YWN-35-004_20201111_Notification

11/2/2020 New Submission
Yard Waste Notification - New Facility
Pursuant to 15A NCAC 13B .1401(a), this provision applies to facilities that accept, store, or produce compost or mulch from yard waste.
Pursuant to 15A NCAC 13B .1402(g)(1), the owner or operator of any Type 1 Solid Waste (yard waste) facility which occupies less than two
acres of land and be limited to no more than 6,000 cubic yards material onsite at any one time, including finished product, shall submit
this form to the Department prior to operation.
1. Facility Name: *
CLEO F')r-
2. Upload aerial Photographs are available from most county tax or planning offices
photograph of the site Upload
Requirements:
a) Must be a scale of 1 inch = 400 feet or less
b) Must show the area around the proposed facility for at least 025 mile
3. Physical Address of Facility
Street 1: *
Street 2:
City: * l r t County:
State: NC i Zip code:
Latitude/Longitude: Use current location or Specify coordinates
4. Primary Facility Contact Information
Name: *
Contacts Title:
Phone:* (?) 9�� �')"/�o - `?� Fax
Email: *
5. Property Owner Contact Information
Name: *
Phone:* (?) 7 ,f �� L`r Fax:
Email: �- —

1112/2020
New Submission
Street I. -
Street 2:
City:
State: NC Zip code:
6. Site Manager Contact Information
Name:
Phone: # (') q— Fax
Email:
Street 1:
Street 2:
City:
State:
7. The land on which this facility is located is described in the deed recorded in:
Deed Book: * / § 13, 1 Page: * = County:
8. What types of yard waste will be accepted at this facility?
check all that apply" Land Gearing Debris Yard Trash Q Other (specify)
9. Provide the approximate anticipated quarterly volumes of yard waste (cubic
yards) for this facility:
Quarter
June 1-August 31
September 1-November 30
December 1-February 28
March 1-May 31
Cubic Yards Received *
Cubic Yards Removed *
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SGG f200
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1112J2020
New Submission
10. Will this facility be a
temporary holding site or
is material processea on-
sfte7'
11. If this is a temporary
holding site, list the
name(s) of the facility (or
facilities) where the
material will be taken to:
12. Describe the
composting process to be
used and the end use of
the finished compost
product: *
13. Describe the mulching
process to be used and
the end use of the finished
mulch product:*
Certification
Q Temporary Holding Site )(Processed on -site
The description of the compost process must minimally include formation of windrows and annual turning of compost (i.e.
passive composting). Temperatures of each new pile must be monitored to maintain a temperature of at least 1317 for
three days_ If additional processing is done, explain briefly (e.g. usage of tub grinder, monthly aeration, etc.).
on I Y Sm .�! / Con U" Za) 7'_ Cevn/0cs�- i5 G /7 VAC
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i� also
The description of the mulching process must minimally include a description of the process, usage of a tub grinder, etc. If
you checked anything under the yard trash category, you must either compost or sell the mulched product for boiler fuel.
�L L D e bri i i 5 12a o k1 euz cZ 5r 14 "%: a4d ccla)
To the best of my knowledge and belief, I certify the information provided in this notification is true, accurate, and
complete. Furthermore, the facility will comply with the operational and setback requirements of Small Type 1 Compost
(yard waste) facilities as outlined in _1406(1) and _1404(a)(1)-(10) of the Solid Waste Compost Rules_
l l C JL Date: �- '" �� Date captured on form
Signature: * Sign submission
Name: * �u(jn r (Ir• Phone:* (?)
Email: *
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• Complete items 1, 2, and 3.
■ Print your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mailpiece,
or on the front if space permits.
1. Article Addressed to:
KC, 'D vJ AA
&Sgpo& ff Ga/Wd�C�u�k r
1uqu, M
9590 9402 6023 0069 9181 01
2. Article Number (71Wfer from
rJ rorm 3?511, July 2015 PSN 7530-M-000_9053
A. Signature
X 13 Agent
❑ Addressee
B. Received by (Printed Name) C. Date of Delivery
D. Is delivery address drfferent from item 17 ❑ Yes
tf YES, enter delivery OK. ❑ No
nov 11, 2020
George Ward
3. Service Type
❑ Adult Signature
❑ P" Mail Expresse
Wt Signature Restricted Delivery
ed Mall®
0 Registered Mail-
R92l3terOd Mall Restricted
LmuverY
Certified Mall Restricted Dell
Collect on Delivery very
Return Receipt for
❑ Collect on Deliveryhandise
❑ Insured Mail Restricted
Sl,�ture Contiirrrta Tv
❑ Insured Mall Restricted
(ov $500)
❑ Sture Confirmation
P-tFkxed Ddrt'efy
DDMestic Return ReCelpt ,