N1031 ROY LAIL DUMP SITE

�JIUIG Vr ..v,... -.. _ _
Department of Environment,
Health and Natural Resources
Division of Solid Wcste Management
James 6. Hunt, Jr.. C-overnot
Jonathan 8. Howes. Secretary
William L Meyer, Director
LAND CLEAgING AND (NEAT DEBRIS LANDFILL NOTIFICATION
FOR REGIBTRg7ION REGfSTFR OF DEEDS
ELIZgBETH T COOPER
200�UFEB 2�U09Y21 N05 qM
BK 1091 PG 530-532 FEE 5s17 00
INSTRUMENT p 2002003120
Pursuant'to 15A NCAC 13B .0563(21I91, th! land ownerlsl and operator(sl of any Land Clearing and
Inert Debris Landfill under two (21 ACrls In Size shall submit this notification form to the Division prior
to constructing or operating thA landfill. This form must b! tiled for recordation in the Resister of
Deeds' OtficA. Th! Register of 6Aeds shall index the notification under the name of the owne�(sl of the
land in the county or counties in which thA land Is located. ThA Register's seal end the date. book, and
page numbAr b{ rAcording MUAt bA inciuddd on thi3 form when submitted to :he Division. This
not cation la hot va to out otizA bplratlon of a landfill unles3 complete, accurate, recorded, and
aubmitted td the blvialaH As required 6y 15A NcAc t3B .056312)1b1.
1. FAcil(ty Name: r, r_ � u ' �' , `-'
2. Facility location Is;relt Addrlssl: L132�a1 �u� (,re�K. ��
City: ��N� � � ��� S County: t31�riC� _Zip• 2Z�i !> f L-
3. Directions to Site:_ Frr+nn Sl2 hy0 Cula hreelG C;«I< �Iw� �.+�� 52
�I�Ll1 ('ub frrvi� S-1 ��ii-e o5 a'� Fr�C e,� fuh �^tell St,
4. ThA land on whi��'j, this laitdhl► is located is described In the deed reocorded in:
-- --•'deed book: b � � paae• g'�'3 county !� wJ? ��
5 Name of lend owner: �n �A I � n -
6. Mailing address of IAnd owner: �t �`2��1 Cr: � L.''� �+�
city: f�_5n��s State: �s�d� C4�aI ii.r .Zip• Z2� 4,f Z
7. TelephonA numbar bi IAntl 6wnerl � Z�ic 1 � I � � Z `I � ?� -
�If the land is owned by morA than dne person, attach additional sheets with the name, aadress,
'and phone number of All Additional land owners.
8 NamA of operator: A{ � � � � —
E. Trod! or business name o{ operator: �' � i1 � 1
10 Martino address of operator: .� � la (-C V1LT t-�� tw+? f (~.�r�- � -
CirrYYwrc''/. ^1`�'UiJ State• /�C- Zip: rRii �C/SS
It the landfill is operated by .-ore than one ��•;; � aduitional sheets •Nlth the name,
address, And phone number of Ail additional operators. j
12. Projlc:ed us! of land After complenon of landfill operations• � �Ci�4
PO.Eox2i667.f<c:eich.PlcrfhCcrcl'me27611-%toi Telechcne9lo-i�3-�::6 F=C+1S-;1-:FCS
An _�:.w^,Coo-� ihi A:me!ive Ae•tcn Eme'erer '_C: ecrc'ed; 1C: cos to^:: e' xox'
�_ �.. . /!1 G�
C'>

161' Aaewau rostonc ^_a measures r..ucwr� ��-
on 9N ereflpn.
pl � ProviNon/ for 11�- �vN ful!Itlnt t0 dfmin trmion moat Di aeeomplished wrthm JO working days ar 1 M ealencu days uan
comp cam o mr pro o arWpl dNNapmint.
181 the 1 Nul b1 IefautW !lrurNl br m11td of plies, shams, berms. leneu, eta la prevent uneutharited ar_.a esca[ when an
operator o on .r ... na n. f w , r n ar pun v: us to essua rreuanee wnh
opentlenN riquirimtr;f and ea prNMt ltxeptinea of unauthorl:ld wastes.
191 Aeces! rA{d! fhil i18i {I•wa{mh etmslmt4lm and proPe�7 maintained.
1101 stirUd wlflr ahf/ :f Qrertad hem th1 weekNq Ilea {nd shop not be impounded over waste
Il n olid waste alu riot ea tpfornea In wlfk.
11 � pm won ptxept
It �I a cone n n . aaptoerve gaeef ganlretld 6Y �e IacRiry chap na[ iaeeed:
Iel twemr-live /arch! el dti bwlr IaplosWa dmit for tn1 gases In I/elary nruemes
lbl th1 lower Inlosiv/ Imk fa fit g1ltl at Ma property boundary
It al Uachlte Nt11 e1 ewclrlr mMo011 Oh ahl tlrmph the the of cutnnt best management princes
t151 S6ou� tom rt naeasaarY. with dr surface whir monitoring, or both, may be reamred as provided lar under aules
0601 a � =+f uaCup.lt
n 61 A sign Phil 6! pertle at tn1 Ndllr 1nMnei NrowMq Me aonotz name and number in cafe of an emergency and :he permit number
the Pan'K remteir n_+Iramerrt U dot appleable Im lacaldas not requiring an InAvidual permit.
Certification by Land Owner:
I certify that the infor-anon provided by me in this notification Is true, accurate, and complete to the
best of my knowledge. The tacilir/ Siting And disposal operations of this Land Clearing &Inert Debris
landfill will comply with the fldulrements of Sections .0563, .0504 and .050"0 of 15A NCAC 138,
North Carolina Solid �YAS:e Management Rules. The tacility And operations of this landfill will also
comply with All Sppfica5ie Peder8l, StatA, And Local laws, rules, reaulatians, and ordinances Where the
operator' 19 diffltAnt f:ari the Isnd eWner, I, the land owner, have knowiedae of the operator's plans
to dispaSA Oi Solid was;S on the land And I specifically grant permission for the operation of the landfill.
I understand that bo;h the IAnd owner And eperatot Are jointly and severally liable for improper
operations and prone: closure of the landfill as provided for by North Carolina General Statute 130A-
309.27 1 futther unde:tand that North Carolina General Statute 130A-22 provides far administrative
penalties of up to five thou411nd dollars 195,000.001 per day per each violation of the Solid Waste
ManagemEnt RuIAS. I tutther understand that the Solid Waste Management Rules may be re•yised or
amended in the tuture And that the facility siting And operations of this landfill will 6e required to
com ly' wfth EII Suca revisions or Amendments.
Print i aura (Owner► Signatur (Owners Date
North Carolina
2.Q County
I,� (7 ,��� t✓ KCz/�--A Notary Public for said County and State, do hereby cerrfy
1,,�, I-u Js o R., La.i I �) ��-Oxa--2e ,¢ a.�
that � pe��gaiad-before me this day an acic owiedoed the
due execution of,the forecoinQ in3trument.
Witness�gj��handy�and��o{ficiel seal, this the � day of t �.�i,L(l%!/L� � (JDa
:,�:�' �' "�"� Notary Public
1 �D/ .:°8� `li
1�� �! 3��y4J

Filed For Registration•
Book.
Document No.:
Recorder
ELIZABETH T COOPER
REGISTER OF DEEDS, BURKE
JUDICIAL BUILDING
201 SOUTH GREEN STREET
MORGANTON, NC 28655
02121/2002 09:21.05 AM
RE 1091 Page: 530-532
2002003120
LNDFIL 3 PGS $17.00
THOMAS BRENDA
State of North Carolina, County of Burke
The foregoing certificate of TERESA S CHAPMAN Notary is certified to be correct This 21 ST of February 2002
ELIZABETH T COOPER�,�JREGISTER OF DEEDS
BY �� / CJ��tl%
DsPnty'IAssistant Register of Deeds
*2002003120*
2002003120
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