NCS00261_Permit2019_Initial

2019
Permit and Registration

Rogers Septic Tank Service
is hereby issued a Septage Management Firm Permit, Permit Number NCS-00261
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. Greenville Utilities WWTP
2. Septage Detention or Treatment Facilities, SDTF-74-14 and SDTF-98-08
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
Roger's Septic Tank Service
The "Firm name" must be exactly as it is shown on your vehicle(s).
NCS-00261
Enter the five digits following the NCS #
City
Greenville
State / Province / Region
NC
Postal / Zip Code
27834
Country
US
Street Address
309 Family Lane
Address Line 2
Pitt
Yes No
2527585164
[e-mail]
Owner Info
Chester Rogers
Yes No
2527585164
Operator Info
Chester B. Rogers Manager
Yes No
2527147588
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
294,000
0
12,000
0
0
North Carolina counties of operation
Pitt, Greene, Lenoir, Wayne, Beaufort, Craven, Edgecombe, Martin, Wilson,
Bertie
Vehicle Info
Yes No
12/31/2018
Manager
Add vehicles
individually
Upload List
Domestic Septage YA108507 1FDPT84A9HVA64605 2,300
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)**
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
Training Sponsored or Provided by
Select one**
Greenville Utilities Wastewater
Treatment Plant
12/31/2019
Yes No
Yes No
SDTF-12/31/2019
Yes No
Septage Management Firm Operator Training Completed
6/23/2018 4
New Bern
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
Comments or notes
Signature
Date
Print Name**Title**
I will be mailing the Treatment Facility paperwork.
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
08:40:52 PM
Chester B. Rogers Manager
AU甘鱒⑱削ZA丁roN T㊤勘SC蘭ARG冨S畳PTAG臣AT A §臣PTAGE TREATM冨NT OR
ST㊤RAGE管AC曲丁Y PERMI丁丁ED T⑱ S⑱MEONE ⑬丁蘭冨R T軸AN YOURS軋F
(This fo「m is used by a detention or treatmentfac冊Y Permit holder to indicate that permission
has been given to a pe「mitted Septage Management Fi「m to discharge septage into the pe「mit
holders detention or treatment fac冊y.)
l, Daniel L Newsome
441 Buck Newsome Rd, Fremont, NC 27830
(干a輔やOpe「ato「)
(Operator Address〉
do hereby authorize: Chester Ro鯵rs
(Owner of Septage Management Firm)
R〇日er’s SeD肩c Tank Se「vice
(Name of Septage Management Firm)
NCS# 00261
309 Fami!vしane Greenv紺e. NC 27834
(Address of Septage Management Firm)
to ut服e septage detention or treatment fac湘ty # 98-08 (00953)　　for the treatment or storage of
SePt鵠e掌
in 20 19　　. The fac紺ty w紺be ope「ated in accordancewith the Septage Management Rules “,
Date: 11/05/18
轟　Asde軸ed in G.S.綿OA置290(a胆2)
単車As de惰れed in鳩Å NCAC 13B.0800
(Fac硝ty Operator)
Retum the properly compIeted form to:
North Carolina Departmentof Environmental QuaIitY
Division of Waste Management
Soiid Waste Section
1646 Mail Service Center
Raleigh, NC 27699-1646
RPAID
FIRM NAME: Rogers Septic Tank Service 
PERMIT #: NCS‐00261 
AMOUNT: $550 
PAID BY: e‐check 
DATE: 12/31/2018 

Chester Cobb