HomeMy WebLinkAboutNCS00826_2020Permit_Initial2020
Permit and Registration
Hunter's Roost Farms Septic
Service
is hereby issued a Septage Management Firm Permit, Permit Number NCS-00826
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.Greenville Utilities WWTP2.Septage Detention or Treatment Facility, SDTF-07-063.Septage Land Application Site, SLAS-07-06
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
Hunters Roost Farm Septic Service
The "Firm name" must be exactly as it is shown on your vehicle(s).
NCS-00826
Enter the five digits following the NCS #
City
washington
State / Province / Region
NC
Postal / Zip Code
27889
Country
United States
Street Address
1774 Wharton station Rd
Address Line 2
Beaufort
Yes No
2529447737
brooke0613@hotmail.com
Owner Info
Harvey & Scott Williamson
Yes No
2529447737
Operator Info
Scott Williamson owner
Yes No
2529447737
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 **
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.
Type and amount of septage pumped in the last 12 months
150,000
0
0
0
0
North Carolina counties of operation
beaufort, craven, martin, washington, pitt, hyde
Vehicle Info
Yes No
12/20/2019
12/19/2019
Add vehicles
individually
Upload List
Domestic Septage YA157559 2XKMAD7X65MO74028 2,500
Septage Disposal Method
For each method, indicate whether you plan to use it by checking yes or no.
Yes No
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
Training Sponsored or Provided by
Select one**
GREENVILLE UTILITIES WWTP 12/31/2020
Yes No
SLAS-07-06 4/11/2021
Yes No
SDTF-07-06 4/11/2021
Yes No
Septage Management Firm Operator Training Completed
5/14/2019 4
WASHINGTon civic center
NC Septic Tank Association
Septage Land Application Site Operator Training Completed
5/14/2019 3
WASHington civic center
NC Septic Tank Association
Registration Type
Comments or notes
Signature
Date
Print Name**Title**
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.
12/19/2019
11:59:44 PM
Scott Williamson owner
PayPoint
Payment Receipt
Application: Solid Waste Credit
Merchant: NDENR-Solid Waste Credit
Merchant City/State: Raleigh, North Carolina
Merchant Location Code: 00001
Payment Status: Settled
Result Message: Payment completed and settled successfully.
Confirmation Number: 19122059451561
Payment Date: 12/20/2019
Posting Date: 12/20/2019
Billing Information: william s williamson 1774 Wharton station Rd washington, NC 27889 2529447737 brooke0613@hotmail.com
Payment Amount: 550.00 USD
Card Type: VISA
Method: Not Present
Reference Information: NCS-00826-2020,27889,Hunter's Roost Farms Septic Service,1774 Wharton Station Rd,Washington,NC,NCS-00826,$550.00
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