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Home My WebLink AboutNCS00304_2020Permit_Initial 2020 Permit and Registration Stay Clean is hereby issued a Septage Management Firm Permit, Permit Number NCS-00304 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. Central Johnson County Regional WWTP, Smithfield NC 2. Hominy Creek WRF, Wilson NC 3. North Harnett Regional WWTP, Lillington NC 4. Neuse River Resource Recovery Facility, Raleigh NC 5. Septage Detention or Treatment Facility, SDTF-51-03 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, 2020. __________________________________________________ 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 STAY CLEAN The "Firm name" must be exactly as it is shown on your vehicle(s). NCS-00304 Enter the five digits following the NCS # City ANGIER State / Province / Region NC Postal / Zip Code 27501 Country US Street Address 670 WIGGINS RD Address Line 2 Johnston Yes No 9194271623 STAYCLEANINC@YAHOO.COM Owner Info GENE STEPHENSON Yes No 919-427-1623 919-639-1091 Operator Info BRIAN DIXON MANAGER Yes No 919-427-1623 919-693-1091 Amount in gallons * DomesticDomestic Portable Toilet WastePortable To ilet Waste Grease (Restaurant)Grease (R estaurant) Treatment PlantTreatment Plant Industrial/CommercialIndustrial/Co mmercial 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* Type and amount of septage pumped in the last 12 months 78,500 222,000 0 0 0 North Carolina counties of operation JOHNSTON, HARNETT, WAKE, WAYNE Vehicle Info Yes No 11/11/2019 Manager 11-11-19 Add vehicles individually Upload List Portable Toilet Waste AB-3220 1GBJC33US1F185502 100 Portable Toilet Waste AB-9020 1HTSDAAL91H335808 750 Portable Toilet Waste AB-3223 1HTSCAALSV475878 950 Portable Toilet Waste EA-3218 1HTSLAAM2SH643707 850 Portable Toilet Waste AB-3222 3FENF80C3KMA00425 900 Domestic Septage YA130876 1HTSCAAN51H348088 2,100 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)** 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** Portable Toilet Waste YA143056 2NKMHD7X55M075130 1,750 Domestic Septage YA143056 2NKMHD7X55M075130 1,750 Portable Toilet Waste JB-7847 3FRWF75S97V487991 1,050 Other X X 0 Septage Disposal Method For each method, indicate whether you plan to use it by checking yes or no. Yes No Nathan Howell;City of Raleigh/Neuse River Resource Recovery Facility 12/31/2020 Scan2019-10- 23_102400.jpg 473.14… Billy J. Thomas (Grade IV WW #995445), ORC of NHRWWTP (NPDES # NC 0021636 12/31/2020 Scan2019-10- 23_103004.jpg 481.79… Yes No Yes No SDTF-1/11/2021 Scan2019-10- 23_105002.jpg 526.65… Yes No Septage Management Firm Operator Training Completed 1/12/2019 4 NC STATE FAIRGROUNDS, RALEIGH NC Date Hours Location Training Sponsored or Provided by Select one** Comments or notes Signature Date Print Name**Title** 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 We will send in an Authorization To Discharge Septage To A Wastewater Treatment Facility Form, from Central Johnston County Regional Wastewater Treatment Plant just as soon as we get it. thanks 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. 11/11/2019 09:15:32 AM BRIAN E. DIXON MANAGER PayPoint Payment Receipt Application: Solid Waste Merchant: NDENR-Solid Waste Merchant Ctty/State: Raleigh, North Carolina Payment Status: Settled Result Message: Payment completed and settled successfully. Confirmation Number: 19111152253131 Payment Date: 11/11/2019 Posting Date: 11/11/2019 Billing Information: Stay Clean Inc. 670 WIGGINS RD ANGIER, NC 27501 9194271623 STAYCLEANINC@YAHOO.COM Payment Amount: 800.00 USD Account Type: Checking Reference Information: ncs-00304-2020,27501,Stay Clean,670 Wiggins Road,Angier,NC,NCS-00304,$800.00 Page 1 of 1 Disclaimer: No convenience fee is charged for. using the eCheck payment method. However, a processing fee of $25.00 or 10% of the amount of the eCheck, whichever is greater, will be charged for an eCheck returned due to insufficient funds. Payments are null and void if payment is made with an eCheck that is returned unpaid by the bank. https://admin.thepayplace.com/epayadmin/paymentreceipt.aspx 11/12/2019