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Home My WebLink AboutNCS01172_2020Permit_Initial 2020 Permit and Registration Triad 24 Pumping is hereby issued a Septage Management Firm Permit, Permit Number NCS-01172 And by virtue of completing the annual training requirements is hereby registered as a Portable Sanitation & 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 Facility, SDTF-34-02 2. Septage Detention or Treatment Facility, SDTF-34-06 3. Septage Detention or Treatment Facility, SDTF-60-09 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?** Phone**Fax Firm Info Triad 24 Pumping LLC The "Firm name" must be exactly as it is shown on your vehicle(s). NCS-01172 Enter the five digits following the NCS # City Lexington State / Province / Region NC Postal / Zip Code 27295 Country USA Street Address 177 Canoe Ln Address Line 2 Davidson Yes No City Lexington State / Province / Region NC Postal / Zip Code 27293 Country USA Street Address P.O. Box421 Address Line 2 3368301858 henryyork@msn.com Owner Info Henry York Yes No 3368301858 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 Henry York owner Yes No 3368301858 Type and amount of septage pumped in the last 12 months 0 0 600,000 0 0 North Carolina counties of operation All Vehicle Info Yes No 12/31/2019 Owner Add vehicles individually Upload List Approved wastewater treatment plant ** 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** Training Sponsored or Provided by** Date Hours Location Training Sponsored or Provided by Select one** Grease (restaurant)YA021820 2fzhawdc07ay57606 3,200 Septage Disposal Method For each method, indicate whether you plan to use it by checking yes or no. Yes No Yes No Yes No SDTF-34-02 12/31/2020 001.tif 7.42MB SDTF-34-05 12/31/2020 SDTF-60-09 12/31/2020 Yes No Septage Management Firm Operator Training Completed 12/7/2019 4 Raleigh 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 Comments or notes Signature Date Print Name**Title** 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. 12/31/2019 11:02:07 PM Henry York owner PayPoint Payment Receipt Application: Solid Waste Merchant: NDENR-Solid Waste Merchant City/State: Raleigh, North Carolina Payment Status: Settled Resutt Message: Payment completed and settled successfully. Confirmation Number: 19123161208188 Payment Date: 12/31/2019 Posting Date: 12/31/2019 Rilling Information: Henry York P.O. Box 421 Lexington, NC 27293 3368301858 henryyork@msn.com Payment Amount: 550.00 USO Account Type: Checking Reference Information: NCS-01172-2020,27293,Triad 24 Pumping,PO Box 421,Lexington,NC,NCS-01172,$550.00 Page 1 of 1 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 1/2/2020