25I_Cieszko_LCID_AFR13-14

LCID 2014 Page 1 25-I-LCID
Facility Name:Cieszko LCID Permit: 25-I-LCID
Physical Address
Street 1: 1090 NC Highway 101
Street 2:
City: Havelock
State:North Carolina Zip: 28532
County: Craven
Mailing Address
Street 1: PO Box 690
Street 2: 249 US Highway 70 West
City: Havelock
State:North Carolina Zip: 28532
Primary Facility Contact Person
Name: Martin G. Cieszko
Phone: [phone] Fax: [phone]
Email: [e-mail]
Billing Contact Person
Name: Same
Phone:Fax:
Email:
1. Tipping Fee: $75.00 per Tandem truck
Tipping Fee: $100.00 per Triaxle Truck
Tipping Fee: $125.00 per Quad, Quint, or Dump Trailer
2. Estimate the amount of waste taken in an average week at this facility?70
3. How many weeks did you operate this year? 50
4. What are the hours/days of operation for this facility? 07:00 to 15:30 Monday - Friday by appointment
5. What is the acreage of the footprint of the waste on site as of June 30? 5.7 Acre(s)
CERTIFICATION: I certify that the information provided is an accurate representation of the activity at this facility.
Signature:Date: 1 July, 2014
Name: Martin G. Cieszko Title: President
Phone Number: [phone] Email: [e-mail]
REMINDER: According to (G.S. 130A-309.09D(b)), this
report must be sent to the Regional Environmental Senior
Specialist for your area and a copy of this report must be
sent to the County Manager of each county from which
waste was received.
Please return your completed report to:
Ray Williams
127 Cardinal Drive Ext.
Wilmington, NC 28405
phone: [phone] email: [e-mail]
6. Did your facility stop receiving waste during this past Fiscal Year? Yes No
If so, please report the date this occurred:
tons
cubic yards
LCID State of North Carolina
Department of Environment and Natural Resources
Division of Waste Management
LAND CLEARING & INERT DEBRIS
LANDFILL
Facility Annual Report
For the period of July 1, 2013-June 30, 2014
According to (G.S. 130A-309.09D(b)) completed forms must be returned by August 1, 2014 and a copy of this report must be sent to the
County Manager of each county from which waste was received. If you have questions or require assistance in completing this report, contact
your Regional Environmental Senior Specialist.
LCID 2014 Page 2 25-I-LCID
Instructions:
NC DENR
Division of Waste Management - Solid Waste Section Risk Assessment Form
Facility Name: Cieszko LCID Permit: 25-I-LCID
Address: 1090 NC Highway 101
City: Havelock State: North Carolina Zip: 28532
Date: 1 July 2014Person completing Assessment: Martin G. Cieszko
Phone Number: [phone] Fax: [phone] Email: [e-mail]
Please indicate either Yes or No for each Receptor and Post Closure Maintenance question. Then please
determine the distance or distances for each Receptor from the Edge of Waste (using range finders and/or GIS
maps) and type that information into the form. Please attach additional information including GIS maps, lists of
potable well locations, etc.
Receptors
1. Are there Residential Dwellings Within 1,500 feet of the Edge of Waste?Yes No
If Yes, how many?
What are the three closest distances from the Edge of Waste?Feet Feet Feet
2. Are there Potable Wells Within 1,500 feet of the Edge of Waste?Yes No
If Yes, how many?
What are the three closest distances from the Edge of Waste?Feet Feet Feet
3. Are there Community/Municipal Wells Within 1,500 feet of the Edge of Waste?Yes No
If Yes, how many?
What are the three closest distances from the Edge of Waste?Feet Feet Feet
4. Are there Surface Water Bodies Within 1,500 feet of the Edge of Waste?Yes No
If Yes, how many?
What are the three closest distances from the Edge of Waste?Feet1005 Feet1050 Feet1650
Please list the names of the water bodies: Hancock Creek
5. Is Public Water Available Within 1,500 feet of the Edge of Waste?Yes No
If Yes, how many of the Residential Dwellings noted above are connected?
Corrective Measures
6. Is there an active methane extraction system (blower, flare, etc.)?Yes No
7. Is there a passive methane extraction system (trench, vents in cap, flare, etc.)?Yes No
8. Is there groundwater remediation taking place on site?Yes No
If Yes, what is the specific remedial technology used?
Comments