NCS01349_Permit2019_Initial

2019
Permit and Registration
HERR Inc.
is hereby issued a Septage Management Firm Permit, Permit Number NCS-01349
And by virtue of completing the annual training
requirements is hereby registered as a 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. Septage Detention or Treatment Facilities: SDTF-26-05, 34-06 and 60-09
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
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
Whiteville
State / Province / Region
North Carolina
Postal / Zip Code
28472
Country
United States
Street Address
PO Box 2345
Address Line 2
910-640-2607 910-640-2609
Operator Info
Michael Stoneman Manager
Yes No
City
Whiteville
State / Province / Region
North Carolina
Postal / Zip Code
28472
Country
United States
Street Address
PO Box 2345
Address Line 2
336-317-0630 910-640-2609
Type and amount of septage pumped in the last 12 months
0
0
0
0
0
North Carolina counties of operation
Columbus, Bladen, New Hanover, Brunswick, Cumberland
Vehicle Info
Yes No
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**
Septage Land Application Sites (SLAS)**
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**
12/31/2018
Manager
Add vehicles
individually
Upload List
Grease (restaurant)MH1809 1FVHBXC5X3H594825 2,800
Septage Disposal Method
For each method, indicate whether you plan to use it by checking yes or no.
Yes No
Yes No
Yes No
SDTF-3405 12/31/2019 Scan_0002.pdf 350.88…
SDTF-6009 12/31/2019 Scan_0002.pdf 350.88…
SDTF-2605 12/31/2019 Scan_0002.pdf 350.88…
Yes No
Septage Management Firm Operator Training Completed
10/23/2018 4
Bur-Mill Park in Greensboro, NC
NC Septic Tank Association
Date Hours
Location
Training Sponsored or Provided by
Select one**
Comments or notes
Signature
Date
Print Name**Title**
NC Septic Tank Association
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.
12/31/2018
12:23:50 AM
Michael Stoneman Manager