Commercial Waste Discharge Permit Application

Permit Information

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

New

Facility Information

Name of Facility	The dirty Tea
Facility Contact Name	Rita Campos
Facility Contact Phone Number	+16786500613
Facility Physical Address	1056 Saint Charles Ave NE, Atlanta GA 30306-4222
Facility Contact Email Address	[email protected]
Is Facility Mailing Address the same as above?	Yes

Owner / Corporate Information

Owner / Corporation Name	The dirty tea
Owner Contact Name	lortia campos
Owner Contact Telephone	---
Owner Address	---

Commercial Waste Pretreatment System - Subsurface, exterior system

Do you have a Subsurface, exterior system?

No

Exterior Tank #1

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

Exterior Tank #2

Trap #2 Type	Grease Trap
Tank #2 Capacity	50-200
Do you have a third 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)	Coffee Shop
Has new equipment been added since business opened?	Yes
List any previous names of business, if business is less than (2) yrs old.	N/A
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	APEX ENVIRONMENTAL SERVICES
F.O.G. Permit Number	017
Company Contact Name	Sherri Pitt
Company Address	3905 OAKCLIFF INDUSTRIAL
Company Telephone Number	+17704092143

Waste Removal

Do you use a Grease/Waste Oil Recycle Company?

No

Service Agreement

Service Agreement Upload

The Dirty Tea Service Agreement.pdf

Certification

Full Name	Lortia campos
Certification	Yes