N0056 APAC-CAROLINA, INC.

17 9 ►un.
S+'t tiEW
�.F HANpYE.. CO. it
OCT 21 P17 2 e22
State of North Carolina
Department of Environme. t, Health, and Natural Resources
512 North S&dxwy Street a Rakfg(s, North Carolina 2704
ILh. Govetttor Division or Sold waste ManWment
ames Solid waste Section )onathart R Howes, Secretary
000091 Td+y- Ols) 73349%
LAND CLEARING AND WERT DEBRIS LANDFILL NOTIFICATION
Pursuant to 15A NCAC 13B .0563121(a), the lard owner(sl and operators) of arty Land Clearing and
Inert Debris Landfill under two 12) apes in size Shan submit this notification form to the Division prior
to constructing or operating the landfill. This form must be fled for recordation In the Register of
Deeds' Office. The Register of Deeds sham index the notification under the name of the owner(s) of
the land in the county or counties in which the land is boated. The Register's seal and the date, book
and page number of recording must be included on this form when submitted to the Division. This
notification Is not valid to authorize operation of a landfi7 unless complete, aec urefe. and recorded as
required by ISA NCAC 13B .0563121(b).
1. Faalityliame: Blue Clay Site
2. Facility location (street address): Dairy Farm Road
la*lt Cape Fear Townshieamtr. New Hanover 2iD' 28429
3. The lard on which this landfill is located is described in the deed recorded in:
deed book: 1787 paw. 0083,0087 cmmtr New Hanover
4. Name of land owner: APAC—Carolina, Inc.
5. Mailing address of land owner: P.O. BOX 399
City Rinston Stare. North Carolina Zo. 28502
6. Telephone number of land owner:) 919 1 527-8021
If the land is owned by more than one person. attach additional sheets with the name. address,
VW phone number of an additional lard owners.
7. Name of operator. APAC—Carolina, Inc.
8. Trade or business name of operator. APAC—Carolina, Inc. — Wilmington Branch
9. Mailing address of operator. P.O. BOX 399
City: Kinston State: North Carolina 2Sp: 28502
10. Telephone number of operator.! 919 1 527-8021
If the landfill is operated by more than one person, attach additional sheets with the name,
address, and phone number of an additional operators.
11. Projected use of land after completion of landfill operations: To allow naturally
occurring vegetative material to cover.
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The following are the applicability. situp. and operv*gWfiJda for Land M r and Inert Debris
Landfills operating under notification.
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Certification by Lard Owner
-
I certify that the information provided by me in this notification is true. accurate. and compete 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 1SA 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. slid ordinances. Where
the operator is different from the land owner. 1. that land owner. have knowledge of the operator's
Plans to dispose of solid waste on the land and 1 specifically grant permission for the operation of the
landfill. I understand that both the Isltd owner and operator we jointly and severally liable for improper
operations and proper closure of the landfill as provided for by North Carolina General Statute 13OA-
309.27. 1 futfner 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 and operations of this landfill vril be required to
comply with all such revisions or ameldMonts.
N.E. Loftin
Print Name IOwrwl Signature (Owner) Date
North Carolina
Lenoir County
1. Levellyn D. Bradshaw a Notary Public for said Coal" and State, do hereby certify
that N- E. Loftin personally appeared before me this day and acknowledged the
dke execution of the foregoing Instrument.
hand and official seal, this the 11th day of October 994
0
N
ion expires October 5 . 19 95
STATE OF NORTH CAROLINA
New Hanover County
the Foreadng/ M11rsW catna a(e) d
l L
Y1If.1 Nn S
V
Ndary Itiehnm) PUMk ts/ ueectlaed
Y be correct. O y,
19
q.`2 fls� /ol.�`edMer.fd tJe
deputy/A�a1A

• 'r ..
823 0177
Certification by Lando Operaw Of differerht from Owned:
I certify that the information provided by me in this notification is true. atxheate, and complete to the
best of my knowledge. The facility situp and disposal operations of this Land Clearing i Inert Debris
landfill will comply with the requirements of Sections .0563..0584 and .0566 of 15A NCAC 136.
North Carolina Solid Waste Management Rules. The facility and operations of this landfill will also
comply with as applicable Federal. State. and Local laws. rules, regulations. and ordinances. I have
informed the land owner of my plans to dispose of solid waste on the land and the land owner has
specirwallY granted percussion for the operation of the landfill. ) understand that both the oparstor and
land owner are jointly and severally fable for improper operations and props closure of the landfill as
Provided for by North Carolina General Statute 13OA-309.27. I further understand that North Carolina
General Statute 130A-22 provides for administrative per of of up to five thousand dollars
IS5,000.00Iper day per each violation of the Sold Waste Manapanalt Rules. I 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 revisions or anhandrrterhts.
Print Name IOperatorl Signature IOpereterl
North Carolina
L
County
L a Notary Public for said County and State. do hereby certify
that personally appeared before no this day and acknowledged the
due execution of the foregoing instruem.
Witness my hall and official seal. this the
IOffieial Seal)
day of . 19
Notary Public
My cormnission expires . 19
For additional 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 ca&w4tims.
aetwenww
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5 N Re "c: k- IN HOtln.d levee am Ul MINIM Y ter eeebdr s/ tlw AfghkM
4

PAGE
Certification by corporate Lend Owner. 1 8 2 3 0176
1 certify that the information provided by rm in this notification is true. accurate. and complete to the
best of my knowledge. The fsc8ity ailing end disposal operations of this Land Clearing & Inert Debris
landfill will comply with the requirements of Sections .0563..0564 and .0566 of ISA NCAC 138.
North Carolina Solid Waste Mrtapemem Rules. The facility and operations of It,A le Well will also
comply with erg applicable Federal. State. and Local laws. miles. reg llIbOr s. and ordinances. Where
the operator is different from the Corporate land owner. the corporate land owner. has knowledge
of
the operators Plans to &$Pose of solid waste on the land and is specific�y granted permission for the
operation of the landfill. h is understood that both the corporate land owner and operator are jointly
and severally liable for improper operations and proper desure of the ral isrudfIn as Provided to by North
Carolina GeneStatute 130A 309.27. III Is Grticar Oabarstacd that Noll Carolina General Statute
13OA-22 Provides for Penalties of up to five thousand dollars ($5.000.001 Per day Per
each violation of the Sorel Waste Management Rules. It is further understood that the Solid Waste
Management Rules may be revised or amended in the future end that the facility siting and operations
Of this landfill will be required to comply with all such revisions or amendments.
10-11-94
Date
Attest
�V1Lam V. Marshall Roberts
t16e Vice esident Name It rinU Caporate� (Print)me (Prin
pp
President or v president Signature Corporatit%VIsetary Signature
North Carolina es �t:
Lenoir County
1._. Lewellyn D. Bradshaw a Notary Public for said
)tss't County and State. do hereby certify
that ci . Marshall Roberts (name 0140;1ery) Personally appeared before me this day and
acknowledged that he RR ) ii uaeuatuy of "AC —Carolina, Inc. 61111111ol
Corporation). a corporation. and that by authority duty given and as the as of the corporation. the
forgoing instrument was signed in its name by its Vice -President
(president or
Or
Baled with its corporate seal, and attested by himself ietlunso as itaruscretary.'
d end Official sae. this the llth day of
expires October 5
ED=IMM
10 94

300K PAGE
Cr rice at by Corporate Lerida Operator Gf different horn Dvrrerle 8 2 3 0 1 % 9
I cartify that the information provided by me in this notification is true. mcorm. and conhpbte to the
best of my knowledge. The facility sftinp and disposal operations of this Land Clearing i Inert Debris
landfill with comply with the ►ima irrnents of Seetiore .0563..0564 and .0566 of 15A NCAC 138.
North Carolina Solid Waste Management Rubs. The fa"w and operations of this hani fll will also
comply with all applicable Federal. State. and Local lawn, tubs, regulations, and Wdrantes. The land
owner has been informed of plans to dispose of solid waste on the b W and the land owner has
gwAfcaiy 0canted Permission for the operation of the landfill. It is understood that both do gmmor
and land owner are jointly and severely iabb for improper operations and prapr closure of the land
as provided for by North Carolina Genial Statute 13GA-309.27. It is further Understood that Nordin
Carolina General Statute 13OA-22 provides for adenin istr"" penalties of up to five thousand lairs
1$5.000.001per day per each violation of the Solid Waste Management Rules. It is further understood
that the Solid Waste Management Rules may be revised or amended n tha funrs and that the f&C*W
siting and operations of this larmif ll wig be required to eomplY with el such revisions or amendments.
corporation Name Wrnu
(Corporate Sealf
President or Vwe-President Name (Prim.
PresWanR or Yrce-14asiaent Signature
North Carolina
0
Attest:
Corporate Secretary Nana (Print)
Corporate secretary Somiture
l _ a Notary Pubic for said County, and State. do hereby m W
that
(name of secreteryl Pwsmaiyapwared before me this day and
aekrawliKAWd that he for she) is secretary of sere of
corporation), a corporation, and that by authority duly given and as the act of the corporation, the
forooma instrument was signed in its name by ffs (president or
vice-WesWenu. sealed with its corporate teal, and attested by hfmsw for hms*W as its secntery.
Witness MY hand and official seal. this the day of . 19
(Official Seal)
Notary Pubic
My commission aspires, 19
6