NCS01411_2019Permit_Initial

2019
Permit and Registration

Liquid Environmental Solutions
(Knoxville)
is hereby issued a Septage Management Firm Permit, Permit Number NCS-01411
And by virtue of completing the annual training
requirements is hereby registered as a Septage Management Firm
in the State of North Carolina.

This permit to operate a Septage Management Firm is issued to the above named person, business or entity alone and is not transferable to any other person, business or entity.
Firm operation shall be in accordance with the provisions of N.C. General Statute 130A-291.1 - 130A-291.3, Title 15A of the N.C. Administrative Code 13B .0800 et.seq., conditions of the permit, and representations made in the application and accompanying documents for a permit. The permit holder is authorized to discharge septage only at the locations(s) listed below:
1. Liquid Environmental Solutions, Knoxville TN. Facility, SWP470001505
This permit does not entitle the permit holder to operate a Septage Land Application Site, a Septage Detention or Treatment Facility, or any other solid waste management facility
not specified herein. Failure to operate as permitted may result in the Department suspending or revoking this permit, initiating action to enjoin the unpermitted operation, imposing administrative penalties, or invoking any other remedy as provided in Chapter 130A, Article 1, part 2 of the North Carolina General Statutes. This permit and registration expires on
December 31, 2019.
__________________________________________________ Adam Ulishney, Environmental Compliance Branch Head

State of North Carolina
Environmental Quality
Waste Management
Application for Permit to Operate a
Septage Management Firm
For questions regarding this form or the online application process, please contact Jeffrey Bullard (919-707-8285) or Chester Cobb (919-
707-8283).
Firm name**
Septage Management Firm permit number (NCS #)**
Street address of office**
County**
Mailing address same as street address of office?**
Mailing Address**
Phone**Fax
Email**
Firm owner's name**
Mailing address same as street address of office?**
Phone**Fax
Firm Info
Liquid Environmental Solutions
The "Firm name" must be exactly as it is shown on your vehicle(s).
NCS-01411
Enter the five digits following the NCS #
City
Knoxville
State / Province / Region
TN
Postal / Zip Code
37917
Country
USA
Street Address
1307 Galway St
Address Line 2
Out-of-State
Yes No
City
Nashville
State / Province / Region
TN
Postal / Zip Code
37210
Country
USA
Street Address
501 Cave Rd
Address Line 2
866-694-7327
[e-mail]
Owner Info
Alan Viterbi
Yes No
214-524-6083 214-872-0058
Firm operator's name**Firm operator's title
Mailing address same as street address of office?**
Mailing address**
Phone**Fax
Amount in gallons*
DomesticDomestic
Portable Toilet WastePortable Toilet Waste
Grease (Restaurant)Grease (Restaurant)
Treatment PlantTreatment Plant
Industrial/CommercialIndustrial/Commercial
List each county you plan to do business in:**
Do you plan to operate pumper vehicles?**
Approved wastewater treatment plant**
Septage Land Application Sites (SLAS)**
Septage Detention or Treatment Facility (SDTF)**
Other disposal method**
Operator Info
Brian Healey Transportation Supervisor
Yes No
City
Nashville
State / Province / Region
TN
Postal / Zip Code
37210
Country
USA
Street Address
501 Cave RD
Address Line 2
615-484-7575
Type and amount of septage pumped in the last 12 months
0
0
500,000
0
0
North Carolina counties of operation
Buncombe, Haywood, Transylvania, Macon, Madison, Cherokee, Jackson, Swain
Vehicle Info
Yes No
Septage Disposal Method
For each method, indicate whether you plan to use it by checking yes or no.
Yes No
Yes No
Yes No
Description*Authorization
Date**Hours**
Location**
Training Sponsored or Provided by**
Date Hours
Location
Training Sponsored or Provided by
Select one**
Comments or notes
Signature
Date
Print Name**Title**
Yes No
SWP-470001505 Knoxville
Disposal
Auth..pdf
97.56KB
Septage Management Firm Operator Training Completed
12/8/2018 4
Raleigh, NC
NC Pumper Group & NC Portable Toilet Group
Septage Land Application Site Operator Training Completed
0
Registration Type
Registered Portable Sanitation Firm
Registered Septage Management Firm
Registered Portable Sanitation and Septage Management Firm
Comments and Notes
Certification Statement
I certify that the information and representations in this application for a permit are true, complete, and accurate to the best of my knowledge and belief. I am
aware that a permit may be suspended or revoked upon a finding that its issuance was based upon incorrect or inadequate information that materially affected
the decision to issue the permit and that there are criminal penalties for knowingly making a false statement, representation, or certification.
12/19/2018
06:28:46 PM
Brian Healey Transportation Supervisor