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Home My WebLink AboutNCS01033_Permit2019_Initial 2019 Permit and Registration A-1 Portable Toilets is hereby issued a Septage Management Firm Permit, Permit Number NCS-01033 And by virtue of completing the annual training requirements is hereby registered as a Portable Sanitation 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. Cross Creek Water Reclamation Facility, Fayetteville NC 2. City of Lumberton Wastewater Plant 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 A-1 Portable Toilets, Inc The "Firm name" must be exactly as it is shown on your vehicle(s). NCS-01033 Enter the five digits following the NCS # City Fayetteville State / Province / Region NC Postal / Zip Code 28306 Country Cumberland Street Address 1645 Tom Starling Road Address Line 2 Cumberland Yes No City Hope Mills State / Province / Region NC Postal / Zip Code 28348 Country United States Street Address PO Box 1051 Address Line 2 9104845219 9104840570 a1portabletoilet@aol.com Owner Info Deborah Anglin 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?** City Hope Mills State / Province / Region North Carolina Postal / Zip Code 28348 Country United States Street Address PO Box 1051 Address Line 2 9104845219 9104840570 Operator Info Deborah Anglin Owner Yes No City Hope Mills State / Province / Region North Carolina Postal / Zip Code 28348 Country United States Street Address PO Box 1051 Address Line 2 9104845219 9104840570 Type and amount of septage pumped in the last 12 months 0 194,088 0 0 0 North Carolina counties of operation Cumberland Robeson County Hoke County Moore County Harnett Vehicle Info "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. 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)** Yes No 12/21/2018 Owner / Operator Add vehicles individually Upload List Portable Toilet Waste EB-8557 1HTMMAAL4DH416423 1,500 Portable Toilet Waste HR*5507 3C7WRMBL3HG656041 900 Septage Disposal Method For each method, indicate whether you plan to use it by checking yes or no. Yes No City of Lumberton 12/31/2019 Lumberton Plant.pdf 320.51… Cross Creek WRF 12/31/2019 Cross Creek Plant.pdf 354.54… Yes No Yes No 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 Print Name**Title** Yes No Septage Management Firm Operator Training Completed 12/8/2018 4 Raleigh. NC 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 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. 12/21/2018 12:06:09 AM Deborah F. Anglin Owner / Operator