HomeMy WebLinkAboutNCS01503_2020Permit_Initial 2020
Permit and Registration
Roto-Rooter (Franklin)
is hereby issued a Septage Management Firm Permit, Permit Number NCS-01503
And by virtue of completing the annual training
requirements is hereby registered as a 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. Tuckaseigee Water & Sewer Authority, Plant #1, Sylva NC 2. Town of Franklin WWTP, Franklin 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?**
Mailing Address**
Phone**Fax
Email**
Firm owner's name**
Mailing address same as street address of office?**
Phone**Fax
Firm Info
roto rooter
The "Firm name" must be exactly as it is shown on your vehicle(s).
NCS-01503
Enter the five digits following the NCS #
City
valdosta
State / Province / Region
ga
Postal / Zip Code
31603
Country
lowndes
Street Address
2598 us hwy 41 south
Address Line 2
truck located at 3106 highlands rd franklin nc 28734
Macon
Yes No
City
valdosta
State / Province / Region
ga
Postal / Zip Code
31603
Country
us
Street Address
po box 1403
Address Line 2
2296307903
williamtebert@yahoo.com
Owner Info
william ebert
Yes No
2296307903
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 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?**
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)**
Operator Info
william ebert owner
Yes No
2296307903
Type and amount of septage pumped in the last 12 months
30,000
0
0
0
0
North Carolina counties of operation
macon jackson
Vehicle Info
Yes No
Septage Disposal Method
For each method, indicate whether you plan to use it by checking yes or no.
Yes No
tuckaeigee water and sewer
12/31/2020
WIN_20191209_…121.24…
Yes No
x ----LIC PLATE: MA78EH VIN: 2FRXF75H77V471507 2300 GALLONS JRB2/5/2020
Town of Franklin
Indefinite
Per TW&S
JRB 2/5/2020
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
Print Name**Title**
Yes No
Yes No
Septage Management Firm Operator Training Completed
10/17/2019 8
franklin 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.
12/9/2019
03:11:09 AM
william ebert owner
PayPoint
Payment Receipt
Application: Solid Waste Credit
Merchant: NDENR-Solid Waste Credit
Merchant City/State: Raleigh, North Carolina
Merchant Location Code: 00001
Payment Status: Success
Result Message: Success
Confirmation Number: 19120957237226
Payment Date: 12/09/2019
Posting Date: 12/09/2019
Billing Information: wllliam t ebert po box 1403 valdosta, GA 31603 2296307903 williamtebert@yahoo.com
Payment Amount: 550.00 USD
Card Type: VISA
Method: Not Present
Reference Information: NCS-01503-2020,31602,Roto-Rooter,US Hwy 41 South, Valdosta,GA,NCS-01503,$550.00
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https://admin.thepayplace.com/epayadmin/paymentreceipt.aspx 12/9/2019