NCS01227_Permit2019_Initial

2019
Permit and Registration

The Plush Flush
is hereby issued a Septage Management Firm Permit, Permit Number NCS-01227
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. Clark Creek WWTP, Newton 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

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?**
Mailing Address**
Phone**Fax
Email**
Firm owner's name**
Mailing address same as street address of office?**
Mailing Address**
Firm Info
The Plush Flush
The "Firm name" must be exactly as it is shown on your vehicle(s).
NCS-1227
Enter the five digits following the NCS #
City
N/A
State / Province / Region
N/A
Postal / Zip Code
N/A
Country
N/A
Street Address
N/A
Address Line 2
Lincoln
Yes No
City
DENVER
State / Province / Region
NC
Postal / Zip Code
28037
Country
UNITED STATES
Street Address
PO BOX 283
Address Line 2
704-574-9421
[e-mail]
Owner Info
ANDREW ALLEN
Yes No
Phone**Fax
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
City
DENVER
State / Province / Region
NC
Postal / Zip Code
28037
Country
UNITED STATES
Street Address
PO BOX 283
Address Line 2
704-574-9421
Operator Info
ANDREW ALLEN OWNER
Yes No
City
DENVER
State / Province / Region
NC
Postal / Zip Code
28037
Country
UNITED STATES
Street Address
PO BOX 283
Address Line 2
704-574-9421
Type and amount of septage pumped in the last 12 months
0
5,000
0
0
0
North Carolina counties of operation
MECKLENBURG, LINCOLN, UNION, IREDELL, CABARRUS, CATAWBA AND SURROUNDING
Vehicle Info
Yes No
PayPoint
Payment Receipt
Application: Solid Waste
Merchant: NDENR-Solid Waste
Merchant City/State: Raleigh, North Carolina
Payment Status: Settled
Result Message: Payment completed and settled successfully.
Payment Date: 10/24/2018
Posting Date: 10/24/2018
Billing Information: The Plush Flush PO Box 283 Denver, NC 28037 7045749421 [e-mail]
Payment Amount: 550.00 USO
Page 1 of 1
Reference Information: NCS-01227-2019,28037,The Plush Flush, LLC,PO Box 283,Denver,NC,NCS-01227,$550.00
Disclaimer: No convenience fee is charged for using the eCheck payment method. However, a processing fee of $25.00 or 10% of the amount of the eCheck, whichever is greater, will be charged for an eCheck returned due to insufficient funds. Payments are null and void if payment is made with an eCheck that is returned unpaid by the bank.
https://admin.thepayplace.com/epayadmin/paymentreceipt.aspx 10/25/2018