HomeMy WebLinkAboutNCS01317_Permit2019_Initial 2019
Permit and Registration
Victory Septic Solutions
is hereby issued a Septage Management Firm Permit, Permit Number NCS-01317
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. North and South Durham WRF 3. Louisburg WRF
4. Neuse River Resource Recovery Facility 5. Warren County WWTP
6. Septage Treatment or Detention Facility, SDTF-35-10
7. Septage Land Application Site, SLAS-35-10
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
Victory Septic Solutions
The "Firm name" must be exactly as it is shown on your vehicle(s).
NCS-01317
Enter the five digits following the NCS #
City
Louisburg
State / Province / Region
North Carolina
Postal / Zip Code
27549
Country
United States
Street Address
186 EF Cottrell Road
Address Line 2
Franklin
Yes No
9198184342
victoryseptic@gmail.com
Owner Info
Marlon Lewis
Yes No
9198184342
Operator Info
Marlon Lewis Owner
Yes No
9198184342
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
subparagraph .0833(c)(14) of the Septage Management Rules.
Type and amount of septage pumped in the last 12 months
450,000
0
4,000
0
0
North Carolina counties of operation
Franklin
Vehicle Info
Yes No
1/7/2019
Owner
Add vehicles
individually
Upload List
Domestic Septage YA131761 1fvacxDc87hy39886 2,500
Septage Disposal Method
For each method, indicate whether you plan to use it by checking yes or no.
Yes No
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)**
If you are not the permit holder for the septage land application site, you must have a signed land application authorization form for each
site.
SLAS #*Expiration Date*Authorization
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
Louisburg WRF 12/31/2019 1546841936011…4.44MB
Neuse River Resource Recovery
Facility
12/31/2019 1546842074931…4.4MB
Durham WRF 12/31/2019 1546842164530…4.26MB
Yes No
SLAS-35-10 12/31/2019 1546842324287…4.72MB
Yes No
SDTF-35-10 12/31/2019 1546842445791…4.79MB
Yes No
Septage Management Firm Operator Training Completed
1/13/2018 4
NC State Fairgrounds
NC Pumper Group & NC Portable Toilet Group
Septage Land Application Site Operator Training Completed
1/13/2018 3
NC State Fairgrounds
Training Sponsored or Provided by
Select one**
Comments or notes
Signature
Date
Print Name**Title**
NC Pumper Group & NC Portable Toilet Group
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.
12/31/2018
12:00:00 PM
Marlon Lewis
RPAID
FIRM NAME: Victory Septic Solutions
PERMIT #: NCS‐01317
AMOUNT: $550
PAID BY: e‐check
DATE: 12/31/2018
Chester Cobb