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HomeMy WebLinkAbout1303_USTire_TireLF_AFR14-15TireLF 2015 Page 1 Facility Name:Permit: Physical Address Street 1: Street 2: City: State:Zip: County: Mailing Address Street 1: Street 2: City: State:Zip: Primary Facility Contact Person Name: Phone:Fax: Email: Billing Contact Person Name: Phone:Fax: Email: 1. Tipping Fee: $per Ton (Attach a schedule of tipping fees if appropriate.) 3. Indicate types of disposal activity occurring at this facility (Check all that apply). Landfilling of residential waste Landfilling of commercial waste Landfilling of industrial waste Landfilling of construction and demolition waste, please estimate percent of waste landfilled:% Landfilling of land clearing and inert debris waste (limbs, brick, stumps) Landfilling of asbestos Landfilling of shredded or split tires Landfilling of ash Landfilling of other waste (specify): 2. Did your facility stop receiving waste during this past Fiscal Year? Yes No If so, please report the date this occurred: TIRE LF State of North Carolina Department of Environment and Natural Resources Division of Waste Management According to (G.S. 130A-309.09D(b)) completed forms must be returned by August 1, 2015 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. TIRE LANDFILL Facility Annual Report For the period of July 1, 2014-June 30, 2015 1303-TIRELF-1988 US Tire Recycling Partners LP 1303-TIRELF-1988 6322 Poplar Tent Rd Concord North Carolina 28027 Cabarrus same North Carolina Gene Helton - General Manager (704) 784-1210 (704) 784-4716 ghelton@libertytire.com 0.00 TireLF 2015 Page 2 4. Total total tires landfilled at this facility during the period of July 1, 2014 through June 30, 2015. Indicate tonnage received by COUNTY of waste origin. If waste was received from a transfer station,treatment and processing, or mixed waste processing facility indicate the COUNTY LOCATION OF THE FACILITY. DO NOT include waste diverted for recycling, reuse, mulching, or composting. Please list ALL counties from which you received waste. Please indicate COUNTY and STATE, if received from another state. Received from Jul Aug Sept Oct Nov Dec Jan Feb Mar Apr May June Total Grand Total CERTIFICATION: I certify that the information provided is an accurate representation of the activity at this facility. Signature:Date: Name: Phone Number:Email: Title: 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: 1303-TIRELF-1988 Cabarrus County 884 868 875 904 689 707 744 632 910 834 769 877 9,693 Iredell County 62.45 50.37 32.32 35.9 40.19 59.32 50.28 51.58 45.1 60.81 50.64 53.06 592.02 10,285.02 Nikki Leonard Digitally signed by Nikki Leonard DN: cn=Nikki Leonard, o=US Tire Recycling, ou, email=nleonard@libertytire.com, c=US Date: 2015.07.21 16:46:18 -04'00'07/21/2015 Nikki Leonard (704) 784-1210 nleonard@libertytire.com A/R Clerk Teresa Bradford 610 East Center Avenue Mooresville, NC 28115 phone: 704.235.2160 email: Teresa.Bradford@ncdenr.gov TireLF 2015 Page 3 Instructions: NC DENR Division of Waste Management - Solid Waste Section Risk Assessment Form Facility Name:Permit: Address: City:State:Zip: Date:Person completing Assessment: Phone Number:Fax:Email: 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?Feet Feet Feet Please list the names of the water bodies: 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 1303-TIRELF-1988 US Tire Recycling Partners LP 1303-TIRELF-1988 6322 Poplar Tent Rd Concord North Carolina 28027 07/21/2015Vance Moore (919) 792-1901 vmoore@garrett-moore.com Approximately 31 1 600 Coddle Creek ALL