HomeMy WebLinkAboutNCS00759_2020Permit_Initial 2020
Permit and Registration
Hurley Backhoe Services Inc.
is hereby issued a Septage Management Firm Permit, Permit Number NCS-00759
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. Town of Troy WWTP, Troy NC
2. City Asheboro WWTP, Asheboro NC 3. Moore County Water Pollution Control Plant, Aberdeen NC
4. Town of Mount Gilead, Mount Gilead NC
5. Rocky River Regional WWTP, Concord NC
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?**
Mailing Address**
Phone**Fax
Firm Info
Hurley Backhoe Services, Inc.
The "Firm name" must be exactly as it is shown on your vehicle(s).
NCS-00759
Enter the five digits following the NCS #
City
Star
State / Province / Region
NC
Postal / Zip Code
27356
Country
US
Street Address
116 Rock Hill Dr.
Address Line 2
Montgomery
Yes No
910-571-0698
hurleybackhoeinc@yahoo.com
Owner Info
Steven Hurley
Yes No
City
Star
State / Province / Region
NC
Postal / Zip Code
27356
Country
US
Street Address
184 Hurley Farm Rd.
Address Line 2
910-571-2028
Firm operator's name**Firm operator's title
Mailing address same as street address of office?**
Phone**Fax
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*
Operator Info
Steven Hurley President
Yes No
910-571-2028
Type and amount of septage pumped in the last 12 months
208,000
41,600
0
0
0
North Carolina counties of operation
Moore, Montgomery, Randolph, Cabarrus
Vehicle Info
Yes No
12/30/2019
President
Add vehicles
individually
Upload List
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)**
Other disposal method**
Portable Toilet Waste JL9295 JALB4B14817004623 650
Domestic Septage AS3887 2FZHAJBC5YAG47965 1,400
Portable Toilet Waste JL9294 1GBE5C1947F425299 950
Portable Toilet Waste JP6533 54DC4W1B0K5810929 950
Septage Disposal Method
For each method, indicate whether you plan to use it by checking yes or no.
Yes No
Moore County WWTP 12/31/2020 2020 Moore
dump
form.tiff
58.78KB
Town of Troy WWTP 12/31/2020 2020 Troy
dump
form.tiff
62.17KB
Town of Mount Gilead WWTP 12/31/2020 2020 MG dump
form.tiff
64.57KB
Rocky River Regional WWTP 12/31/2020 2020 Cabarrus
dump
form.tiff
56.43KB
City of Asheboro WWTP 12/31/2020 2020 Randolph
dump
form.tiff
57.85KB
Yes No
Yes No
Yes No
Septage Management Firm Operator Training Completed
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**
1/15/2019 6
Hickory, 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.
12/30/2019
03:49:03 AM
Steven Hurley President
PayPoint
Payment Receipt
Application: Solid Waste
Merchant: NDENR-Solid Waste
Merchant City/State: Raleigh, North Carolina
Payment Status: Settled
R.esult Message: Payment completed and settled successfully.
Confirmation Number: 19123060953990
Payment Date: 12/30/2019
Posting Date: 12/30/2019
BIiiing Information: Hurley Backhoe Services inc. 116 Rock Hill Drive Star, NC 27356 9105710698 hurleybackhoeinc@yahoo.com
Payment Amount: 800.00 USD
Page 1 of 1
Account Type: Checking
Reference Information: NCS-00759-2020,27356,Hurley Backhoe Services Inc,184 Hurley Farm Road,Star,NC,NCS-00759,$800.00
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 12/31/2019