Application Date:
New or Renewal:
The following information must be provided and completed in order to obtain a Waste Hauler registration permit:
Mailing Address:
Business Address:
Ownership Type:
APPLICANT OWNERSHIP INFORMATION
If the Applicant is a partnership or corporate entity, list all individuals and/or parent corporate entities. (Please list additional individuals on a separate sheet if necessary)
INSURANCE INFORMATION: All persons applying for, maintaining, or renewing a permit to collect and transport Septage Waste in Monroe County must obtain and maintain the following insurance coverage.
Certificate(s) of Insurance are required for the insurances below. The Waste Authority must be listed as the Certificate Holder.
In addition to all other provisions/terms/language of this application, notice is hereby given to the Applicant concerning the following:
Note 1: Permits are NOT transferrable and must be assigned to a vehicle. If any registered vehicle is sold or in any way transferred by the applicant, notice must be provided to the Waste Authority within five (5) days of such sale or transfer. Further, all permits received from the Waste Authority must be removed prior to any sale or transfer of a registered vehicle.
Note 2: To add vehicles and request additional permits, complete page number 5 and submit it to the Monroe County Waste Authority by email or fax.
Note 3: Any registration and/or permit issued by the Waste Authority is subject to immediate revocation by the Waste Authority for any violation of the terms of this application.
Note 4: If this application is approved, the applicant agrees to provide a full and complete list of all its customers within the geographic boundaries of Monroe County, Pennsylvania upon issuance of such a request by the Waste Authority. Applicant agrees to provide a full and complete response to a request for a customer list from the Waste Authority within five (5) days from the date the request is issued by the Waste Authority.
Disposal Sites for Septage Haulers
Greater Hazleton Joint Sewer Authority
500 Oscar Thomas Road West Hazleton, PA 18202
Lehigh County Authority
7676 Industrial Boulevard Allentown, PA 18106
Lackawanna County River Basin Authority
145 Boulevard Avenue Throop, PA 19464
Pottstown WWTP
Industrial Hwy & Moser Road Pottstown, PA 19464
Roerre-Honesdale
416 Adams Pond Road Honesdale, PA
Pond Hollow Ag
5167 Berry Hollow Road Bangor, PA 18013
Hartfield
3200 Advance Lane Colmar, PA 18915
Annville WWTP
675 West Main Street Annville, PA 17003
Derry WWTP
670 Clearwater Road Hershey, PA 17030
Land Application J.R. Borger, Inc.
RR1 Saylorsburg, PA 18353 (Disposed on Multiple farms)
Finken Farm (Lawson)
1018 Benders Church Road Pen Argyl, PA 18072
Wyoming Valley Sewer Authority
PO Box 33A Wilkes-Barre, PA 18703
Delcora
100 E.5th Street Chester, PA 19016
Sile Bay Farm (Koberlein)
2809 Eastern Turnpike (Rt. 296) Waymart, PA18472
Henry Yeska Farm
821 Georgetown Road Nazareth, PA 18064
Middlesex County Utilities Authority
2571 Main Street Sayreville, NJ 08772
Commonwealth Disposal (Hartponce Farm)
Yostville Road (Route 2018) Moscow, PA18444
FLEET INFORMATION:
Click here to download our Fleet Information List PDF .
Please print, fill out the Fleet Information List, scan, and upload below. You may also take a clear high quality photo of the completed document and upload below.
Upload Completed Fleet Information
METHOD OF PAYMENT:
I Date .
This payment is for
NOTARIZATION:
Click here to download our Notary Form .
Please print, fill out the Notary Form, have it notarized by a licensed Notary, scan, and upload below. You may also take a clear high quality photo of the completed document and upload below.
Notarized Signature Form
CERTIFICATION:
I hereby certify that all the information provided in this application to be true and correct to the best of my knowledge, information, and belief. I also certify that all vehicles and containers specified herein are owned or leased by the applicant; that said information is true and correct; and that I am familiar with and will comply with the Ordinance and the Rules and Regulations. I/we agree to dispose of all regulated waste collected in Monroe County, Pennsylvania at a designated facility identified in the plan, which currently are Alliance Landfill and Grand Central Sanitary Landfill. I/we will pay all fees and accept all penalties set forth in the Plan, Act 97, Act 101, the Ordinance, the Rules and Regulations of Monroe County and the Waste Authority along with any other applicable statutes, regulations, ordinances or contractual agreements. Further, by executing this application, the Applicant hereby acknowledges and agrees to the jurisdiction and venue of the Court of Common Pleas of Monroe County Pennsylvania for any and all claims arising out of or in any way related to this application, its conditions or any subsequent registration or permitting by the Waste Authority.
COMMONWEALTH OF PENNSYLVANIA, COUNTY OF
My name is:
I, being duly sworn, according to law, Upon my oath, do depose and say that I am the Of
