U0033_GAPineBluff_OOS_AFR14-15

OS 2015 Page 1 028-039D(SL)
OS State of North Carolina
Department of Environment and Natural Resources
Division of Waste Management
We ask that completed forms be returned to: NC Solid Waste Section, 1646 Mail Service Center, Raleigh, NC 27699 or by email. If you have
questions or require assistance in completing this report, contact Ethan Brown ([e-mail] or 919.707.8249).
Facility Name: Pine Bluff Permit: 028-039D(SL)
Facility Website (URL):
Physical Address
Street 1: 13809 East Cherokee Drive
Street 2:
City: Ball Ground
State: Georgia Zip: 30107
County: Cherokee
Mailing Address
Street 1: Same as physical
Street 2:
City:
State:Zip:
Primary Facility Contact Person
Name: Brian Evola
Phone: [phone] Fax: [phone]
Email:[e-mail]
Secondary Facility Contact Person
Name: Faye Jenkins
Phone: [phone] Fax: [phone]
Email: [e-mail]
OUT OF STATE FACILITY
Facility Annual Report
For the period of July 1, 2014-June 30, 2015
1. What type of facility is this?
Municipal Solid Waste Landfill Transfer Station
Construction & Demolition Landfill Treatment and Processor
Industrial Landfill Materials Recovery
Other (specify)
2. If this facility is a Transfer Station, Treatment and Processor, or Materials Recovery Facility, please indicate the facility(s) that received
your non-recycled waste material:
NAME, PERMIT #, and LOCATION (city, state) of FACILITY Tons
TOTAL
Facility Type
OS 2015 Page 2 028-039D(SL)
3. Total waste received at this facility during the period of July 1, 2014, through June 30, 2015 from NORTH CAROLINA COUNTIES.
Indicate tonnage received by COUNTY of waste origin. If waste was received from a transfer station, indicate the COUNTY LOCATION
OF THE TRANSFER STATION.
Received from Jul Aug Sept Oct Nov Dec Jan Feb Mar Apr May June Total
Clay 443.96 391.79 364.37 383.56 318.84 354.06 290.77 244.2 372.02 382.78 408.63 453.75 4,408.73
Graham 690.3 538.9 506.27 508.79 373.33 437.1 419.4 317.76 477.48 495.7 503.6 485.52 5,754.15
Grand Total 10,162.88
CERTIFICATION: I certify that the information provided is an accurate representation of the activity at this facility.
Signature:Date: Aug 31, 2015
Name: Brian Evola
Phone Number: [phone] Email:[e-mail]
Title: District Manager
Return completed forms to:
Ethan Brown
NC Solid Waste Section
1646 Mail Service Center
Raleigh, NC 27699-1646
Or by e-mail:
[e-mail]
[e-mail] Digitally signed by [e-mail]
DN: cn=[e-mail]
Date: 2015.08.31 15:36:01 -04'00'