NCS00469_Permit2019_Initial

2019
Permit and Registration

Bell’s Septic Tank Cleaning
is hereby issued a Septage Management Firm Permit, Permit Number NCS-00469
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. Tar River Regional 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?**
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
Bell’s Septic Tank Cleaning
The "Firm name" must be exactly as it is shown on your vehicle(s).
NCS-00469
Enter the five digits following the NCS #
City
Nashville
State / Province / Region
NC
Postal / Zip Code
27856
Country
USA
Street Address
5138 Old Bailey Hwy
Address Line 2
Nash
Yes No
[phone]
[e-mail]
Owner Info
Paul G Bell
Yes No
[phone]
Operator Info
Paul G Bell Owner
Yes No
[phone]
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
875,400
0
0
0
0
North Carolina counties of operation
Nash, Edgecombe, Wilson, Franklin, Johnston, Wake, Halifax, Pitt, Wayne
Vehicle Info
Yes No
12/3/2018
Owner
Add vehicles
individually
Upload List
Domestic Septage YA127613 1FVHCYCY5GHHG8548 3,650
Domestic Septage YA000838 2FZACGBS57AY09711 2,800
Septage Disposal Method
For each method, indicate whether you plan to use it by checking yes or no.
Yes No
Signature
Date
Print Name**Title**
12/3/2018
07:32:53 AM
Paul Bell Owner