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Home My WebLink AboutNCS00339_2019Permit_Initial 2019 Permit and Registration Gilreath Septic Tank & Port-a-John Service is hereby issued a Septage Management Firm Permit, Permit Number NCS-00339 And by virtue of completing the annual training requirements is hereby registered as a Portable Sanitation & 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. Cub Creek WWTP, Wilkesboro NC 2. North Wilkesboro WWTP 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 Gilreath Septic Tank & Port a John Service The "Firm name" must be exactly as it is shown on your vehicle(s). NCS-00339 Enter the five digits following the NCS # City Hays State / Province / Region NC Postal / Zip Code 28635 Country United States Street Address PO Box 73 Address Line 2 Wilkes Yes No City Hays State / Province / Region North Carolina Postal / Zip Code 28635 Country United States Street Address po Address Line 2 3369576961 stevedowell7@gmail.com Owner Info Steve Dowell Yes No 3369576961 Firm operator's name**Firm operator's title Mailing address same as street address of office?** 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?** "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** Pumper Vehicles Usage*License Tag #*Vehicle Identification #*Tank Capacity* Operator Info Steve Dowell Owner/operator Yes No 3369576961 Type and amount of septage pumped in the last 12 months 214,000 0 0 0 0 North Carolina counties of operation Wilkesboro North Wilkesboro Vehicle Info Yes No 11/5/2018 owner/operator Add vehicles individually Upload 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 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 Domestic Septage YA-98390 1HTSDAAN2YH246190 1,800 Domestic Septage YA-112054 1XKWD29XXGJ336421 2,500 Septage Disposal Method For each method, indicate whether you plan to use it by checking yes or no. Yes No Wilkesboro 12/31/2019 00339.pdf 130.54… North Wilkesboro 12/31/2019 Yes No Yes No Yes No Septage Management Firm Operator Training Completed 2/1/2018 6 Hickory NC Septic Tank Association Septage Land Application Site Operator Training Completed 0 Registration Type Select one** Comments or notes Signature Date Print Name**Title** 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. 11/5/2018 06:44:28 PM Steve Dowell Owner/Operator PayPoint Page 1 of 1 Payment Receipt Application: Solid Waste Merchant: NDENR-Solid Waste Merchant City/State: Raleigh, North Carolina Payment Status: Success Result Message: Success Payment Date: 11/05/2018 Posting Date: 11/05/2018 Billing Information: Steve Dowell PO Box 73 Hays, NC 28635 3369270665 stevedowel I7@g mai I. com Payment Amount: 800.00 USO Reference Information: NCS-00339-2019,28635,Gilreath's Septic Tank & Port-a-John Service,P O Box 73,Hays,NC,NCS-00339,$800.00 Disclaimer: No convenience fee is charged for using the eCheck payment method. However, a processing fee of $25.00 or 10% of the amount of the eCheck, whichever is greater, will be charged for an eCheck returned due to insufficient funds. Payments are null and void if payment is made with an eCheck that is returned unpaid by the bank. https://admin.thepayplace.com/epayadmin/paymentreceipt.aspx 11/6/2018