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Home My WebLink AboutNCS00397_Permit2019_Initial 2019 Permit and Registration Billingsley Septic Tank Company is hereby issued a Septage Management Firm Permit, Permit Number NCS-00397 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. Mebane Bridge WWTP 2. Septage Detention or Treatment Facility SDTF-79-02 3. Septage Land Application Sites: SLAS-79-02 and SLAS-79-06 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 BILLINGSLEY SEPTIC TANK COMPANY The "Firm name" must be exactly as it is shown on your vehicle(s). NCS-00397 Enter the five digits following the NCS # City REIDSVILLE State / Province / Region NC Postal / Zip Code 27320 Country United States Street Address 149 PENN RD Address Line 2 Rockingham Yes No 3363420608 3363420678 billingsleysepti@triad.twcbc.com Owner Info Wayne Billingsley Yes No 3366132444 Operator Info Wayne Billingsley Yes No 3366132444 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* Type and amount of septage pumped in the last 12 months 672,200 0 38,500 0 0 North Carolina counties of operation Rockingham, Alamance, Caswell, Guilford and Stokes Vehicle Info Yes No 12/20/2018 Owner Add vehicles individually Upload List Domestic Septage YA30506 94141 2,500 Grease (restaurant)YA113244 31712 2,500 Domestic Septage YA30508 81212 3,000 Domestic Septage YA136965 03457 2,500 Septage Disposal Method For each method, indicate whether you plan to use it by checking yes or no. 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)** If you are not the permit holder for the septage land application site, you must have a signed land application authorization form for each site. SLAS #*Expiration Date*Authorization Septage Detention or Treatment Facility (SDTF)** If you are not the permit holder for the septage detention/treatment facility, you must have a signed detention/treatment authorization form for each site. SDTF #*Expiration Date*Authorization Other disposal method** Date**Hours** Location** Training Sponsored or Provided by** Yes No Mebane Bridge Wastewater Treatment 12/31/2019 Eden Wasterwater Treatment.pdf 538.53… Yes No SLAS-7902 3/18/2019 SLAS-7906 4/9/2021 Yes No SDTF-00397 3/18/2019 Yes No Septage Management Firm Operator Training Completed 10/23/2018 4 Greensboro, NC NC Septic Tank Association Septage Land Application Site Operator Training Completed Date Hours Location Training Sponsored or Provided by Select one** Comments or notes Signature Date Print Name**Title** 10/23/2018 3 Greensboro NC NC Septic Tank Association 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. 12/20/2018 08:49:13 AM Wayne Billingsley Owner AUTHORIZATION TO DISCHARGE SEPTAGE TO A WASTEWA丁ER 丁REATMENT FAC田TY No刷Ca「o冊a Department of Environment and Natural Resources Division of Waste Management - So=d Waste Section 401 Obe佃n Rd,, Ste. 150, Raleigh, N,Ci 27605 Fee assessmentS and waste dete「minations w紺be 「equjred a=he djscretion 。f the wastewater t「eatment fac冊y. The fac冊y has the u-timate p「erogative to deny discha「ges of any wastes to the incoming 」一世吐世d - C掴Eden器譜票語詰討Super而endent　　　- -臆」坦坤aneB「idqe Road _ Eden' NC 27篭馬丁　　　　　i一一糟竿--do hereby authorize「語盤豊嵩豊黒革 of臆臆F冊nasley Se匝Ta[k COmDanV NCS# lseptage Management Firm Name and NCS number) to dispose of: domestic septage POhable to=et waste grease septage (g「ease t「ap pumpings) NIA commercial/industrial septage N/A　, f「om -臆　Roc刷am countY and surro豊鴇'「apr剛「ea,　　　　　- at the above named wastewate「 treatment fac冊y. Septage sha= be discha「ged at: 一世bane Bndqe Wastewate「 T「e麺並地上2器討e B畦Road Eden‘ NC 27288　. between the hours of　7:OO a.m. -4:00 p.m. Monday- Friday ○○ Septagew冊e accepted afte「hours bvappt. 〔出血 After hours & eme「gencies ca=: 336後627■1009 ext" 4 Reint「oducing pa固iy treated liquid into a g「ease t「ap is acceptabIe This authorization sha= beva=d untiI Decembe「31, 2019 Yes X No Dat。臆臆臆臆喜作ファー雁 (Fac=ity Ope「ato「) Swom to and subscribed befo「e me this 《光れ埴叫U告巾ルV、4 My Commissjon expires: 醇も直面釜戸 20沌 3破鐘需給 (Nota「y Pub"c) (OFF'C-ALSEAL) :一・二　i▲、　了　十」　二号 N。t。‥ Falsifi。ati。n 。f this d。。um。nt by th。 S。Ptage management firm shail lead to permit 「evocation+了 PAID FIRM NAME: Billingsley Septic Tank Company PERMIT #: NCS-00397 AMOUNT: $800 PAID BY: e-check DATE: 12/20/18 Chester Cobb