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HomeMy WebLinkAboutNCS01191_Permit2019_Initial2019 Permit and Registration Twin Lakes RV Resort is hereby issued a Septage Management Firm Permit, Permit Number NCS-01191 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. City of Washington 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?** Mailing Address** Phone**Fax Firm Info Twin Lakes RV Resort The "Firm name" must be exactly as it is shown on your vehicle(s). NCS-01191 Enter the five digits following the NCS # City Chocowinity State / Province / Region NC Postal / Zip Code 27817 Country United States Street Address 1618 Memory Ln. Address Line 2 Beaufort Yes No 252-946-5700 252-974-2691 twinlakes_mgr@equitylifestyle.com Owner Info MHC Twin Lakes LLC Yes No City Chicago State / Province / Region IL Postal / Zip Code 60606 Country United States Street Address 2 North Riverside Plaza Address Line 2 Suite 800 312-279-1400 Firm operator's name**Firm operator's title Mailing address same as street address of office?** Mailing address** 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** Operator Info Kenneth Whaley Maintenance Manager Yes No City Chocowinity State / Province / Region NC Postal / Zip Code 27817 Country United States Street Address 1618 Memory Ln. Address Line 2 252-946-5700 Type and amount of septage pumped in the last 12 months 4,500 1,200 0 0 0 North Carolina counties of operation Beaufort Vehicle Info Yes No 11/6/2018 Maintenance Manager 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 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)** Expiration Date* Other disposal method** Date**Hours** Location** Maintenance Manager Add vehicles individually Upload List Domestic Septage N/A 1 300 Septage Disposal Method For each method, indicate whether you plan to use it by checking yes or no. Yes No City of Washington Wastewater Treatment Plant 12/31/2019 Authorization to discharge Septage.pdf 314.74… Yes No No 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. Authorization Yes No Septage Management Firm Operator Training Completed 12/12/2015 4 Training Sponsored or Provided by** Date Hours Location Training Sponsored or Provided by Select one** Comments or notes Signature Date Print Name**Title** Raleigh, NC NC Pumper Group & NC Portable Toilet Group Septage Land Application Site Operator Training Completed 0 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. 11/6/2018 01:43:54 PM Kenneth Whaley Maintenance Manager Late Fee PAID FIRM NAME: Twin Lakes RV Resort PERMIT #: NCS-01191 AMOUNT: $275 PAID BY: e-card DATE: 01/19/2019 Chester Cobb PAID (late) FIRM NAME: Twin Lakes RV Resort PERMIT #: NCS-01191 AMOUNT: $550 PAID BY: e-card DATE: 01/23/2019 Chester Cobb