Commercial Waste Discharge Permit Application (New or Renewal)

Permit Information

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

Existing

Facility Information

Name of Facility	Parkside Shoppes - Prep Kitchen & Bathroom
Facility Contact Name	Udi Hershkovitz
Facility Contact Phone Number	+14704622299
Facility Physical Address	5920 Roswell Rd, Sandy Springs GA 30328-4913
Facility Suite Number	Bldg C - Suites 140 A / 140 B
Facility Contact Email Address	[email protected]
Is Facility Mailing Address the same as above?	No

Facility Mailing Address

Facility Mailing Address	4880 Lower Roswell Rd, Marietta GA 30068-4375
Facility Mailing Suite Number	Suite 790Simplify the introduction page to cater to all users, recognizing that not everyone is proficient with technology. The goal is to make the process user-friendly for establishments using the clear forms, preventing any complications for office staff. Please note that payments made using clear forms do not automatically update in Swift Comply. This can lead to awkward situations in the field when reports indicate establishments are delinquent, even when they've made their payments. Rather than generating a receipt, the printed page should serve as a permit. This eliminates the need for preparing and mailing a separate permit. To enhance efficiency, payments made on Clear Forms should automatically populate and update expired permits to active status. We require a batching feature to display all payments, delinquent accounts, and expired permits categorized by area. For instance, under the "RECENT ACTIVITY" heading, we propose a drop-down menu that batches payments upon completion and provides the total collections to date. Additionally, the export function should offer selective options for printing specific columns, avoiding the need to send the entire report to Excel.
Facility Mailing Email Address	[email protected]

Owner / Corporate Information

Owner / Corporation Name	Jamestown
Owner Contact Name	Leah Crawford
Owner Contact Telephone	---
Owner Address	---

Type of Business

Type of Business (restaurant, school, car maintenance)	Other
Has new equipment been added since business opened?	No
List any previous names of business, if business is less than (2) yrs old.	Carl's Cafe

Multiple Utilities Jurisdictions

Water Jurisdiction	Sandy Springs
Sewer Jurisdiction	Fulton County / Sandy Springs

Commercial Waste Transporter Service (Pumper)

Company Name	Southern Green Industries
F.O.G. Permit Number	204
Company Contact Name	Rob Del Bueno
Company Address	4565 Fredrick Dr., SW Atlanta, GA 30336
Company Telephone Number	+14044196887

Waste Removal

Do you use a Grease/Waste Oil Recycle Company?

Yes

Grease / Waste Oil Recycle Company

Company Name	Southern Green Industries
Company Contact Name	Rob Del Bueno
Company Address	4565 Fredrick Dr., SW Atlanta, GA 30336
Company Telephone Number	+14044196887
How often is recycled grease / oil waste removed?	Once per Quarter
Container Capacity	1500

Certification

Full Name

Dottie Simzyk