HomeMy WebLinkAboutNCS00410_2019Permit_Initial 2019
Permit and Registration
Overbey's
is hereby issued a Septage Management Firm Permit, Permit Number NCS-00410
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. TZ Osborne WRF
2. Septage Detention or Treatment Facilities: SDTF 41-04 and 41-20
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
Overbey's
The "Firm name" must be exactly as it is shown on your vehicle(s).
NCS-00410
Enter the five digits following the NCS #
City
McLeansville
State / Province / Region
North Carolina
Postal / Zip Code
27301
Country
Guilford
Street Address
5301 Burlington Road
Address Line 2
Guilford
Yes No
336-697-8169 336-697-0397
overbeys@bellsouth.net
Owner Info
Ronnie Overbey
Yes No
336-697-8169 336-697-0397
Operator Info
Ronnie Overbey Owner
Yes No
336-697-8169 336-697-0397
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*
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
Type and amount of septage pumped in the last 12 months
950,000
0
0
0
0
North Carolina counties of operation
Guilford
Vehicle Info
Yes No
11/12/2018
Owner
Add vehicles
individually
Upload List
Domestic Septage YA130556 5KKHAVDV3HPHW3234 3,500
Domestic Septage YA37310 1HTWPAZT87J471751 3,600
Septage Disposal Method
For each method, indicate whether you plan to use it by checking yes or no.
Yes No
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)**
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**
Date Hours
Location
Training Sponsored or Provided by
Select one**
TZ Osborne Water Reclamation Facility 12/31/2019 2019
Authorization…
621.77…
Yes No
Yes No
SDTF-41-20 4/26/2022 41-20.pdf 7.81MB
SDTF-41-04 4/26/2022 41-04.pdf 1.21MB
Yes No
Septage Management Firm Operator Training Completed
2/1/2018 6
Hickory, North Carolina
NC Septic Tank Association
Septage Land Application Site Operator Training Completed
0
Registration Type
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.
11/12/2018
01:24:00 PM
Ronnie Overbey Owner
PayPoint
Payment Receipt
Application: Solid Waste Credit
Merchant: NDENR-Solid Waste Credit
Merchant City/State: Raleigh, North Carolina
Merchant Location Code: 00001
Payment Status: Settled
Result Message: Payment completed and settled successfully.
Payment Date: 11/12/2018
Posting Date: 11/12/2018
Billing Information: Ronnie D Overbey 5301 Burlington Road McLeansvllle, NC 27301 3366978169 overbeys@bellsouth.net
Payment Amount: 800.00 USD
Method: Not Present
Page 1 of 1
Reference Information: NCS-00410-2019,27301,Overbey's,5301 Burlington Road,McLeansville,NC,NCS-00410,$800.00
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https :/ /ad.min. thepayplace.com/ epayadmin/paymentreceipt.aspx 11/13/2018