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Home My WebLink AboutNCS01420_2020Permit_Initial 2020 Permit and Registration Redbox+ (Manns Harbor NC) is hereby issued a Septage Management Firm Permit, Permit Number NCS-01420 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. Elizabeth City WWTP Elizabeth City, 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?** Mailing Address** Firm Info redbox+ of Manns Harbor The "Firm name" must be exactly as it is shown on your vehicle(s). NCS-01420 Enter the five digits following the NCS # City MANNS HARBOR State / Province / Region NC Postal / Zip Code 27953 Country United States Street Address 5630 OLD FERRY DOCK RD Address Line 2 P.O. Box 161 Dare Yes No City MANNS HARBOR State / Province / Region NORTH CAROLINA Postal / Zip Code 27953 Country United States Street Address P.O. Box 161 Address Line 2 2524737116 jralph@redboxplus.com Owner Info jonathan ralph Yes No Phone**Fax 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** City MANNS HARBOR State / Province / Region NC Postal / Zip Code 27953 Country United States Street Address p.o. box 161 Address Line 2 2524737116 Operator Info jonathan ralph owner Yes No 2524737116 Type and amount of septage pumped in the last 12 months 0 2,855 0 0 0 North Carolina counties of operation Dare, Bertie, Camden, Currituck, Gates, Hertford, Hyde, Pasquotank, Perquimans, Tyrrell, Washington Vehicle Info Yes No 12/28/2019 Title** Choose how to add vehicle descriptions** Pumper Vehicles Usage*License Tag #*Vehicle Identification #*Tank Capacity* 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** Date**Hours** Location** Training Sponsored or Provided by** Date Hours 12/28/2019 owner Add vehicles individually Upload List Portable Toilet Waste YA142437 5PVNV8JV5J4558220 96 Septage Disposal Method For each method, indicate whether you plan to use it by checking yes or no. Yes No Elizabeth City Waste Water Treatment Plant 12/31/2020 Scan_0340.pdf 431.74… Yes No Yes No Yes No Septage Management Firm Operator Training Completed 1/12/2019 8 Raleigh Fairgrounds NC Pumper Group & NC Portable Toilet Group Septage Land Application Site Operator Training Completed 0 Location Training Sponsored or Provided by Select one** Comments or notes Signature Date Print Name**Title** 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. 12/28/2019 08:09:06 AM jonathan a ralph 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: 19121858915837 Payment Date: 12/18/2019 Posting Date: 12/18/2019 Billing Information: J&M Ralph Enterprises LLC OBA Redboxplus 5630 Old Ferry Dock Rd P.O. Box 161 Manns Harbor, NC 27953 2524737116 Jralph@redboxplus.com Payment Amount: 550.00 USO Page 1 of 1 Account Type: Checking Reference Information: NCS-01420-2020,27953,Redbox+,5630 Old Ferry Dock Road,Manns Harbor,NC,NCS-01420,$550.00 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