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HomeMy WebLinkAboutNCS00138_Permit2019_Initial 2019 Permit and Registration Able Rent-A-Jon is hereby issued a Septage Management Firm Permit, Permit Number NCS-00138 And by virtue of completing the annual training requirements is hereby registered as a Portable Sanitation 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. French Broad River Water Reclamation Facility 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?** Phone**Fax Email** Firm owner's name** Mailing address same as street address of office?** Phone**Fax Firm operator's name**Firm operator's title Mailing address same as street address of office?** Phone**Fax Firm Info Able Rent-A-Jon & Waste Services The "Firm name" must be exactly as it is shown on your vehicle(s). NCS-00138 Enter the five digits following the NCS # City Asheville State / Province / Region NC Postal / Zip Code 28803 Country United States Street Address 108 Sweeten Creek Road Address Line 2 Buncombe Yes No 8285752253 ablerentajon@charter.net Owner Info Richard Sieburg Yes No 8285752253 Operator Info George Sieburg Yes No 8282797649 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?** "I certify, under penalty of law, that the pumper vehicle or vehicles listed in the submitted permit application meets the requirements for safe and sanitary transportation of septage as required by 15A NCAC 13B .0844(a) and vehicle lettering as required by 15A NCAC .0844(b). Furthermore, I also certify that a log is maintained of each septage pumping event as required by 15A NCAC 13B .0839(a). I am aware that there significant penalties for false certification including the possibility of fine and imprisonment." Signature Date** Title** Choose how to add vehicle descriptions** Upload vehicle list** Approved wastewater treatment plant** If yes, list the facilities below and upload or submit by mail a copy of Wastewater Treatment Authorization for each plant as indicated in subparagraph .0833(c)(14) of the Septage Management Rules. Mail forms to: NC DEQ Type and amount of septage pumped in the last 12 months 0 769,750 0 0 0 North Carolina counties of operation Buncombe, Haywood, Henderson, Madison Vehicle Info Yes No 12/21/2018 President Add vehicles individually Upload List You can upload a file with a list of vehicles to be used. Please be sure to include the following information for each vehicle on your upload: Usage, License Tag #, Vehicle Identification #, and Tank Capacity. NCDENR portable toilet truck info.xlsx 10.38KB Septage Disposal Method For each method, indicate whether you plan to use it by checking yes or no. Yes No Division of Waste Management - Solid Waste Section 1646 Mail Service Center Raleigh, NC 27699-1646 Wasterwater Treatment Facility Name*Expiration Date*Authorization Septage Land Application Sites (SLAS)** Septage Detention or Treatment Facility (SDTF)** Other disposal method** Date**Hours** Location** Training Sponsored or Provided by** Date Hours Location Training Sponsored or Provided by Select one** Comments or notes Signature MSD of Buncombe County 12/31/2019 Yes No Yes No Yes No 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. Date Print Name**Title** 12/21/2018 04:00:10 PM George Sieburg President Truck Model Truck Type Waste/Water Truck VIN Tag #Permit # 2013 Ford F-550 Portable toilet Truck 600/400 1FDU5HT8DEB83938 EK-8360 64 2015 Ford F-550 Portable Toilet Truck 600/400 1FDUF5HT0FEA44213 FK-5587 73 2008 Dodge 4500 Portable Toilet Truck 400/300 3D6WD66AX8G146487 BX-6875 1 2009 Dodge 5500 Portable Toilet Truck 400/200 3D6WD76L89G514013 JB-6179 4 2015 Ford F-550 Portable Toilet Truck 900/300 1FDUF5HY6FED32619 HH-7722 92 2016 Ford F- 550 Portable Toilet Truck 650/300 1FDUF5HY0GEB62811 HK-7493 94 2018 Ford F-550 Portable Toilet Truck 700/300 1FDUF5HYHEB81348 JE-2922 75 2018 Ford F-550 Portable Toilet Truck 650/300 1FDUF5HY2JDA03155 JH-6219 17 PAID FIRM NAME: Able Rent-A-Jon PERMIT #: NCS-00138 AMOUNT: $800 PAID BY: e-check DATE: 12/21/18 Chester Cobb