Florida Department of Environmental ProtectionWaste Tire Collector Registration Notification

Expires April 1, 2019

Wednesday, March 14,2018 The Company listed below has registered with the Department as a Waste Tire Collector in accordance with Chapter 62-711.520, F.A.C., and registration decals have been issued to the vehicles listed below. These decals are valid until April 1, 2019 unless revoked. Decals must be affixed to the assigned vehicle on the driver's side door of that vehicle. Decals are $35.00 each.

For further information call "Waste Tires" at 850-245-8756.

_______________________________________________________________________________________________________

WACS ID: 00097121 Name: PHILLIP TIDWELL DBA: J. SCOTT ENTERPRISE / METRO TIRE, INC.

No Decal # YR MAKE TYPE VIN # TAG # ST Owner # _______________________________________________________________________________________________________ 1 458 2014 FRHT TT 3ALXFB002EDFR1723 1116538 AL 2 459 2015 KENW TT 1XKYD49X8FJ459640 1116552 AL

; DE\>]'omfi A2-7()I.V(K)(1K). F.A.C.

j Form Title; Wtistc Tire Collector RcgisirntionI Application

I Fffcctiw Date: J;iniiar\-n. 201 (II DFP Application No. (CompIctcd-byDFP)

FEB 0 5 2018

Florida Department ofEnvironmental Protection

Bob Martinez Center 2600 Blair Stone Road

Taliahassee, Fiorida 32399-2400

Waste Tire Collector Registration ApplicationPursuant to Ruie 62-711.520, Fiorida Administrative Code, to obtain a waste tire coiiector registration number and approvai to transport waste tires, a coiiector shall submit the foilowing information on this form to the Department.

Type of Collector: Q For Hire Collector |X| Not For Hire Q Registered with ICC Q Government Entity

Part i - Business information:

1. Business Name of collector: PHILLIP TIDWELL WACS ID: 00097121(assigned by Department)

2. Other business names of collector (DBA's):

3. Mailing address of collector: P O Box 1839

City: Pinson_________________________________

J. SCOTT ENTERPRISE / METRO TIRE, INC.

State: AL Zip: 35126

4. Street address of collector:

City: Birmingham_______

198 Pawnee Village Rd

County: All State: AL Zip: 35217

5. Telephone number of collector: (205)841-1930

6. Federal Employer Identification number (FEID) of Collector:

Email address: melanie@metrotireinc.com

631182363

7. Have any enforcement actions been taken by the Department or other governmental agency against the applicant forviolation of Department rules relating to the collection or disposal of waste tires? This includes any Complaint, Notice ofViolation, revocation or suspension of a registration, as well as any Consent Order in which a violation of Department rulesis admitted. It does not include a Warning Letter, Warning Notice, Notice of Noncompliance, or other similar documentwhich does not constitute agency action.

No If yes, attach a history and description of the enforcement actions.

Part II - Person in charge of Waste Tire Collection Operations:

1. Name of Person in charge of Waste Tire Collection Operations:

2. Date of Birth of Person in charge of Waste Tire Collection Operations:

Corporations also complete Part III.

1. Corporation Name: J. SCOTT ENTERPRISE, INC._____________

MELANIE RODGERS

2. Corporation Filing Date:

3. Corporation Officers:

11/3/1997

(\\\ f 5 >TF t V \ Pistate of Incorporation:

res.,4. Florida Resident Agent of Corporation:

DEP FORM 62-701.900(18) Effective January 6, 2010

Page 1 of 2

Shlli

WACS ID Number: 00097121

Part IV - Collection and Disposal Information:

1. List all known locations where you will be collecting waste tires (attach additional sheets if necessary)

Name Address City State

/\0 \A<

2. List ail known locations where you will be delivering or depositing waste tires for recycling or disposal (attach additional sheets if necessary)

Name Address City

yvQ lA’g

Part V - Vehicles to be Registered;

1. Number of vehicles to be used:

2. Vehicles registration information:a. A legible copy of the current vehicle registration is required for each vehicle registered. The registration must show

State of registration, year, make, tag number, vehicle identification number, and registered owner.

b. IF the vehicle is not owned by the collector, an authorization from the vehicle owner for the vehicle to be registered for waste tire collection must be attached to this application.

c. IF Common Carrier, list Interstate Commerce Commission (ICC) authority number for the company:

Part VI - Registration Fee Information

1. Waste tire collector registration status: Q New ^ Renewal

If registration is a renewal, list previous registration number(s)

2. Attach payment for registration fees pursuant to Rule 62-711.520(11), F.A.C.

Number of vehicles # O x $35 = $ —^ D

Part Vll-Certification

6oo^ 7/ 2-1

: Amount of Payment

State

To the best of my knowledge and belief, I certify the information provided in this application is true, accurate and correct. I have attached all documents and/or authorizations that are required.

MELANIE RODGERSPrint Name of Authorized Agent Signature of Authorized Agent Date

Mail completed form to:

DEP FORM 62-701.900(18) Effective January 6, 2010

Department of Environmental Protection Division of Waste Management

2600 Blair Stone Road, MS 4550 Tallahassee, Florida 32399-2400

Page 2 of 2

CEMEX 1617 Arcola Road Demopolis AL

Alabama Department of Revenue

Motor Vehicle Division

International Registration PlanP. O. Box 327620 * Montgomery, AL 36132-7620 * (334) 242-9000

(www.revenue.alabama.gov)

CAB CARDCARRIER RESPONSIBLE FOR SAFETY MOTOR CARRIER: J SCOTT ENTERPRISES INC

J SCOTT ENTERPRISES INC

198 PAWNEE VILLAGE ROAD BIRMINGHAM, AL 35217

USDOT: 000916087 ADDRESS: PO BOX 1839

PINSON, AL 35126

CLIENT ID FLEET SUPP REG YEAR REG DATE DATE EXPIRED ENFORCE DATE1653 1 0 2019 02/01/2018 01/31/2019 02/01/2019

OWNER/LESSOR:J SCOTT ENTERPRISESPLATE TYPE FUEL UNIT VIN MODEL AXLES MAKE UNLADEN

WGTCOMBINED

WGT1116538 TR D 995 3ALXFB002EDFR1723 2014 3 FRHT 80,000 80,000

The vehicle described has been proportionally registered between the State of Alabama and the jurisdictions shown below :

JUR WEIGHT JUR WEIGHT JUR WEIGHT JUR WEIGHTAL QUAL AR 80,000 AZ 80,000 CA 80,000CO 80,000 CT 80,000 DC 80,000 DE 80,000FL 80,000 GA 80,000 lA 80,000 ID 80.000IL 80,000 IN 80,000 KS 80,000 KY 80,000LA 80,000 MA 80,000 MD 80,000 ME 80,000Ml 80,000 MN 80,000 MO 80,000 MS 80,000MT 80,000 NC 80,000 ND 80,000 NE 80,000NH 80,000 NJ 80,000 NM 80,000 NV 80,000NY 80.000 OH 80,000 OK 80,000 OR 80,000PA 80,000 Rl 80,000 SC 80,000 SD 80,000TN 80,000 TX 80,000 UT 80,000 VA 80,000VT 80,000 WA 80,000 Wl 80,000 WV 80,000WY 80,000 AB 36,287 BC 36,287 MB 36,287NB 36,287 NL 36,287 NS 36,287 ON 36,287PE 36,287 QC 6 AXL SK 36,287

* QUAL indicates that the vehicle is registered at a weight greater than 80,000 pounds in Alabama.

It is the registrant's responsibility to ensure that the information listed on the IRP cab card is correct.

The apportioned registration cab card must be carried in the vehicle to which it is issued and must be presented on demand, for inspection by law enforcement officers.

Alabama law requires that current proof of liability insurance coverage and a current and valid registration receipt be carried within the vehicle.

Possession of this document declares that the registrant has knowledge of federal motor carrier safety regulations and federal hazardous materials regulations adopted by the State of Alabama.

J SCOTT ENTERPRISES INC

■.>= .

Alabama Department of RevenueMotor Vehicle Division

International Registration PlanP. O. Box 327620 * Montgomery, AL 36132-7620 * (334) 242-9000

(www.revenue.alabama.gov)

J SCOTT ENTERPRISES INC

198 PAWNEE VILLAGE ROAD BIRMINGHAM, AL 35217

CAB CARDCARRIER RESPONSIBLE FOR SAFETYMOTOR CARRIER: The Motor Carrier Responsible for Safety is

expected to change during the registration period.

USDOT:

ADDRESS:

CLIENT ID FLEET SUPP REG YEAR REG DATE DATE EXPIRED ENFORCE DATE1653 1 0 2019 02/01/2018 01/31/2019 02/01/2019

OWNER/LESSOR:PACCAR FiNANCIAL CORPORATIONPLATE TYPE FUEL UNIT VIN MODEL AXLES MAKE UNLADEN

WGTCOMBINED

WGT1116552 TR D 1013 1XKYD49X8FJ459640 2015 3 KW 18,000 80,000

The vehicle described has been proportionally registered between the State of Alabama and the jurisdictions shown below :

JUR WEIGHT JUR WEIGHT JUR WEIGHT JUR WEIGHTAL QUAL AR 80,000 AZ 80,000 CA 80,000CO 80,000 CT 80,000 DC 80,000 DE 80,000FL 80,000 GA 80,000 lA 80,000 ID 80,000IL 80,000 IN 80,000 KS 80,000 KY 80,000LA 80,000 MA 80,000 MD 80,000 ME 80,000Ml 80,000 MN 80,000 MO 80,000 MS 80,000MT 80,000 NC 80,000 ND 80,000 NE 80,000NH 80,000 NJ 80,000 NM 80,000 NV 80,000NY 80,000 OH 80,000 OK 80,000 OR 80,000PA 80,000 Rl 80,000 SC 80,000 SD 80,000TN 80,000 TX 80,000 UT 80,000 VA 80,000VT 80,000 WA 80,000 Wl 80,000 WV 80,000WY 80,000 AB 36,287 BC 36,287 MB 36,287NB 36,287 NL 36.287 NS 36,287 ON 36,287PE 36,287 QC 3 AXL SK 36,287

* QUAL indicates that the vehicle is registered at a weight greater than 80,000 pounds in Alabama,

It is the registrant's responsibility to ensure that the information listed on the IRP cab card is correct.

The apportioned registration cab card must be carried in the vehicle to which it is issued and must be presented on demand, for inspection by law enforcement officers.

Alabama law requires that current proof of liability insurance coverage and a current and valid registration receipt be carried within the vehicle.

Possession of this document declares that the registrant has knowledge of federal motor carrier safety regulations and federal hazardous materials regulations adopted by the State of Alabama.

SilBI J SCOTT ENTERPRISES INC

Florida Department of

Environmental ProtectionBob Martinez Center

2600 Blair Stone Road Tallahassee, Florida 32399-2400

DEP Form* 62-701 900(22), E A.C ■ rorm Tillc: Waste Tire Collocior Annual Reporl

i'ft'ective Dale: January (\ 20 10 DEP Application No.

(Completed b\’ Dl-1’)

WASTE TIRE COLLECTOR ANNUAL REPORT (For Calendar Year Ending 2016 )

Pursuant to Rule 62-711.520, Florida Administrative Code, waste tire collectors are required to submit the following information to the Department by March 1 of each year. The annual report must be submitted along with the annual registration renewal application and registration fee as a condition of holding a waste tire collector registration number.

1. Business Name: PHILLIP TIDWELL WACS ID Number: 00097121

2. Business Mailing Address:

City: Pinson___________

PC Box 1839

State: AL Zip: 35126

3. Business Street Address:

City: Birmingham______

198 Pawnee Village Rd

State: AL Zip: 35217

4. Business telephone: (205) 841-1930 Email address: melanie@metrotireinc.com

5. Total quantity of waste tires, expressed in tons, collected or generated during the calendar year (assumelOO tires per ton or 10 tires per cubic yard):

6. Describe how the waste tires collected were disposed of during the calendar year, reported in tons.(assume 100 passenger tires per ton, 20 truck tires per ton.)

tons tires

A. List total quantity of waste tires sold as used tires.

B. List quantity of waste tire casings sold.

C. List quantity of waste tires hauled off by other Waste Tire Collectors. Attach additional sheets, if necessary.

Name of Other Collector Collector Registration Number

A. tons tires

B. tons tires

Quantity in tons

tons tires

D. List the facilities where waste tires were deposited for disposal or recycling and the quantity disposed at each location. Attach additional sheets, if necessary.

Name of Facility Address / City / StateQuanitity in

tons

TOTAL Tires sold or deposited for disposal or recycling

D. tons tires

A + B + C + D tons tires

DEP FORM 62-701.900(22) Effective January 6, 2010

Page 1 of 2

WACS ID Number: 00097121

7. Explain any differences between Waste Tires Collected (item 5) and Waste Tires Deposited (item 6):

pO&>\(X.KT>C8. Waste tire collector registration number(s):

9. Authorized person preparing report: __

10. Telephone number of person preparing report:

11. Certification:

To the best of my knowledge and belief, I certify the information provided in this report is true, accurate and correct

MELANIE RODGERSPrint Name of Authorized Agent Signature of Authorized Agent

i-aT-iSDate

Mail completed form to:

Department of Environmental Protection Division of Waste Management

2600 Biair Stone Road, MS 4550 Tallahassee, Florida 32399-2400

DEP FORM 62-701.900(22) Effective January 6. 2010

Page 2 of 2

MyFDEPFlorida Department of Environmental Protection

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Pending Document DetailsNATIVE NAME:PHILLIP TIDWELLDOC LOG ID: 39029 WACS ID:97121

CITY: BIRMINGHAM COUNTY: ALL FL CNTYS

View email records

WTC Approvals

Document Types

Document Type Primary Type Discontinued On

WTC Y

Email Addresses

Affiliation-ID Interest Type Email Native ID Native Name

Processes

Document Type Process Date Author Delete

WTC Logged 02/06/2018 SIMMONS_JLS

WTC Completeness Review 02/19/2018 THIGPEN_H

WTC Waiting for information 02/19/2018 THIGPEN_H

WTC Completeness Review 03/14/2018 OCONNOR_L

WTC Data Entry Completed 03/14/2018 OCONNOR_L

WTC Final Review 03/14/2018 OCONNOR_L

WTC Authorization 03/14/2018 OCONNOR_L

Add A New Process

Document Type Process DateWaste Tire Collector (WTC) Booked into Oculus (T) 03/14/2018 Add Process

Comments

Document Type Date Comment Author

WTC 02/19/2018 Missing two registrations, sent email. THIGPEN_H

WTC 03/14/2018Emailed Melanie for missing information on 3/14/2018. Per email from Melanie, no tires were collected or deposited in 2017. Registration maintained just in case. The company will only be using 2 vehicles, so a refund will be issued

for $70.00.OCONNOR_L

Add A New Comment

Document Type CommentsWaste Tire Collector (WTC) Add Comment

Pending Document Details