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HomeMy WebLinkAboutNCS01484_2020Permit_Initial 2020 Permit and Registration Clearwater Septic and Pumping LLC is hereby issued a Septage Management Firm Permit, Permit Number NCS-01484 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. Rocky River Regional WWTP, Concord 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?** Phone**Fax Firm operator's name**Firm operator's title Mailing address same as street address of office?** Phone**Fax Firm Info Clearwater septic and Pumping llc The "Firm name" must be exactly as it is shown on your vehicle(s). NCS-01484 Enter the five digits following the NCS # City Mooresville State / Province / Region Nc Postal / Zip Code 28115 Country United States Street Address 110 pleasant grove lane Address Line 2 Iredell Yes No 9805653255 clearwatersepticandpumping@gmail.com Owner Info Reginald d Childers Yes No 9805653255 Operator Info Reginald Childers Manager Yes No 9805653255 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* 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: Type and amount of septage pumped in the last 12 months 150,000 0 0 0 0 North Carolina counties of operation Iredell Rowan Catawba Gaston mecklenburg Vehicle Info Yes No 5/4/2020 Owner Add vehicles individually Upload List Domestic Septage Jr1927 1FDXH81A4PVA00489 1,500 Septage Disposal Method For each method, indicate whether you plan to use it by checking yes or no. Yes No 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 Select one** Comments or notes Signature Rocky River regional wastewater treatment plant 6/6/2021 2020-05- 04_204712.jpg 655.86… Yes No Yes No Yes No Septage Management Firm Operator Training Completed 1/14/2019 6 Fayetteville nc NC DEQ - New Operator Training 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 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. Date Print Name**Title** 5/4/2020 08:16:51 PM Reginald Childers Owner PayPoint Payment Receipt Application: Solid Waste Merchant: NDENR-Solid Waste Merchant City/State: Raleigh, North Carolina Payment Status: Settled Result Mes.age: Payment completed and settled successfully. Confirmation Number: 20050482645860 Payment Date: 05/04/2020 Posting Date: 05/04/2020 Billing Information: Reginald D Childers 110 pleasant grove lane Mooresville, NC 28115 9805653255 Clearwatersepticandpumping@gmail.com Payment Amount: 825.00 USO Page 1 of 1 Reference Information: NCS-01484-2020,28115,Clear Water Septic and Pumping LLC,110 Pleasant Grove Lane,Mooresville,NC,NCS-01484,$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 5/8/2020