NCS01454_2020Permit_Initial

2020
Permit and Registration
Carolina Cans LLC DBA
Redbox+
is hereby issued a Septage Management Firm Permit, Permit Number NCS-01454
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.Septage Detention or Treatment Facility SDTF-10-21
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
redbox+ (Legal Name is "Carolina Cans LLC")
The "Firm name" must be exactly as it is shown on your vehicle(s).
NCS-01454
Enter the five digits following the NCS #
City
Oak Island
State / Province / Region
NC
Postal / Zip Code
28465
Country
United States
Street Address
113 NE 71st Street
Address Line 2
Brunswick
Yes No
9105068628
[e-mail]
Owner Info
Hugh Crawford
Yes No
7042365174
Operator Info
Hugh Crawford Manager
Yes No
7042365174
Permitted name: Carolina Cans,
LLC DBA Redbox+
truck lettered as: redbox+
JRB 1/9/2020
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 **
Septage Land Application Sites (SLAS)**
Type and amount of septage pumped in the last 12 months
0
3,000
0
0
0
North Carolina counties of operation
Brunswick, New Hanover, Pender, Onslow, Columbus
Vehicle Info
Yes No
10/22/2019
Manager
Add vehicles
individually
Upload List
Portable Toilet Waste YA151231 2NKHHM7X9KM352018 98
Septage Disposal Method
For each method, indicate whether you plan to use it by checking yes or no.
Yes No
Yes No
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**
Signature
Date
Yes No
SDTF-10-21 12/15/2019
Yes No
Septage Management Firm Operator Training Completed
12/7/2018 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
Comments or notes
Changed continuing ed training from new operator to current JRB 1/9/2020
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.
10/22/2019
Contracts with permitted Septage Management Firm to empty SDTF
See comments below
JRB 1/9/2020
Print Name**Title**
10/22/2019
05:54:35 AM
Hugh Crawford Manager (Owner)