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Home My WebLink AboutNCS00790_2020Permit_Initial 2020 Permit and Registration Shamrock Environmental Corporation is hereby issued a Septage Management Firm Permit, Permit Number NCS-00790 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. T Z Osborne WRF, Mcleansville NC 2. Septage Detention or Treatment Facility, SDTF-41-03 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?** Mailing Address** Phone**Fax Firm Info Shamrock Environmental Corp The "Firm name" must be exactly as it is shown on your vehicle(s). NCS-00790 Enter the five digits following the NCS # City Browns Summit State / Province / Region NC Postal / Zip Code 27214 Country United States Street Address 6106 Corporate Park Dr Address Line 2 Guilford Yes No 8008811098 3363751801 jhollingsworth@shamrockenviro.com Owner Info Greg Kiser Yes No City Browns Summit State / Province / Region NC Postal / Zip Code 27214 Country United States Street Address 6106 Corporate Park Dr Address Line 2 3363751989 3363751801 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 Greg Kiser President Yes No 3363751989 3363751801 Type and amount of septage pumped in the last 12 months 0 0 0 0 1,521,390 North Carolina counties of operation All Counties Vehicle Info Yes No 12/10/2019 HSE Director 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)** 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** Other LR-5183 1XPFDR9XXSN377409 3,500 Other LT-3226 1NP5LR0X0WN483637 3,500 Other LR-5175 1NP5LU0X83D803680 3,500 Other ND-4298 2M2N179Y3HC008033 3,500 Other ND-4297 1XPGDB9X84D827451 3,500 Other AH-78473 5HTNA422095E23572 6,000 Other AH-78474 1PMA14228B1037913 6,000 Other CH-82792 1A9114123Y1005065 6,000 Septage Disposal Method For each method, indicate whether you plan to use it by checking yes or no. Yes No City of Greensboro TZ Osborne WWTP 12/31/2019 GSO Auth2Discharg… 211.23… Yes No Yes No SDTF-4103 8/31/2023 Yes No Septage Management Firm Operator Training Completed 12/7/2019 4 Raleigh, NC Training Sponsored or Provided by** Date Hours Location Training Sponsored or Provided by Select one** Comments or notes Signature Date Print Name**Title** 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 Collect industrial & domestic septage as well as grease trap waste. Permit holder for SDTF-41-03. Updated WWTP authorization to be mailed with application/payment 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. 12/10/2019 02:04:13 AM Jim Hollingsworth jhollingsworth@shamrockenviro.com AUTHORIZATION TO DISCHARGE SEPTAGE TO A WASTEWATER TREATMENT FACILITY North Carolina Department of Environmental Quality Division of Waste Management -Solid Waste Section 1646 Mail Service Center, Raleigh, NC 27699-1646 Fee assessments and waste determinations will be required at the discretion of the wastewater treatment facility. The facility has the ultimate prerogative to deny discharges of any wastes to the incoming wastewater stream. Bradley Flynt, ORC-T Z Osborne Water Reclamation Facility 1, ______________________________________________________________________ _ (Plant Operator in Responsible Charge (ORC), ORC License Number, Name of Plant) 2350 Huffine Mill Road, Mcleansville, NC 27301 (Address) 336-433-7262 Gail McGroary _________________ do hereby authorize--------------------------------------- (Phone Number) (Owner/Operator of Septage Management Firm) of Shamrock Environmental Corp NCS# 790 (Septage Management Firm Name and NCS number) XX no to dispose of: domestic septage ------J portable toilet waste ________ _, no no grease septage (grease trap pumpings) ________ commercial/industrial septage --------....J from Guilford County (County or other Geographic Area) at the above named wastewater treatment facility. Septage shall be discharged at: T Z Osborne water Reclamation Facility (Location) between the hours of 7:00 a.m. -6:00 p.m. Reintroducing partially treated liquid into a grease trap is acceptable __ Yes X __ No . . December 31, 2019 This authorization shall be vahd until -------------------------------------------(Usually December 31, Year) Aq~~~~A~ ~~~~S NOTARY PUBUC GUILFORD COUN'TY, NC Note: Falsification of this document by the septage management firm shallle MY&9ffiWi~iQR,~~V.~~ay 21' 2021 S:/Solid_Waste/CLA/SEPTAGE/FORMS/2018 Firm Application/WWTP Authorization Form 2018 PAID FIRM NAME: Shamrock Environmental Corporation PERMIT #: NCS-00790 AMOUNT: $800 PAID BY: paper check DATE: 12/17/2019 Chester Cobb