit from we Division of Scild Waste Management Is not requited tot Lind Clewing and truirt Debris Mr
meet AD of the following =:ndstiortsa
(a)
to W
The facility is ^e operated for %ft disposal of land clearing waste, inert debriso untreated wooA and yard vask Operat
must be consunoom and in compliarica with the local government solid waste management Plan as approved by Me
of Solid Waste Managemem
(b)
The total disposal area is under two acres in sizoo
(c)
The facility and oractices; comply with :dtaria under Rule
all o Statat or Local laws, ordinances, R
regulations, or wome Including but not limited to zotdM restrictionst Road plain restrictions, wattand restricitic
sedimentation wita waskm control requirematim " mining regulations.
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Where an individual permit is not rsquirrad� VA following applies:
owner of ine Wid he landfill is tamed must notify
- whererecaroad t.;t•
as bar Awe -.^'i. taro rrr; owner. ..-rn also so the Motion
+- the prescribed notification form tot jecardation in IVW 01r: r:
to
'=Mai'm in the grantor ind" impair me RaR'M of the wraia in the county at Counties in w
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r6ft A Wof the recorded nodflicartion, affixed with the Ra9Ww*s seal and the date* back and pap
at recording an&# be am TO On Division at Solid Waste Management,
(C)
When the land on which the Land Clawing and Imt Debris Landfill
the dead at otner metrurnem of tr9astar shall contain in the description section in no smaller Me U%4n that used in the
of the dead at instrument a statement that the prapeirty has been used as a Land Clewing it and
reference by book wul page to the recordation of the notificatim
.0684
SITING
CRITERIA FOR • y(LCMI LANDFILLS
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as Identified in 50 M editions.
material Is available for inspection at the Department of Environment, Health, and Natural Res�urcss, r i•. Waste
27605 where copies can be obtained at no cast.
IS) Facilities or practices shed tot cause an adverse impm an a state park, recreation or sceni area, or any other lands included in the state
nature and historic waseres.
(6) Facilities shad not be located in any wed" as defined In the Clean Water AcL Section 404(bl*
(7) It must be shown that acecusta suitable soft are available for cover, either from on at off site.
(6) Land Clearing wW inert Down; (4) Facilities or practices aftail not damage or destroy an archaeological or historical sitiL
Facilities
of the National Poibitant Discharge 7 "1 Clean
(b) Facilities or pni== shall riot cause a discharge of dredged materials at fill material into waters at the state that is in violation
of the requirements under Section 404 of the Clean
to) facilities or practices shall not cause nonIxtint source pollution of waters of the state that violates assigned water quality
(d) Waste in tanaft with a disposal am greater than two acres shall be placed a minimum of four I set above the seasonal high
water table, except where an alternative separation is approved by the Divisim
fal Waste in P. with a disposal am liters than two acres shO be placed above the seasonal high water table,
facility
r feet from the waste boundary to all surface waters of the state as defined in G.S.
Buffer(b) 1013 feet from the disir;Q am to propwty Knes, residential Wdw4ffings. commercial ar public buildings, and wells.
(101 The facility shad meet all requirements of any applicable
OPERATIONAL*0566 '/NG AND INERT DEMS JLCID) LANDFILLS
Land Clewing and Inl DZ�m rr
Olierational plane OW be soproved and followed as specified for the facility.
(M The facility shell only acteat those solid wastes which it is permitted to racme*
.r„t. Waste Visit 06 restricted to We smatlest area fitasidile
(4) Adequate sod cover snall be aooW monthly, or when the active area reaches orts acre in size, whichever occurs am calendar days Mew camoledrin of any phase of disposal openritionas or upon revocation of a permite the disposal area " be covered
with a minitrun of one to= of suitable sad cover sloped to allow surface water runaff In a controlled mannerl. The Division may require
further action in order to Correct any condition which is or may become injurious to the public heafth* or a rvidsance to the community,
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{B)' Adequate erosion c^r.-„� measures. suuctures. or devices shad be utilized to prevent sift from leaving the site and :o prevent excessive
on site erosion.
t71 Provisions for a group« saver suftic:ent to restrain erosion must be accomplished wkhin 30 working days or t20 calertcar days aeon
eompietion of any phase of Iandfiil development.
tat The facility shag be aaeauateiy screed by means of gates, chairs, berms, fences, etc. to prevertt unauthorized access except when an
operator �s on n atten an; a e o w n i use o assure w.^..p shoe with
operational requiremer.:s and to prevent acceptance of unauthorized wastes.
iS) Access roads shall be of ag•weatner tnmstruedon and properly mairnained.
tt01 Surface water shall ba diverted tram the warfcb+g face and shall not be impounded over waste.
I1 t 1 SoNd waste soar pat oe ouoosed o in water.
t121 pen ummg o son waste ie protuon
t131 a concen n o ex Delve gases generated by the facility shag not exceed:
la1 Twenty-rwe Decant of the lower explosive Rnut for the gases ht taeptty atructurea.
tbl The lower explosive limb for the gases et the property boundary.
t14i Leaehate shag be pre«edy managed on site though the use of current beat management practices.
(151 tihould the Division Beam it necessary, ground water of surface water monitoring, or both, may be required as provided for under Rules
.080t and .0602 oi'-`.is Subchapter.
(t 81 A sign shag be posted at the fadlity entrance showing the contact name and number in case of an emergency and the permit number.
The permit number recuirement is not applicable for faeiGdes not requiring an individual permit.
Certification by Land Owner:
1 certify that the information provided by me in this notification is true, accurate, and complete to the
best of my knowledge. The facility siting and disposal operations of this Land Clearing &Inert Debris
landfill will comply with the requirements of Sections .0583, .0564 and .0586 of 15A NCAC 13B,
North Carolina Solid Waste Management Rules. The facility end operations of this {andfiil wil{ also
comply with all applicable Federal, State, and Local laws, rules, regulations, and ordinances. Where the
operator is different from the land owner, i, the land owner, have knowledge of the operator's plans
to dispose of solid waste on the sand and I specifically grans permission for tfie operation of the landfill.
I understand that both the land owner and operator are jointly and severally liable for improper
operations and proper closure of the landfill as provided for by North Carolina General Statute 130A-
309.27. (further understand that North Carolina General Statute 130A-22 provides for administrative
penalties of up to five thousand dollars ($5,000.001 per day per each violation of the Solid Waste
Management Rules. I further understand that the Solid Waste Management Rates may be revised or
amended in the future and that the facility siting and operations of this. landfill wilt be required to
comply with all such revisions or amendments.
�h�r �C,P ��J,�"���ftlk� Caj�D�.r�1 ��,�>��rr.� S'- z �' �1 ` �'
Print Name (Owned Signature {Owner) - Date
North Carolina
�����4�1 County
I, ��/ �� -P¢(>� . a Notary Public for said County and State, do hereby certify
that f 6' ersonally appeared before me this day and acknowledged the
due execution of the foregoing instru ant.
Witness my hand and official seal, this the �`G�— _day of �� . 19_�.
i:;��^:'`. %�$�., �S Puts=��:�-4►,�/�re t:t:*=" :d tc a,r r:f3r,^,
i:i?,.... ::li.�*;3 ro. !;;f;isE•ra4�;n z:itU ._. ..,
t�i :. `^...�.,_.....,, day of
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Certification by Landfill Operator (if different from Ownerl:
I certify that the information provided by me in this notification is true, accurate, and complete to the
best of my knowledge. The facility siting and disposal operations of this Land Clearing & Inert Debris
landfill will comply with the requirements of Sections .0563, .0564 and .0566 of 15A NCAC 13B,
North Carolina 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. 1 have
formed the land owner of my plans to dispose of solid waste on the land and the land owner has
specifically granted permission for the operation of the landfill. I understand that both the operator and
land owner are jointly and severally liable for improper operations ani proper closure of the landfill as
provided for by North Carolina General Statute 130A-309.27. I further understand that North Carolina
General Statute 130A 22 provides for administrative penalties of up to five thousand dollars
($5,000.00) per day per each violation of the Solid Waste Management Rules. I further understand that
the Solid Waste Management Rules may be revised or amended in the future and that the facility siting
an to ra ion of is landfill will be requ* e o 3rpo with all such revisions or amendments.
Print Name (Operator) Signature (Operator) Date
North Carolina
Henderson County
l� Norma W. Gaillard a Notary Public for said County and State, do hereby certify
fobthat aauyr Be921ey personally appeared before me this day and acknowledged the
execution of the foregoing instrument.
�' ,p �s my hand and official seat, this WINN day of . 19
N tary Public
expires June 28 A 19 98
Fo"rlditional land owners and landfill operators, attach separate notarized certifications for each
additional land owner and landfill operator.
For Corporate land owners and/or operators, use the Corporate Certifications, pages 5 and 6. Contact
the Division of Solid Waste Management for proper applicable certifications.
PO Box 27887
to Raleigh. North Carolina 2761146
Disposition: This tam will be ttetntertad to the State Records Center when reference value ands. Records will ba held for agency in the
Stets Records Carrcar five t51 additional Years and then transferred to the custody of the Archives.
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