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Home My WebLink AboutNCS00834_2020Permit_Initial2020 Permit and Registration Rachel Locklear Porta John Service is hereby issued a Septage Management Firm Permit, Permit Number NCS-00834 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.City of Lumberton WWTP 2.Septage Detention or Treatment Facility, SDTF-78-193.Septage Land Application Site, SLAS-78-19 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 Rachel Locklear Porta Jon Service The "Firm name" must be exactly as it is shown on your vehicle(s). NCS-00834 Enter the five digits following the NCS # City Pembroke State / Province / Region NC Postal / Zip Code 28372 Country United States Street Address 2161 Evergreen Church Road Address Line 2 Robeson Yes No 910-734-1759 910-521-9310 r_and_d_waste@yahoo.com Owner Info Rachel Locklear Yes No 910-734-1759 910-521-9310 Operator Info Rachel Locklear Owner Yes No 910-734-1759 910-521-9310 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 ** Type and amount of septage pumped in the last 12 months 0 100,000 0 0 0 North Carolina counties of operation Robeson, Cumberland, Columbus, Scotland Vehicle Info Yes No 12/18/2019 Owner Add vehicles individually Upload List Portable Toilet Waste CF2216 1HTSDAAM71H314108 1,000 Portable Toilet Waste HJ2043 3C7WRMBLGG377724 1,200 Portable Toilet Waste JM2589 5PVNJ8JL4K4S52243 1,600 Septage Disposal Method For each method, indicate whether you plan to use it by checking yes or no. 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)** If you are not the permit holder for the septage land application site, you must have a signed land application authorization form for each site. SLAS #*Expiration Date*Authorization 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 Yes No Lumberton WWTP 12/31/2020 Cross Creek WRF 12/31/2020 Yes No SLAS-78-19 1/6/2021 Yes No SDTF-78-19 1/6/2021 Yes No Septage Management Firm Operator Training Completed 1/12/2019 4 Gov. Martin Building, State Fairgrounds 1025 Blue Ridge Rd Raleigh, NC 27607 NC Pumper Group & NC Portable Toilet Group Septage Land Application Site Operator Training Completed 1/12/2019 3 Gov. Martin Building, State Fairgrounds 1025 Blue Ridge Rd -------------------------------------------------------Disposal Authorization does not include portable toilets waste JRB 2/7/2020 Training Sponsored or Provided by Select one** Comments or notes Signature Date Print Name**Title** Gov. Martin Building, State Fairgrounds 1025 Blue Ridge Rd Raleigh, NC 27607 NC Pumper Group & NC Portable Toilet Group 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. 12/18/2019 02:13:00 PM Rachel Locklear Owner PayPoint Payment Receipt Application: Solid Waste Merchant: NDENR-Solid Waste Merchant City/State: Raleigh, North Carolina Payment Status: Settled Result Message: Payment completed and settled successfully. Confirmation Number: 19121858965507 Payment Date: 12/18/2019 Posting Date: 12/18/2019 Billing Information: R & D Associates of Pembroke, Inc. 2161 Evergreen Church Road Pembroke, NC 28372 9107341759 r _and_d_waste@yahoo.com Payment Amount: 800.00 USD Account Type: Checking Page 1 of 1 Reference Information: NCS-00834-2020,28372,Rachel Locklear Porta John Service,2161 Evergreen Church Rd,Pembroke,NC,NCS-00834,$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 12/20/2019