79_N0150_CedarTreeLCID_Notification

�(. 1. ``r�' 1300Ctl►,JLD
`� ', �,� :?AONA H. PAGE
ROWNG
Mate of North Carcilitla OCT 1$ it 41 •aM r��
De artmetlt of Ctivit'O11111etlt, I lealt11, atld Natural Resurces 1 n Book 909, Page 300
512 North Sallshury Street 16 fialeiph, North Carolina 27GU1
Division of Solid Waste Management
)arnes 0. Hunt, )r., Governor Solid Waste Section Jonathan 1. Howes, Secretary
'1 eierftnne [phone]
LAND CUAhIMG AND INERT DEBRIS LANDFILL NOTIFICATION
Pursuant to 15A NCAC 1313 .056312)(a), file land owneris) and opersto►(s) of any Land Clearing and
Inert Debris Landfill tinder two 121 acres in size shall submit this notification form to the Division prior
to constructing or operating fire landfill. This form must be tiled for recordation in the Register of
Deeds' Office. The Register of Deeds shall index fie notification Under the name of the owner(s) of
the land in the county or counties in which lire Iand is located. The Register's seal and the date, book,
and page number of tecordinq most he included ort fills form when submitted to the Division. This
notilication is not valid to tiuthorhtl operbffon of 6 limdfiil ulrless complete, eccurbte, and recorded es
required by 10 NCAC 1311 .05511211b).
1. Facility Marne: �. .f i'� ►' �',
2. Facility location Istreel add►essl:_ y L C ^,'4
/eta;; 11
County. i
C►tv'_ t ,.,J
3. file land on which this landfill Is located Is described In the deed recorded in:
deed book: _ pager county'_ v - &
4. Name of land owner: %1/
5. Mailing address of land owner: f > 5 r L [
City: .4 (y ics /I.' State: c' y Zip: L rr44
6. Y elephone number of land
It the land is owned by more than one person, attach additional sheets with the name, address,
and phone number of all additional land owners
7_ Marne of operator:_WJ� %"/3»1 :�i oo( �R..AC +ill G1
9. Trade or business trarne of operator_Z41,49- ez ./1314011 1-1 J X ucks
9. Mailing address of operator:. 11 m M C>i i 6' 9
!V 4�s, Zip: �2 % t,
10. 1elephone number of oheratnr.l_ _q ) 0j_ _. _ 5_s �-Y --
It Ili" Iandlill is operated by more than one person, attach additional sheets Willi the name,
address, and phone rnirnber of all additional operators.
1 I. Projected use of land after completion of landfill operations:k' k-
f .0 fiox 276R7, lblrlRlt. Nrittlt Catalina 27(11-7(R7 Wrrl,rn,e 919-733 4984 fax A 919 733 0513
Ail Fgttal Ortxitttmity A f tmative /Moon V.mrlrrm
`(a.x «r t. rito� I-- .....,�.... r.r.«
tc.

1 arirnms o►7eratiNp ureter riomIC Mon
.0101 tWIN1110NS
1771 'land rinnth+p w"alfo' .,A"na Solid wonln wl+lrl, to pnnnr"lod solely Grim lend denting ar.tivitlna aticl. foot MtunipS, trnnn, timhr, brtieG,
Q.A.S. end olt."r r,Alurnlly ncctntir+p vepelo(ivfo mAl"rinl,
17.11 'lmr,d 0.1111np "rid 4n 1 dwhflr on..ditll' rnnana A fwciltty for Ill" Innd dlarnsal of l.tnff clnsri.p wants, rnnr..rsim, brick, conrtAln block.
Vnrnnlnndnfofeff roll, pravnl mr,d rock, uniteatnd end titipalnt"d wood, and yntd traoll.
1741'YA,dtrnah'rr,"w1,SSolhtwoalnra"trhinpltnmlm"Aacnpl"Pond yard innt"tanoor"'?, Atich An Its" Ilvilbot. "old al"Ill"t vegetative
r: n,Natinin,
.0003 AtrtfCAlfllity nE0k?InFMF.NIS 1`011 IAND Ct.FAnINO AND INFnt DFnnIS IICIDI IANDrIIIS
Mmn"pnninno of Innd el"Sdnp And Innd d"Grim Shall hot In orrmdenr.e w10% Ili" Simon hisrorrhy tot rnen"pinp Solid wants "A providnd for under
WC.G.S. I 130A 900.041n1. Dlrrnnmt In it i"ndllll In enn"ldnrad to Its it.. (n"St dosllnhts metl,off of rn*naptnp land risTtna and Ir,"to d"bfin. Wl,era
Inndlilli..p IS n"rsessry, it," ragtiirrn,dntn of IMA nod" Apply.
it) A„ h,tllvldrtfof pnnnit horn Il.a Divirinn of Snlld WmmtA Manwpnn.nnt In tint rmquhad for land Clanrlrip And instl D"h lm flCI0I Inndlilla that
r.nnt n11of Iola Inllowlnprondltlor,n:
lot Thn Incilily IS to hot nrarAlnd In, fh" ATmro-ml of ISnd cina.tnp wm*tm, bin0 dahlia, untrsoted wood, and yard tteah. Oralatlona
.,tint be ennnlnlent And In cnrnpllwnre with the Incnl gnvnr"mnnt *nitd wanln mannpmmnnt plmn as approved by ills Divislon
of Solid Wert" Mnr.np nn,nnl,
fill The total diepnSwl Aran In undar Iwo Arran in ahn.
Irl Thn ler.Mly And pr"r1ICA* ronrty _111i film aping crtlnrla un.fnt riuln .011,04, Slid OpnrnitnnAltagvfrsmrnte undar nuin .0000.
(dl Thn 1111 activity In not ">.empi from, sod tnumf cot"ply w111, all otl,"r red.nml, Stste, no local t*wa, ordhneneea, nulos,
rnpul"tim,M, or old",v. inclndi..p hill not Ifmit"d to zonh,p 100,1CltonS, flood plain ta"Irlellonn, wnliand rtistdctoone,
"ndlr.,nntntInn and "ro"1"n Conlrol rotgld+emm�lr., Sndlninlnp repnlntinnn.
171 Wl,a." an i,dtvtdvwt potndl to not rng!rtrad, to," Iollowinp Arnlin":
lAl It'" owns, n/ the tend where the lar,d11111m loc St"d mnSt notify 11,e Dovlelon an a pr rob"d form, duty elpntid, notarized, and
r"corded nA par null .Oti0�12)Ihl. Thm rirS,.tor of tI,* iwnff till, it dlffe.Ani from if." load ownmt, 01,0011 wino Sip. the rinitlle"tlon
lot...
fill Tl.e owner n,ttwt film Ill" p,e"eribmd nnlllirwttm, in.... lot rnr,nrd-tfa- In •t.n ringlets, of De"dit' Office. Me Mullion, of Deride
0-Ill ... few Il,s n"11fi.a110" I" ihn pr enlor 1... 1na undar If," nnms of Il.n ewnar "f ihA Innd in th* eon.ly for rounll". In which
Ihn Innd In locntnd. A .,,noy of ihn r"no f.d nolllfcn(Lr,, sfft'tAd will, the nnptata"s ."of and the date, book and PAO" numb"r
of rerrodlnp S1w11 be Sant to to," Division "1 Solid Wsnlw Msnsgencani.
fr) Wynn it'.Isnd not which it,,, inn.) CfAS,i.,p and b,rni OAh,I" "ondpll IA amid, Inannd, Cri.waynd. or h*rnaerr"d In any Mar ... "r,
th" dmsd no oil,"r 1".t.umer,l ,1 bona tar .hall cm,IwM Ir, it,, do"Crfr(fnn *Action In rip amollar 1yp" IhS,. that 11""d In ll,e body
of it," d"rid or inn hnrnnnl A Ai Alam.,n1 111st It'- prorsrly h"a bane a"wff w* a lend rfa"drip And Inart O"btlm Lon'dfill and a
rnlm.ene" by hook and PAO" in tl,n feco.dslinn "f it," r,nllllrminn.
.06114 sITINO CnlrEnfA rOn 1-AND CLEAIIINO AND INrnt DFnnin ILCIDi IANDril.l9
ihn friltowir.p 1101.0 crltetin shnit apply for la...I Ct"n.Jnp Sol Inar1 Omhtla fICID) (nndlllfo:
Ill rmrllitln* for r. nr.l icon, "I+nll nol hot locniAd 1,. it," Ion yefof IfondplMI,,,
f2) rnclltlina o, rr"cfic"n 01,011 tint esu"e nr eo,,Wbul" to Ilia tsklnp of tiny and Snpn.wff m q.tnnlm,nff rp"aoeA of 1.!atitA. 11.11, or wlidiif n.
fa) rmrllhlnsofpredicerep"lotint remutlIli film drmtntr.finnornffvnrsAmndillr.ntlonoflhActlllcmtl,ntillnlolandnnp"r"dofthreet"n"dspecies
SS Id"110fl-d In GO Crn Part 17 which In lwahy h,cnrrnrwtAd by rofa,aiwa Inr.ludtnp any oifh"equsnl mnandlnente end Adlllon*. Tt'im
mwtnriwl IS Avwtlnhla tar Innrnr.tini. at fl+s DApwtlr..mA of Envhnr.... mnl, Nnnllh, stiff Nwhnfoi nanmtrcea, DIVIAIon of Solid Wootton
Mnn"pmnm,t, 4O1 Ohn.Un no"d, rinlnipl., North Cw. ollr.S 27nP6 wham Copies Can he oho Ainnd "I no "So.
14) 1'for1111ten or rr nrticnM *limit not dmn.npn of dAatr.y Sn n.rh wn.tnpic tit for Idatmie ill allot,
If) r Ar,11111ea or p.aclir,"m "limit not rMumn an sdvnrma Impmel on to "talo pork, recim"tlon or aeonlr Minn. or any other fmr.dS Ineludnd In It's
stale nnlurA end i,imiodc rr"anrv".
101 rorlllll"e At'all not ba Incnted In nay wntlnnd SA defh,md In Ills Oman Wools, Act, Section 404(b1.
171 If must be "howl, that "dnnu"ta titillation violin "to evallnhle for covnr, either Iron nit or oft nits. .
in) land Ctnnrinp and Innd Onbrlm imw.111I a "Gaol "'Ant tons foltnwlnp riurl*ra and Ormond wAlmr regutrnn.onle:
(ill rnrtltltem no rrmcltcso nl,nli not rmfmn o dincl+o.pn of pnllnlArnts Into w"tmrM of film "Inls thnl is In vloln(inn of lhA rentibAnronta
of ihn Nnitnnnl Pnlhrinnl blact'n/pn Flln,inatlnn SYMlsrn RIMES1. tinff"r Snrllon 407. of the Man Writer Act, not nr„andnd.
(ill rartlillen for ptnclireo Shall tint ro„mo m dimcl,efpn of dredpnd mntartti►" or lilt ",elntlaf Inln wooers of Ills elate that to in
violation of it,,, rsgnlran+enlit undar S"clinn 404 no film Man Wa1mr Art, foot a ... nnded.
Ill racllili.a orptaclicnn ti11n11 tint cation nnn point Anurr." pnfhrtlnn of wolnrs of Ilia Monts tl,ml violate* assigned water rlunlily
St. ... I ford it. ,
Idl WmMI" It In it' fiffn with A dlrpna"I A."n plmnlmr Ill on Iwo nr.re*,mIioff It" pf�ecmd * n,hJtvitim a lnur Ina I! nftovs Ih" Ion opt onalidph
w Mar tab"", ""Cnpl wl,ni" tin *ltnrnmflvn ""rat Piton, 10 "prtnvmd by ill" blviminn.
1m1 Wnr,tn h, loot"IMla with A dinpnSnl for"fo inn* Ilan own Acts" "limit hm rtwcad ohnvm Ilia "national 111011 wmfnr inbi".
Ipl the (nr_illly "hall mono Il,e foloowin4 nI'll ... m. hnffar rng,ff.mm�ntn:
iA► GO f,,.I Irnm Ihn wools hmrndn.y to "It SvrinrA w"I"A of If,, Aisle AS dnfinnd In O.S. 1,4 1 712.
ib) 100 1..91 Ito... the dlnpneat mine in pmporty Ih,n*, r""Idst,110 I—nffl,lg", cotnmatOMI nr puhilr hulldinpn, "rid wmlin.
icl filmy b" md),lntnd AM neraSMnry in Inmuta rid"fluatn prolactlon of puhlir hnalth and ill" anvironm"ill.
Ion) Tl," Inclllly "limit roost oil roglrirnmnntm .f any nprlir.nhin z*ndnp mdh+nncn,
.Ornn nrrttAIIONAI hrntlonlMr.NIS f On I.AND rIFAMNO AND Mtn M111119 (1.CID11 ANDf11IS
lnn.l rinn,inp n.a1 InA,t Dnhrlw (LClll) Inn.11iflw "boll Mont Il.s folfnv.inp npmnllnn"1 rng+rhnn+enl":
11) Ors1e11011nl plan" Shall be "rproved mod Inllgwnd *m wpaciliad for Ihn lacltlty.
121 the larllily "►,all only "cr.npi Ilion" solid wmnirm whlrh It in pnnnhied In rnrnov",
Ill Solid want" "hell be tetittirind to fit" "nt"IbInt "inn Innnibla "rid rmnpoload "a dnnm"ly not prncttcal Into Calls.
2

IFI I7V (1ar"non, any, nnm .: , .............
envermd with w mtntnnn., of one toot of aullabie soil 00v"r stored to elf"w "uriwem water "Inert In " rnntr011nd mar.nrir. 11,e v o on
mwy .equlre�ls�rther action In order in Conact any condition which la Or may bacoma Inlurlmr" to fit" public health, or a nuisance to the
enmrnunity.
10) Adeguolm emolon control meaatrtea, afruetoreo, or d"vicao al."Uhe trtlllrerf to rrevant gill from lonvinc the alle and to prevent excew"Ive
on alto ernnlon.
171 prmvlat"na for a UrounJ Inver aufllcle..t to re"trwin "melon muwt tin "remn,pli"Led within 90 wnrklnU Jaya or 170 col"ndsr Jeye upon
cernplelfon of any follow" of l"r.dlll) J"v"lopmm,t.
r"vent
fill Thm facility "h"ll ba adeguntely sneered n"
nered by me"of Unfair, ehmh.n, beno fo
berme, feces, nor. tun"uthodted acce"a except when
ar. opireint In on duty. An atl"nJanl el -all be m. July "t all itmn" —I'll" ll,m 16114101 In Orrin Inv pubile too" to ensure compUsnc" with
opnr allo.al regnlren.enlw arid to prevent "ecripl anr" of unmuthotired wanton.
to) Access rode "brill be of m11 wmatl.nr cor.at.uclion end prnrmly mnir,imh,ed.
1101 Curfoea wafer "hall he dlv",fold Ito," 1h" W0411'a fee" "rid ,hall n"1 he Impound"J Over wa-le.
1111 Solid -main "Loll not boo dlmpo"rid of It, wafer.
1121 Open burnlnU of solid wmetm I" prohibited.
11,11 Thn concnntr"tlon of axploelve limne" 11"nerolnd by 11" facility "hell not exerted:
1-1 Twonty love pmrrent of flit, lower "xpfnaiv" limit for tit" Qmmea In facility atructurew.
tit) The low"r nxploolve Ifmit for film Uawe" at Ihm rt"rt,rty bmn,dery.
1t41 lrt"chnte "hall be properly n,mnaond On alim tl,rmrph the one of currrn,t he"t man"Ut,mant rtartlrme.
11 M sbottld Ili" Olvtelon deem It n"c"ww"ry, Ormond wort"r of eons," writer monllnrinp, or bell,, may bm rmgutrod an provided Inv under aulen
000t ar.d .0(107 of thlm suhcharlmr.
11 fit A "lpn whell be printed at the lariflty "Illy Mile" mLowl"I the cor,toct n"rna and number In ant, of en "n."raency and the permit number.
Tit" pmrmll numb", regrdramnnl In not arpltrobl" Inc fwc11111f," not regold"o; "n Individual rorn.it.
cer6ficetion by Land Owner -
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 tine requirements of Sections .0563..0564 and .0566 of 15A NCAC 139,
North Carolina Solid Waste Management Rules. the facility and operations of this landfill will also
comply with pit applicable f'edr±ral, State, and Local laws, rotes, regulations, and ordinances. Where
the operator is different from the land owner, 1, 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. I understand that both the land owner and operator are Jointly and severally liable for improper
one►alions and proper closure of the landfill as provided for by North Carolina General Statute t 30A-
309.27. 1 further understand flint North Carolina General Statute 13OA-22 provides for administrative
penalties of up to five thousand dollars (f5,000.00) per day per each violation of the Solid Waste
iJlnnaga"rne►It flutes. 1 fertile, understand flint the Solid Taste Managerriant flutes may be revised or
amended in the futitre and that the facility siting and operations of this landfill will be required to
comply with all such revisions or amendments. ,+
Print Name lowlier) Signature (Owner) Date
North Carolina
1 a Nditiry hublic for said County and State, do hereby certify
personally appeared before me this day and acknowledged the
,tat µ
due exec>1d+'dp,f the foregoing instrt)rnent.
Witness my Its* old officin) seal, this the _ day of ���
>, — -,.
(Official Senl1
Notary Public
My commission expires__
41

1303
I certify that the Information provided by me In this notification N true, accurate, and complete to the
best of my lcrlowledpe. The facility si(lrtg and disposal operatlons of this Land Clearing & Inert Debris
landfill will comply with the requlretmhnts of Sections .0563, .0564 And .0566 of 15A NCAC 136,
North Carolina Solid Waste Management hules.'ire facility and operations of this landfill will also
comply with all applicable r-ederal, Stale, and local laws. rules, regulations, and ordinances. I have
irlforrrlpd the land owner of my plans to dispose of solid waste on the land and the land owner has
specifically pranted permission for the operation of the landfill. 1 understand (hat both the operator and
land owner 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. 1 further understand that North Carolina
General Statute 130A-22 provides for administrative penalties of up to five thousand dollars
(S5,000.00) 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 will be refluirpd to comply with all such revisions or amendments.
Print Name (Operator) Signature (Oppratnr) Date
North Carolina
Ao cA Al /trri Count
r
1 w , a No ary�4�Fis fo said County and State, -do hereby certify
tha / personally appeared before me this day and acknowledged the
due execution of the foregoing Instrument.
Witnes_s,m.y..hand and official seal, this the day of ze�i '
10MicLiI SPaII:��r ;-
` Notary Public
My commission expires Of" V rlQ 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 certifications.
1NsrnvcrloNg ��3141578��
pvrpnwn' Motlllrntlnn of Lwnd Vowing wnd Inerl bnhrlw 1.wndllllw nndwr two IS.; wrrew In wlrw to rerfulred tonn6 NCAC 1340 �jy
06A,11711.1. Cnnlnrl Il'w Anrl,l Wwwlw Awrtlnn wl If," wd.lrwww hwln•v to, hrrll.nr lnlormwllnn, Ci `.3•
plwlrlhuNnnt Mnfl rnmpinlwd rnrnrdwd nrlpinwl rmllllrwllnn In It," tnitnwlnp wddrwww: 1�7
gab
010.10n nl fielld Ww01w Mwnwpnrnnnl •S w Aa
Solid Wwwle Serllon
1`0 flow 7711117 \ a� �C-j
flwlnllih. Nnith Cwrollne 77011.1097
pinrnwllfrim 11,10 loan will hn Irnowlennd 1. Ili" Slnln nnrordw Cenlwr whop inlnrwnr.n vwlun nndw. nnenrdw will hn held Inv epnncyln the
St on nncnTde Cnnler tivn 161 wddillnnwl ynwrw rn+d Ihnn lrwvrwferred to the cuelndy of the Arelrlvee.
North Carolina — Rockingham County
The foregoing certificates of Teresa F. Dick, a Notary Public of Guilford, N. C. are
certified to be correct. This the 18th day of October, 1994. A
Ramona H. Page, Register of Deeds
1 �: Asst.
$2.00 Probate Fee Pd. By:
$12.00 Rec. Fee Pd.

Stage of North Carolina
Department of Environment,
Health and Natural Resources
Division of Solid Waste Management
James B. Hunt, Jr., Governor
Jonathan B. Howes, Secretary
William L. Meyer, Director
November 2, 1994
William Dick
P. 0. Box 191
Madison, NC 27358
Ref: Land Clearing & Inert Debris Notification
Mr. Dick:
A74iij
;I
�EHNR
��Z3456 )ai
NO
0 N
RECE�VEO
v/
The Solid Waste Section has received your Land Clearing and Inert Debris landfill notification.
As long as your disposal activities remain under 2 acres, you may operate under the provisions
of this approval. If your landfill disposal activities grow in size to more than 2 acres, please
contact the Solid Waste Section for assistance in obtaining an individual permit.
If this property is sold, leased, conveyed or transferred, the deed or other instrument of
transfer shall contain in the description section, in no smaller type than used in the body of the
deed or instrument, a statement that the property has been used as a Land Clearing and Inert
Debris landfill.
Amendments or revisions to the Solid Waste Management Rules or violation of groundwater
standards may necessitate modification of the construction and operation of this facility or
closure of this facility.
This approval is not transferrable.
The Land Clearing and Inert Debris landfill is permitted to receive:
• Land Clearing Waste as provided for in 15A NCAC 13B .0101(72); stumps,
trees, limbs, brush, grass, and other naturally occurring vegetative material.
• Inert Debris and untreated wood as provided for in 15A NCAC 13B .0101(73);
concrete, brick, concrete block, uncontaminated soil, gravel and rock, untreated
and unpainted wood.
• Used asphalt as provided for under North Carolina General Statute § 130A-
309.09B(a)(1); used asphalt or used asphalt mixed with dirt, sand, gravel, rock,
and concrete.
Site preparation and construction shall be in accordance with 15A NCAC 13B .0564, Siting
Criteria For Land Clearing and Inert Debris (LCID) Landfills.
P.O. Box 27687, Raleigh, North Carolina 27611-7687 Telephone [phone] FAX [phone]
An Equal Opportunity Affirmative Action Employer 50% recycled/ 1 o% post -consumer paper

The facility must be operated in accordance with 15A NCAC 13B .0566, Operational
Requirements for Land Clearing and Inert Debris (LCID) Landfills.
All sedimentation and erosion control activities shall be conducted in accordance with 15A
NCAC 4, Sedimentation Control. Construction and operations involving sedimentation and
erosion con ppp ivities greater than 1 acre typically require approval from the Land Quality
Section.-gbrirtact t'h1;1L- nd Quality Section to determine if your activities require approval.
Ground water quality at "this facility is subject to the classification and remedial action
provisions of 15A NCAC 2L,'. Classifications and Water Quality Standards.
If you have any questions or if we can provide any other assistance, please do not hesitate to
contact1he Regional Waste Management Specialist, Mr. Hugh Jernigan at [phone].
Thank you,
Susan Wright
Approved:
L&1104 C C—tZ4�L
te
s C. Coffey, Sup i r
ing Branch
Solid Waste Section
copy: Steve and Jean Puckett - Land owners
Hugh Jernigan - DSWM
C AW RIGHT\LCID\NOTIFY\DIC K.1