NCS01050_2020Permit_Initial

2020
Permit and Registration

Better Choice Grease Trap
Pumping
is hereby issued a Septage Management Firm Permit, Permit Number NCS-01050
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. Septage Detention or Treatment Facilities: SDTF-34-02 and SDTF-92-12
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
Better Choice Grease Trap Pumping
The "Firm name" must be exactly as it is shown on your vehicle(s).
NCS-01050
Enter the five digits following the NCS #
City
Julian
State / Province / Region
NC
Postal / Zip Code
27283
Country
United States
Street Address
4270 Old Julian Road
Address Line 2
Guilford
Yes No
336-674-0565
[e-mail]
Owner Info
Caleb Keene
Yes No
336-880-6930
Operator Info
Caleb Keene Owner
Yes No
336-880-6930
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*
Type and amount of septage pumped in the last 12 months
0
0
202,050
0
0
North Carolina counties of operation
Guilford,Randolph,Alamance,Davidson,Rockingham,Durham,Wake,Chatham
Vehicle Info
Yes No
12/23/2019
Owner
Add vehicles
individually
Upload List
Grease (restaurant) JE-2681 1FVACWDC97HX17807 1,500
Septage Disposal Method
For each method, indicate whether you plan to use it by checking yes or no.
Approved wastewater treatment plant **
Yes No
Septage Detention or Treatment Facility (SDTF)
Yes No
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.
SDTF Expiration Date*Authorization
Date**Hours**
Location**
Training Sponsored or Provided by**
Date Hours
Location
Training Sponsored or Provided by
Select one**
Comments or notes
SDTF-92-12 12/31/2020 better choice
grease
2020.pdf
555.59…
SDTF-34-02 12/31/2020 Ws dump
authorization
2020.pdf
1.21MB
Other disposal method**
Yes No
Septage Management Firm Operator Training Completed
1/24/2019 6
Hickory 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
I have one more place that I unload but have not received my form from them
yet.
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.
JRB 3/6/2020
Signature
Date
Print Name**Title**
12/23/2019
09:00:00 AM
Caleb Keene [e-mail]