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HomeMy WebLinkAboutNCS01401_2020Permit_Initial 2020 Permit and Registration Anderson Pumping Service is hereby issued a Septage Management Firm Permit, Permit Number NCS-01401 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. Lauradale WWTP, Scientific Water & Sewerage Corporation: Jacksonville 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 Anderson Pumping Service Inc The "Firm name" must be exactly as it is shown on your vehicle(s). NCS-01401 Enter the five digits following the NCS # City Jacksonville State / Province / Region North Carolina Postal / Zip Code 28540 Country United States Street Address 1716 Catherine Lake Rd Address Line 2 Onslow Yes No 9103247655 andersonpumping1990@gmail.com Owner Info Joshua Rochelle Yes No City Jacksonville State / Province / Region North Carolina Postal / Zip Code 28540 Country United States Street Address 237 Sewell Rd Address Line 2 9106502863 Firm operator's name**Firm operator's title Mailing address same as street address of office?** Mailing address** 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** Operator Info Joshua Rochelle Owner Yes No City Jacksonville State / Province / Region North Carolina Postal / Zip Code 28540 Country United States Street Address 237 Sewell Rd Address Line 2 9106502863 Type and amount of septage pumped in the last 12 months 785,000 0 0 0 0 North Carolina counties of operation Onslow,Duplin,Jones Vehicle Info Yes No 12/30/2019 Owner/operator 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 Location Training Sponsored or Provided by Owner/operator Add vehicles individually Upload List Domestic Septage YA93387 FDYW82E6SVA31313 3,600 Septage Disposal Method For each method, indicate whether you plan to use it by checking yes or no. Yes No Scientific Water 12/31/2020 Yes No Yes No Yes No Septage Management Firm Operator Training Completed 9/24/2019 4 Carteret Community College NC Septic Tank Association Septage Land Application Site Operator Training Completed 0 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. 12/30/2019 12:37:37 AM Joshua Rochelle Owner �O r O DtSCH/l P GE SEll A 10 A IJilfiST[\flf/jTC:ft H c1n /[�I\: rt OU r North Carolina Departm ht of Environmental Quality Division of Waste Manas ment _ Solid waste Section .l6'1G MJil 5crvice Ccn r, RJICl(lh, NC 27699-1646 . . h d' crction of the wastewaterfoe assessments .ind .•1.:1stc dctcrmin.:1t1ons will be required :.it t e is f t to the . d disch.:irges o .:iny was es trc:itmcnt facility. The facility hJs the ultimate prcro3otIvc to cny incoming wastcwntc-1 stIct1n1. 1, _____ -_j=-··-. gff �,-_vv,pr-1 tJhllJC /.3-1-V-L-f,,__/_1 --. -l one lin:n',C r· t;nt {:[ r ': ... o,' ,.r,' (Plant Operator in rtcspon:.ihlc Cli"r (OrtC , ' (Address) do hereby authorize JC)�� }!.o.cLllt---{-f'f-1o_n_e_l_u_m_b_e_r) __ . (O· 0r/Opcr.itor of Sq.Jt,:[;c t1:m:ig,:ment Firm) to dispose of: domc�tic scp' .:cc-)9 _, gr��1se -�µ-.1,;.� Lw�1s� tmp pumpincs) ____ commcn:ia!/ind• 1strial scptage _____ from (Count'/ or other ,Gcogr::iphic l\rea) at i'hc ;:ibovc nJm,:c..:l -,•1ast0w:_rt�r tr;1:_rtmcnt hcility. cpt::ige sh:.ill be disch;:irged at: (Loe ·on) between the hours of ------------r-------------------- Tl1i::> �wihori/. . .1tion sh.ill be 1101id until �. 'h� \ ,�\:1.-�� -�..c;;?C)_;.,,,:.o.�::(D::::::.._ __ _ (Usually December 31, Year) 5igned �----ll�::�-=�::::::::::::_-:-------Oate / {fJdlh Operator) IJ' f� o , --�QM�'------day of J..Ctt..w....YJ.g ,.. • 20 _j_C)__ Lauradale WWTP See accompanying DWR Document JRB 1/6/2019 North Carolina Department of Environmental Quality Division of Water Resources Jacksonville, NC 28540 End Of Aragona Blvd Lauradale WWTP Discharging 100% Domestic < 1MGD NC0036226 Permit Type: Facility Name: Facility Address1: Facility Address2: City, State & Zip: Permit Number: *** Legally Responsible for Permit *** Jacksonville, NC 28540 Owner Information Details: Organization Scientific Water & Sewerage Corporation Non-Government baaragona@gmail.com 910-455-3743 112 Scientific Lane Ben Aragona President 910-455-6081 (Responsible corporate officer/principle executive officer or ranking elected official/general partner or proprietor; or any other person with delegated signatory authority from the legally responsible person.) MUST submit a Change of Name/Ownership form to DWR to make any changes to this Owner information. (Click Here for "Change of Name/Ownership" Form) Fax: Title: Owner Type Group: Owner Name: Owner Type: Owner Affiliation: Address1: Address2: Work Phone: Email Address: City, State & Zip: EmailFaxAddressPhoneContact Name Title Owner Contact Person(s) EmailFaxPhoneAddressTitleContact Name Facility Contact Person(s) baaragona@gmail.com910-455-6081910-455-3743112 Scientific Lane, Jacksonville, NC 28540 Ben Aragona Back-up ORC moonwalk3@gmail.com910-330-8167Jeffrey A Jarman ORC EmailFaxPhoneAddressTitleContact Name Permit Contact Person(s) EmailFaxPhoneAddressTitleContact Name Permit Billing Contact Person(s) baaragona@gmail.com910-455-6081910-455-3743112 Scientific Lane, Jacksonville, NC 28540 Ben Aragona EmailFaxPhoneAddressTitleContact NameType Persons with Signatory Authority moonwalk3@gmail.com910-455-3743112 Scientific Ln, Jacksonville, NC 28546 PermitPermit Jeffrey A Jarman Page 11/6/2020 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: 19123060914860 Payment Date: 12/30/2019 Posting Date: 12/30/2019 Billing Information: Anderson Pumping Service 1716 Catherine Lake Rd Jacksonville, NC 28540 9103247655 andersonpumping1990@gmail.com Payment Amount: 550.00 USD Account Type: Checking Page 1 of 1 Reference Information: NCS-01401-2020,28540,Anderson Pumping Service,1716 Catherine Lake Rd,Jacksonville,NC,NCS- 01401,$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 12/31/2019 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 Anderson Pumping Service Inc The "Firm name" must be exactly as it is shown on your vehicle(s). NCS-01401 Enter the five digits following the NCS # City Jacksonville State / Province / Region North Carolina Postal / Zip Code 28540 Country United States Street Address 1716 Catherine Lake Rd Address Line 2 Onslow Yes No 9103247655 andersonpumping1990@gmail.com Owner Info Joshua Rochelle Yes No City Jacksonville State / Province / Region North Carolina Postal / Zip Code 28540 Country United States Street Address 237 Sewell Road Address Line 2 9106502863 2019 Permit Application Firm operator's name**Firm operator's title Mailing address same as street address of office?** Mailing address** 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?** "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** Operator Info Joshua Rochelle Owner Yes No City Jacksonville State / Province / Region North Carolina Postal / Zip Code 28540 Country United States Street Address 237 Sewell Road Address Line 2 9106502863 Type and amount of septage pumped in the last 12 months 900,000 0 0 0 0 North Carolina counties of operation Onslow Duplin Jones Vehicle Info Yes No 11/27/2019 Owner 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 Location Training Sponsored or Provided by Owner Add vehicles individually Upload List Domestic Septage YA93387 FDYW82E6SVA31313 3,600 Septage Disposal Method For each method, indicate whether you plan to use it by checking yes or no. Yes No Scientific Water 12/31/2019 Yes No Yes No Yes No Septage Management Firm Operator Training Completed 3/27/2018 4 Onslow County Government Complex NC Septic Tank Association Septage Land Application Site Operator Training Completed 0 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. 11/27/2019 11:27:26 AM Joshua Rochelle Owner PayPoint Payment Receipt Application: Solid Waste Merchant: NDENR-Solid Waste Merchant City/State: Raleigh, North Carolina Payment Status: Success Result Message: Success Confirmation Number: 19121758756357 Payment Date: 12/17/2019 Posting Date: 12/17/2019 Billing Information: Anderson Pumping Service Inc 1716 Catherine Lake Rd. Jacksonville, NC 28540 9103247655 andersonpumping1990@gmail.com Payment Amount: 550.00 USD Page 1 of 1 Reference Information: NCS-01401-2019,28540,Anderson Pumping Service,1716 Catherine Lake Rd,Jacksonville,NC,NCS-01401,$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 ://ad.min. thepayplace.com/ epayadmin/paymentreceipt.aspx 12/17/2019 Paid $550.00 12/18/2019 JRB 2/21/2020 PayPoint Payment Receipt Application: Solid Waste Merchant: NDENR-Solid Waste Merchant City/State: Raleigh, North Carolina Payment Status: Success Result Message: Success Confirmation Number: 19121758757152 Payment Date: 12/17/2019 Posting Date: 12/17/2019 Billing Information: Anderson Pumping Service Inc 1716 Catherine Lake Rd Jacksonville, NC 28540 9103247655 andersonpumping1990@gmail.com Payment Amount: 275.00 USO Page 1 of 1 Reference Information: NCS-01401-2019LF,28540,Anderson Pumping Service,1716 Catherine Lake Rd,Jacksonville,NC,NCS-01401,$275.00 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 12/17/2019 Paid $275.0012/18/2019JRB 2/21/2020