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Home My WebLink AboutNCS00860_Permit2019_Initial2019 Permit and Registration Village of BHI Utilities Dept is hereby issued a Septage Management Firm Permit, Permit Number NCS-00860 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.Bald Head Island 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?** Mailing Address** Phone**Fax Email** Firm owner's name** Mailing address same as street address of office?** Mailing Address** Firm Info Village of BHI Utilities Dept. The "Firm name" must be exactly as it is shown on your vehicle(s). NCS-00860 Enter the five digits following the NCS # City Bald Head Island State / Province / Region North Carolina Postal / Zip Code 28461 Country United States Street Address 256 Edward Teach Extension Address Line 2 Brunswick Yes No City Bald Head Island State / Province / Region North Carolina Postal / Zip Code 28461 Country United States Street Address VBHI Utilities Department Address Line 2 P.O. Box 3009 9104577350 9104577353 dmintz@villagebhi.org Owner Info Village of Bald Head Island Yes No Phone**Fax Firm operator's name**Firm operator's title Mailing address same as street address of office?** 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** City Bald Head Island State / Province / Region North Carolina Postal / Zip Code 28461 Country United States Street Address 106 Lighthouse Wynd Address Line 2 9104579700 9104576206 Operator Info David P. Mintz Jr.Utilities Field Supervisor Yes No 9104480623 9104577353 Type and amount of septage pumped in the last 12 months 1,045 13,120 0 0 0 North Carolina counties of operation Brunswick NC Vehicle Info Yes No 1/2/2019 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. 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)** Other disposal method** Date**Hours** Location** Training Sponsored or Provided by** Date Hours Location Utilities Field Supervisor Add vehicles individually Upload List Portable Toilet Waste 85763-T 1FDWF36567EB12503 300 Septage Disposal Method For each method, indicate whether you plan to use it by checking yes or no. Yes No Village of Bald Head Utilities Department 12/31/2019 WWTP Autor.pdf 274.93… Yes No Yes No Yes No Septage Management Firm Operator Training Completed 1/12/2019 4 Martin Building, NC Fairground 1025 Blue Ridge Rd. Raleigh NC NC Pumper Group & NC Portable Toilet Group Septage Land Application Site Operator Training Completed 0 Training Sponsored or Provided by Select one** Comments or notes Signature Date Print Name**Title** Registration Type Registered Portable Sanitation Firm Registered Septage Management Firm Registered Portable Sanitation and Septage Management Firm Comments and Notes Training delayed due to Hurricane Florence. Also will be attending another class during the fall of 2019. 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 08:36:09 AM David P. Mintz Jr.Utilities Field Supervisor