0904T-TRANSFER-BLADEN COUNTY TRANSFER STATION SW023-0067 PARF & INVOICE 6-13-2023

SW023-0067
P0501
PERMIT APPLICATION REVIEW FORM (PARF)
Review Requested by:
Diana (Deana) Yitbarek
Date Requested:
6/13/2023
Facility Name and Permit ID
0904T-TRANSFER-1995- Bladen County Transfer Station
Applicant (Owner) Name
Description of Permit Request
[This is the action the applicant
is requesting in accordance with
NCGS 130A-294(a3)]
Bladen County
❑ (1)a. New — New Facility
❑ (1)b. New — Substantial Amendment
❑ (1)c. New — Expand Waste Boundary
❑ (1)d. New — Waste Category Change
❑ (1)e. New — Permit Less than LoS Duration
❑ (2)a. Amendment — Renewal/Review
❑ (2)b. Amendment — Change in Ownership
® (3)a. Modification — Change to Approved Plans (No CHR)
❑ 3 b. Modification — Five-year Limited Review No CHR
Permitted Annual Tonnage
<25.000
Permit Fee (New Only)
0
Date Application Received
5/24/2023
Contact Name & Title
Kip McClary, Solid Waste Director
Phone #
[phone]
Email Address
kmcclary(a)bladenco.ora
Company
NA
911 Address
1522 Mercer Mill Rd., Elizabethtown, NC, 28337
Mailing Address
1522 Mercer Mill Rd.
City/State/Zip
Elizabethtown, North Carolina 28337
Parent Company
NA
Known Subsidiaries
NA
Other known names business
has operated under
NA
Known Counties of Operation
Bladen
Does the applicant have a past
or current solid waste permit?
Yes ® No ❑ Unknown ❑
Facility Type: Transfer Station Permit #: 0904T-TRANSFER-1995
Did the permit applicant submit
Financial Assurance cost
estimates?
Yes ® No ❑ Not Needed ❑
(If Yes or No checked, copy Sarah Moutos when submitting
PARF)
Other notes
Permit modification for revised operation plan and closure plan

North Carolina Department of Environmental Quality
Division of Waste Management
Solid Waste Section INVOICE
NORTH CAROLINA
thNrorvneNNQ-w
Division of Waste Management
Solid Waste Section
1646 Mail Service Center
Raleigh, NC 27699-1646
phone: [phone]
To: KIP MCCLARY, SOLID WASTE DIRECTOR
Bladen County Transfer station
1522 Mercer Mill Road
Elizabethtown, NC 28337
Invoice Date: June 13, 2023
Invoice #: SW023-0067
DESCRIPTION AMOUNT DUE
Facility -Application: $0.00
BLADEN COUNTY TRANSFER STATION (0904T-TRANSFER-1995-)
1522 Mercer Mill Road
Elizabethtown, NC 28337
3A MODIFICATION CHANGE TO APPROVED PLANS
Total Amount Due
Pavment Oations:
Date Due: July 13, 2023
E-check - Available online at https://deq.nc.gov/swpay
Requires bank account and routing information. You will need to use the zip code in the description box and the invoice number
shown on this invoice to access your account. If a zip code is not listed, use the code: 99999 alonq with the invoice number.
Credit Card - Available online at https://deq.nc.gov/swpay
Accepts MasterCard, Visa, and Discover cards. You will need to use the zip code in the description box and the invoice number
shown on this invoice to access your account. If a zip code is not listed, use the code: 99999 along with the invoice number.
*Convenience Fee of 2.65% added to amount invoiced.
Paper check - Make checks payable to N.C. Division of Waste Management, Solid Waste Section, include Permit Number and invoice number on
check. If you are paying by electronic transfer, include the invoice number with your electronic transfer. Please return a copy of this
invoice with your payment.
Mail paper checks to:
N.C. Division of Waste Management
Solid Waste Section
1646 Mail Service Center
Raleigh, NC 27699-1646
[G.S. 25-3-506: A $25.00 processing fee will be charged on all returned checks.]
Explanation of Invoice Amount is Based on Facility's Current Permit Application:
Pursuant to North Carolina General Statute 130A-295.8 you are required to pay fee(s) based on your solid waste management activities. The fee(s) shall
be used to support the solid waste management program. An application is deemed incomplete until all fees are received.
Solid Waste Contacts:
Billing process:
Theresa Williams [phone] - Payments, e-Payments
Sherri Stanley [phone] - Fee Amounts
Regulations and Technical Assistance:
Sherri Stanley [phone] - Landfills, Transfer Stations, Compost Facilities
Perry Sugg [phone] - Land Application Sites
More information available on the web:
North Carolina Department of Environmental Quality (DEQ) - http://deq.nc.gov/
North Carolina Solid Waste Program - http://deq.nc.gov/about/divisions/waste-management/solid-waste-section
NC DEQ:WM Solid Waste Invoice Form 1-2023