N1015 DANNY YOUNG

_ � �
' � State of North Carolina FILEO
•�� Department of Environmen�L1zAl3F?hl T r_,npnL-R
• Health and Nctural Resources ��� b/ �,���6 � � i
Division of Solid Wcste Manageme,
�6 SEP 13 �,P�1 %,5�+ ��
James 6 Hunt, Jr ,Governor �� � � �- -p"- p E H N 1�
Jonathcn B. Howes, Secretary GISICR Oi U, � C�"
William L Meyer. Director BUKKF c(r , N r
LAND CLEARING AND INERT DEBRIS LANDFILL NOTIFICATION
Pursu9nt to 15A NCAC 138 .0563t211a►, the land ownerls) sand operator(sl of any Land Clearing and
Inert Debris Landfill under two (21 acres In size shall submit this notification form to the Division rp for
to cori"strutting or operating the landfill. This form must be filed for recordation in the Register of
Deedsr Office. The Register of Deeds shall Index the notification under the name of the ownerlsl of the
land in the county or eoun;ies in which the land is located. The Register's seal and the date, book_and
page number of recoreing must be included on this form when submitted to thn Division. This
hotlficat on is not valid to authorize operation of a landfill unless complete, accurate, recorded, and a•,
s3ubmittAd to the Division as required by 15A NCAC 138 .05631211b1.
1. facility Name:___�_�,d,
2. facility location Is:reet addre sl: � "�
City: or County: as- �— Zip:.
3. Directions to Srte• �� � a r d S /(/ai
d.
' 5.
6.
The land on which this landfill is located is described In the deed recorded in:
deed book: .3,5'8� - - page: 2/ li county: ,�a✓�{i
Telephone number of land owner:J_,�9' "( 1 (o �—Z �
' If the land is owned by more than one person, attach additional sheaf's with the name, address,
and phone number of all additional land owners.
B. Name of operator:
9. Trade or business name of t
t0. Mailing address of operator•
11. Telephone number
! State• �%� .� Zip: Z�'c ©� -
rt ?�Y I J'S7 G Z9,T
If the landfill is operated by more than one person, attach additional sheets with the name,
8ddress, and phone number of all additional operators. 4 - -
12. Projected use of land after completion of landfill operatlons:� ✓ � � � /7 ���
P O.Sox 2i6d7. Rcleigh. North Carolina 27611-76fl7 Telephone [phone] FPJ( 919-71�3605
Ar _c..:.i Ccx^. nity A"rmclrve Acticn EmFloyer SC°6 recyclfdl i9°kP�l�ortoc>�.e r�
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I61 ' Adnpuate erosion ccr_:i measures s:vctures, or devrtes shall be unlixed to Orevent Silt tram taavtng the eitd end :o prevent axcesswe
on min eroson,
1)1 Prpwstons tat a grounc :over sulh: en[ tp restrain erovon must be accomDhshed within 30 working days or 120 calenear days upon
tamp anon o any D^ase o andldi devaloDman[
191 The faugry !hap be acspuately sec.red by mearu pf gates, chains, berms, fences. ate to prevent unauthorized access except when an
oDero[or a on u:v ,.n a en ant sna eon u y fines w i e e n n or Du is use o aasue comb ran[e wnh
apaauonal raQurtamer•s and to prevent acceptance of unauthonzed wastes
191 Aecess roads !hall be of all-weetner cpnstrunion and properly maintained
I101 Surface water shall bs drvened !rain the working face and shall no[ be impounded over waste
1111 fiohd waste shag net oa pisoosad o In water
1121 Pnn ummg o soup waste rs promorte
1131 a eoneantra[ton o asp psrve gases generated by the facility shall not exceed•
Ial Twan[yrwa oercent of the lower exDiostve Ilmtt far the gases in Iae6iry ltructures.
(bl The lower exPlotiva Emit for the gases at the property boundary
1141 � Leetduta shall be pre:erly managed on site through the use of currant bee[ management practices
It 51 t e rvuion teem rt necessary, gro d water or surface water monl[oring, or both, may be repaired as prowdad far under aulas
.0601 an o, :.`.�s u c apter-
1161 A argn ahatl he poster it the faciliry entrance showrnq Ns contact name and number in rase of en emergenry and the permit number
The permit number rettnrement is not applicable for latdidns np[ rapwnng an Indmdual permit.
Certification by Land Owner:
I certif that the Information provided by me in this notification is true, accurate, and complete to the
best of my knowledge. The facilir/ siting and disposal operations of this Land Clearing &Inert Debris
landfill will comply with the requirements of Sections .0583, .0564 and .0566 of 15A NCAC 138,
North Carolina Solid 4Vaste 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 Is different from the land owner, I, the land 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.
1 understand that both the land owner and operator are Jointly and severally liable for improper
operat one 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
penaitlr}s of up to five thousand dollars (S5,000.001 per day pf;r each violetion of the Solid Waste
Menagement Rules. I further understand that the Solid Waste Management Rules may be revised or
amehded in the future and that the facility siting and operations of this landfill will be required to
comply with/fall Such revisions or amend eats /��//� t
X Print Name (O ner) SigAature f0 n r) D a : •r��•'i^
.� 3':, 0 1
North Carolina
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that
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_ County `, �`'� , , 0 �� .'�r S�
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J a Notary Public for said County end State, do hereby'G�_r[�y�i�t:�-�'v�,.�l
personally appeared before me !his' day and
due execution of the foregoing instrument.
Witness my hand and official seal, this the
(Official Seal1
8TA'P'' ^i lifi^7rr r,nnr .rn tt�y,7 r6�1►.//-. V
_day of T;,, -aK-pin • r,•,r�.:--� � _, BEd( yncr�.l.�,
an I,e am a r- rzzcc.::] t�. `�'s�
Notary Prubl'le,-„��__ �dxye - Iq%'��
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19 � ,, y � Ft�.:r�tu�
My commission expires----_�/��i . c/oo
North Carolina -Burke County �a-`-i��
�;
I, Shirley B. McCurry, a notary public of said county and state do certify-tha't
Eddie D. Z]mne>:man, personally appeared before me this day and being duly swoz'rt,
stated that in his presence Virgil C. Young,, signed the foregoing >_nstrumen�
Witness my hand and official seal this the 13th day of September, 1996. c,=j
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My Comrtussion Expires: July 20, 1999
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