The URL can be used to link to this page

Home My WebLink AboutNCS01432_2019Permit_Initial 2019 Permit and Registration Reliable Onsite Services is hereby issued a Septage Management Firm Permit, Permit Number NCS-01432 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. McAlpine Creek WWTP, Charlotte NC 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 APPLICATION FOR PERMIT TO OPERATE A SEPTAGE MANAGEMENT FIRM DIVISION OF WASTE MANAGEMENT - SOLID WASTE SECTION – 1646 MAIL SERVICE CENTER, RALEIGH, NC 27699-1646 (1.) Firm name: (The “Firm name” must be exactly as it is shown on your vehicle(s)). Street address of office: City: State: ___ Zip: Mailing address (if different): City: ______________ State: ________Zip: _________________________ Phone: Fax: ________________________________________ E-Mail: ______________________________________________________________________________ County: Septage Management Firm permit number: NCS # (2.) Firm owner's name: Mailing address (if different): City: ______________ State: _______ Zip: _________________________ Phone: Fax: ________________________________________ (3.) Firm operator's name: Firm operator’s title: Mailing address (if different): City: ______________ State: _______ Zip: _________________________ Phone: Fax: ________________________________________ (4.) Type(s) of septage pumped: Write in the number of gallons pumped in last 12 Months (Example: Domestic: 50,000). Domestic Portable Toilet Waste Grease (Restaurant) Treatment Plant Industrial/Commercial (5.) N.C. Counties of Operation: _______ ____________________________________________________________________________________ (List each county you are authorized to do business in) (6.) Total Number of Pumper Vehicles Operated: Number used for: Domestic Septage:___________ Grease (restaurant): ____________ Other: ____________________ Portable Toilet Waste: __________ Vehicle Information: (use additional paper if needed) License Tag # Vehicle Identification # Tank Capacity 1 2 3 4 5 APPLICATION CONTINUED ON PAGE 2 Reliable Onsite Services 5600 Union Road Gastonia 28056 791 East 64th Avenue 303-286-4394 Gaston 01432 United Rentals (North America), Inc. 791 East 64th Avenue 303-286-4394 United Rentals (North America), Inc. 303-286-4394 65500 4 JC6355 JALE5W164K7300873 500 JE2552 1FDUF5HT8JEC27223 800 JE7468 5PVNJ8JV1K4S72807 1100 YA143984 5PVNJ8JV8K4S70925 1100 NC Denver CO 80229 gzoldows@ur.com Denver CO 80229 Denver CO 80229 Mecklenburg, Lincoln, GAson, Catawba, Rowan, Cleveland, Polk, Columbus, Cabarrus, Union, Ireland, Rutherford, Onslow 4 PAGE 1 APPLICATION FOR PERMIT TO OPERATE A SEPTAGE MANAGEMENT FIRM (CONTINUED FROM PAGE 1) (7.) Septage Disposal Method: (check one) a) Approved wastewater treatment plant: ( ) yes ( ) no. If yes, submit Wastewater Treatment Authorization for each plant, as indicated in Subparagraph .0833(c)(14) of the Septage Management Rules. b) Septage Land Application Site (SLAS) Permit Numbers: (use additional sheets if needed) SLAS#: Expiration Date: SLAS#: Expiration Date: ____________ c) Septage Detention or Treatment Facility (SDTF) Permit Numbers: (use additional sheets if needed) SDTF#: Expiration Date: _ SDTF#: Expiration Date: ____________ (8.) Septage Management Firm Operator Training Completed: Date: _________________ Location: _______________________ Hours: _____ Training Sponsored or Provided by: _____________________________________________________________ (9.) Septage Land Application Site Operator Training Completed: Date: _________________ Location: _______________________ Hours: _____ Training Sponsored or Provided by: _____________________________________________________________ (10.) Registration type requested: CHECK ONE Registered Portable Sanitation Firm: ______ Registered Septage Management Firm: ______ Registered Portable Sanitation and Septage Management Firm: ______ 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. ______ Signature (Signature of company official required) Date ______ Print Name Title Other Comments: S:/Solid_Waste:/CLA/SEPTAGE/FORMS/2018 Firm Application/FirmPermitApplication2018 PAGE 2 X X Grant Zoldowski Director Environmental Management 1/18/2019 NC SEPTAGE MANAGEMENT FIRM S:\Solid_Waste\cla\septage\forms\Pumper Vehicles Cetification.doc Recertification of Pumper Vehicle(s) Septage Firm Permit #: NCS- Number of Pumper Vehicles: CERTIFICATION: “I certify, under penalty of law, that the pumper vehicle or vehicles listed in the submitted permit application meet the requirements for safe and sanitary transportation of septage as required by15A NCAC 13B .0844 (a) and vehicle lettering as required by 15A NCAC 13B .0844 (b). 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 are significant penalties for false certification including the possibility of fine and imprisonment.” Signature (Signature of company official required) Date Print Name Title 01432 4 Grant Zoldowski Director Environmental Management 1/18/2019 Scott Toole for NCS-01432 Paid $800 electronically on 10/24/2018. Chester Cobb APPLICATION FOR PERMIT TO OPERATE A SEPTAGE MANAGEMENT FIRM DIVISION OF WASTE MANAGEMENT - SOLID WASTE SECTION – 1646 MAIL SERVICE CENTER, RALEIGH, NC 27699-1646 (1.) Firm name: (The “Firm name” must be exactly as it is shown on your vehicle(s)). Street address of office: City: State: ___ Zip: Mailing address (if different): City: ______________ State: ________Zip: _________________________ Phone: Fax: ________________________________________ E-Mail: ______________________________________________________________________________ County: Septage Management Firm permit number: NCS # (2.) Firm owner's name: Mailing address (if different): City: ______________ State: _______ Zip: _________________________ Phone: Fax: ________________________________________ (3.) Firm operator's name: Firm operator’s title: Mailing address (if different): City: ______________ State: _______ Zip: _________________________ Phone: Fax: ________________________________________ (4.) Type(s) of septage pumped: Write in the number of gallons pumped in last 12 Months (Example: Domestic: 50,000). Domestic Portable Toilet Waste Grease (Restaurant) Treatment Plant Industrial/Commercial (5.) N.C. Counties of Operation: _______ ____________________________________________________________________________________ (List each county you are authorized to do business in) (6.) Total Number of Pumper Vehicles Operated: Number used for: Domestic Septage:___________ Grease (restaurant): ____________ Other: ____________________ Portable Toilet Waste: __________ Vehicle Information: (use additional paper if needed) License Tag # Vehicle Identification # Tank Capacity 1 2 3 4 5 APPLICATION CONTINUED ON PAGE 2 Reliable Onsite Services 5600 Union Road Gastonia 28056 791 East 64th Avenue 303-286-4394 Gaston 01432 United Rentals (North America), Inc. 791 East 64th Avenue 303-286-4394 United Rentals (North America), Inc. 303-286-4394 65500 4 JC6355 JALE5W164K7300873 500 JE2552 1FDUF5HT8JEC27223 800 JE7468 5PVNJ8JV1K4S72807 1100 YA143984 5PVNJ8JV8K4S70925 1100 NC Denver CO 80229 gzoldows@ur.com Denver CO 80229 Denver CO 80229 Mecklenburg, Lincoln, GAson, Catawba, Rowan, Cleveland, Polk, Cabarrus, Union, Ireland, Rutherford 4 PAGE 1 APPLICATION FOR PERMIT TO OPERATE A SEPTAGE MANAGEMENT FIRM (CONTINUED FROM PAGE 1) (7.) Septage Disposal Method: (check one) a) Approved wastewater treatment plant: ( ) yes ( ) no. If yes, submit Wastewater Treatment Authorization for each plant, as indicated in Subparagraph .0833(c)(14) of the Septage Management Rules. b) Septage Land Application Site (SLAS) Permit Numbers: (use additional sheets if needed) SLAS#: Expiration Date: SLAS#: Expiration Date: ____________ c) Septage Detention or Treatment Facility (SDTF) Permit Numbers: (use additional sheets if needed) SDTF#: Expiration Date: _ SDTF#: Expiration Date: ____________ (8.) Septage Management Firm Operator Training Completed: Date: _________________ Location: _______________________ Hours: _____ Training Sponsored or Provided by: _____________________________________________________________ (9.) Septage Land Application Site Operator Training Completed: Date: _________________ Location: _______________________ Hours: _____ Training Sponsored or Provided by: _____________________________________________________________ (10.) Registration type requested: CHECK ONE Registered Portable Sanitation Firm: ______ Registered Septage Management Firm: ______ Registered Portable Sanitation and Septage Management Firm: ______ 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. ______ Signature (Signature of company official required) Date ______ Print Name Title Other Comments: S:/Solid_Waste:/CLA/SEPTAGE/FORMS/2018 Firm Application/FirmPermitApplication2018 PAGE 2 X X Grant Zoldowski Director Environmental Management 2/11/2019