Fulton County Pretreatment Services

Commercial Waste Discharge Permit Application

Jun 21, 2023
submission #864
Permit Information

Permit Information

Is this application for a New or Existing Permit (Renewal)? New

Facility Information

Name of Facility Mansell Village - Grease Trap
Facility Contact Name Benton Green
Facility Contact Phone Number +17709568383
Facility Physical Address 580 E Crossville Rd, Roswell GA 30075-3361
Facility Suite Number 450
Facility Contact Email Address [email protected]
Is Facility Mailing Address the same as above? No

Facility Mailing Address

Facility Mailing Address 35 Johnson Ferry Rd, Marietta GA 30068-4906
Facility Mailing Email Address [email protected]

Owner / Corporate Information

Owner / Corporation Name Mansell Retail Owner, LLC
Owner Contact Name Elaine Mclaney
Owner Contact Telephone ---
Owner Address ---

Commercial Waste Pretreatment System - Subsurface, exterior system

Do you have a Subsurface, exterior system? Yes

Exterior Tank #1

Trap #1 Type Grease Trap
Tank #1 Capacity 50-200
Do you have a second Subsurface, exterior system? No

Commerical Waste Pretreatment System - Interior System

Do you have an interior PT system? No

Type of Business

Type of Business (restaurant, school, car maintenance) Restaurant
Has new equipment been added since business opened? No
List any previous names of business, if business is less than (2) yrs old.
Are your water and sewer provided by same jurisdiction? Yes, same jurisdiction

Utilities Jurisdiction

Water & Sewer Jurisdiction Fulton County

Commercial Waste Transporter Service (Pumper)

Company Name southern green industries
F.O.G. Permit Number 83
Company Contact Name Robert Delbueno
Company Address 4565 Frederick Ct SW, Atlanta GA 30336-1864
Company Telephone Number +14044196887

Waste Removal

Do you use a Grease/Waste Oil Recycle Company? No

Maintenance Letter (Exterior 3 months)

Notarized Maintenance Letter upload Southern Green - Grease Trap Service Agreement for Suite 450 - Mansell Village.pdf

Service Agreement

Service Agreement Upload Mansell Village - Dept of Publix Works - Commercial Pretreatment (Suite 450).pdf
Certification

Certification

Full Name Benton Green
Registered Agent (if applicable) Benton Green
Certification Yes
Verification & Permit Fee Calculation

Fee Calculation

How many subsurface system (exterior) tanks does the facility have? 1-5 ($250)
How many Manual (interior) 10-100 pound units does the facility have? 0
How many Automatic Grease Recovery 20-35 GPM units does the facility have? 0
Is the payment for the current year permit considered late? (RENEWALS ONLY: If today's date is prior to May 31, 2023, the answer should be no. If today's date is after May 31, 2023 the answer should be yes) No
Please enter how many years permit has been unpaid in the past (please enter 0 for none) (RENEWALS ONLY): 0