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Home My WebLink AboutNCS00128_Permit2019_Initial 2019 Permit and Registration Elvis Service Co., Inc is hereby issued a Septage Management Firm Permit, Permit Number NCS-00128 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. Septage Detention or Treatment Facility SDTF-78-22 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 Elvis Service Co., Inc The "Firm name" must be exactly as it is shown on your vehicle(s). NCS-00128 Enter the five digits following the NCS # City Myrtle Beach State / Province / Region South Carolina Postal / Zip Code 29577 Country United States Street Address 2200 Executive Ave Address Line 2 Out-of-State Yes No City Myrtle Beach State / Province / Region SOUTH CAROLINA Postal / Zip Code 29577 Country United States Street Address 2200 EXECUTIVE AVE Address Line 2 8434485016 info@elvisservicecompany.com Owner Info PHILLIP LEROY ELVIS 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 Myrtle Beach State / Province / Region South Carolina Postal / Zip Code 29577 Country United States Street Address 2200 EXECUTIVE AVE Address Line 2 8434485016 Operator Info PHILLIP ELVIS OWNER Yes No City Myrtle Beach State / Province / Region South Carolina Postal / Zip Code 29577 Country United States Street Address 2200 EXECUTIVE AVE Address Line 2 8434485016 Type and amount of septage pumped in the last 12 months 15,000 50,000 46,000 0 0 North Carolina counties of operation BRUNSWICK AND NEW HANOVER 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)** 12/31/2018 OWNER Add vehicles individually Upload List Domestic Septage P797239 1HTSHPCRYPH505722 3,500 Domestic Septage P426201 1HTSDAAN6Y11299281 2,500 Domestic Septage PT72836 1T9AE15B0LF0D3031 7,000 Grease (restaurant)P101296 1HTSAAN5TH313700 3,500 Grease (restaurant)P741739 1HTWAHTX6J341371 5,000 Portable Toilet Waste P101302 1FDAF57P27EB50784 750 Portable Toilet Waste P101303 1HTMMAAL92H548946 1,150 Portable Toilet Waste P291814 1HTMMAAL625H534891 1,150 Portable Toilet Waste P530024 1HTMMAAL96H196408 1,250 Portable Toilet Waste P361527 1HTMMAAL66H345583 1,150 Grease (restaurant)P744183 5KKMAEBGXGPHJ1312 5,500 Portable Toilet Waste P504949 3HAMMMML8FL709056 1,150 Grease (restaurant)P753957 5KKHAXDV4JLP7132 4,000 Grease (restaurant)P747584 1HTMMMMNXHH475660 2,700 Domestic Septage P752356 5KKHAXDV2HPJC0670 3,500 Portable Toilet Waste P659509 3C7WRMCL8HG753864 750 Portable Toilet Waste P661006 1HTMMMML4JH344907 1,150 Septage Disposal Method For each method, indicate whether you plan to use it by checking yes or no. Yes No Yes No 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)** Other disposal method** Date**Hours** Location** Training Sponsored or Provided by** Date Hours Location Training Sponsored or Provided by Select one** Comments or notes Signature Date SLAS-78-22 12/31/2019 Yes No Yes No Septage Management Firm Operator Training Completed 4/24/2018 4 SHALLOTTE, NC 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 Print Name**Title** 12/31/2018 01:06:16 PM PHILLIP ELVIS OWNER PAID FIRM NAME: Elvis Service Co., Inc PERMIT #: NCS-00128 AMOUNT: $800 PAID BY: e-card DATE: 12/20/18 Chester Cobb