NCS01317_2020Permit_Initial

2020
Permit and Registration

Victory Septic Solutions
is hereby issued a Septage Management Firm Permit, Permit Number NCS-01317
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:
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
1. Henderson WWTP
2. Louisburg WRF
3. Neuse River Resource Recovery Facility 4. North and South Durham WRF
5. Septage Land Application Site, SLAS-35-10
6. Septage Treatment or Detention Facility, SDTF-35-10
7. Warren County WWTP

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
Victory Septic Solutions
The "Firm name" must be exactly as it is shown on your vehicle(s).
NCS-01317
Enter the five digits following the NCS #
City
Louisburg
State / Province / Region
NC
Postal / Zip Code
27549
Country
United States
Street Address
186 EF Cottrell Road
Address Line 2
Franklin
Yes No
9198184342
[e-mail]
Owner Info
Marlon Lewis
Yes No
9198184342
Operator Info
Marlon Lewis Owner
Yes No
9198184342
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
Type and amount of septage pumped in the last 12 months
500,000
0
0
0
0
North Carolina counties of operation
Franklin
Vehicle Info
Yes No
12/29/2019
Owner
Add vehicles
individually
Upload List
Domestic Septage ya131761 1fvacxdc87hy39886 2,500
Domestic Septage ya155637 1fvhc5cv19haf9364 4,000
Septage Disposal Method
For each method, indicate whether you plan to use it by checking yes or no.
Yes No
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)**
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**
Neuse River Resource Recovery
Facility
12/31/2020 Raleigh WWTP
2020.pdf
377.07…
City of Durham Wastewater Division 12/31/2020 Durham WWTP
2020.pdf
289.36…
Louisburg Water Reclamation 12/31/2020 Louisburg
WWTP 2020.pdf
408.24…
Warrenton Wastwater Treatment Plant 12/31/2020 Warrenton
WWTP 2020.pdf
407.66…
Henderson Wastewater Plant 12/31/2020
Yes No
SLAS-35-10 12/31/2020
Yes No
SDTF-35-10 12/31/2020
Yes No
Septage Management Firm Operator Training Completed
12/7/2019 4
Fairgrounds, Raleigh
NC Pumper Group & NC Portable Toilet Group
Date Hours
Location
Training Sponsored or Provided by
Select one**
Comments or notes
Signature
Date
Print Name**Title**
NC Pumper Group & NC Portable Toilet Group
Septage Land Application Site Operator Training Completed
12/7/2019 3
Fairgrounds, Raleigh
NC Pumper Group & NC Portable Toilet Group
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.
12/5/2019
08:48:36 PM
Marlon Lewis Owner
AUTHORIZATION TO DISCHARGE SEPTAGE TO A WASTEWATER TREATMENT FACILITY
North Carolina Department of Environmental Quality
Division of Waste Management -Solid Waste Section
1646 Mall Service Center, Raleigh, NC 27699-1646
Fee assessments and waste determinations will be required at the discretion of the wastewater
treatment facility. The facility has the ultimate prerogative to deny discharges of any wastes to the
incoming wastewater stream.
I, /iLefYlllJ,f A-II<"'-,()fl( /,'(-('4 k,4--tff?fJ? lk1ec,J~ lui,-11/ 1 (Plant Operator In ~esponsible Charge (ORC), ORC License Number, Name of Plant)
It Lft Wr /-v, CfrwJ A-v(, rlz11/~(J,JA-, tf/( :2 7JJ~ 7 (Address)
(). $'~ tf]l-'f S l(7
(Phone Number)
do hereby authorize /4 ci.r U, 'l-t Le Wt 'r
(Owner/Operator of Septage Management Firm)
of /J; C ~I; SetJ~ G/o,k {
(Septage Management Firm Name and NCS number)
NCS# QI ?17
to dispose of: domestic septage X, , portable toilet waste __ A__._ __ _,
grease septage (grease trap pumpings) ____ commercial/industrial septage ___ __, from
(County or other Geogra 1c Area)
at the above named wastewater treatment facility. Septage shall be discharged at:
Xn fl ut0 1--lfeA_ d l Jor-lf
(Location)
between the hours of __ 7.::.,_' · .... ]_IJ_,~-"fr--_ ___..:.+-e_-c-::J;y ..... ffl')........._~a.J,.m_..:..,-,t--:,IYl....i....::::OnLl.-l,,,d,...Je'.,.Jk:__--_kJ=.i:i1:1....c;d,;....ei;...µtl_ J ~l · I
Reintroducing partially treated liquid into a grease trap is acceptable __ Yes ~No
This authorization shall be valid until _p.......,;:5;"'"'C""--.e=""'-'-"'b,. ........... v:'--,,-....,.3'-'/-+-1 -2~a~b~o=--------
(Gsuall{oecember 31, Year)
Signed _:7_'/ ____ /4_..~......,_~dk:-:"--"'---------
r?' (Facility Operator)
Date 2 /)-~(/1
n th-
subscribed and affirmed before me this --------0-· .... ]~_day of F~b ti.Jae] , 20 l j
My Commission expires: '-I f I 7 / ,2 Q.l. 3 /'J,rue K-Q,o(.,.fR .s
(Notary Public) i 1
NINA K ROGERS
Notary ~@ALS L)
North Cerollne
V11tteC01t•t
Note: Falsification of this document by the septage management firm shall lead to permit revocation.
S:/Solid_Waste/CLA/SEPTAGE/FORMS/2018 Firm Appllcatlon/WWTP Authorization Form 2018
AUTHORIZATION TO DISCHARGE SEPTAGE TO A WASTEWATER
TREATMENT FACILITY
North Carolina Department of Environment and Natural Resources
Division of Waste Management -Solid Waste Section
401 Oberlin Rd ., Ste . 150, Raleigh, N.C. 27605
Fee assessments and waste detenninations will be required at the discretion of the wastewater treatment
facility. The facility has the ultimate prerogative to deny discharges of any wastes to the incoming
wastewater stream .
I, _N=a=th=a.:..:....n .:....:.Ho::...:.w=e=II :--=C=ityc...:o:.:...f .:....:.Ra=le=ig=h,..:_/ ~Ne;;;;u=se:'-;;R:--"-iv.:...=e~r R.:....:.e::..;=s~ou::.!..:rc~e-!:R~ec~o::.!.:ve~ryL;F~a~c1~·11t:Ly l!.:(N~R~R:!..!.RF'-J.) ____ _
(Plant Operator and Name of Plant)
8500 Battle Bridge Road, Raleigh, NC 27610 (P. 0. Box 590, Raleigh , NC 27602)
(Address)
-----"('-"-9""-"19~) =99=6--=-3-'-'70=0 __________ do hereby authorize _....:.;M:.-=:=a=rlo=n=,-;:L=ew=i=-s ----:-::----:-----:,-,----=----
(Phone Number) (Owner/Operator of Septage Management Firm)
of _ ___:.;Vi=ct=ory.i..=Se2p=tic::..:S=o=lu=tio=n:...s _________________ .....;..;.NC=-S=0:..:.1:...31:..:..7 __ _
(Septage Management Firm Name and NCS number)
to dispose of: domestic septage -----'X-'----' portable toilet waste ----=X'-'--__ _,
grease septage (grease trap pumpings) NIA commercial/industrial septage _.....;..;;N/-'-'A'-----' from
Wake County
(County or other Geographic Area)
at the above named wastewater treatment facility. Septage shall be discharged at:
8500 Battle Bridge Road, Raleigh, NC 27610
(Location)
between the hours of 8am -4pm Monday Thru Friday (Except Holidays)
Reintroducing partially treated liquid into a grease trap is acceptable __ Yes _X_No
This authorization shall be valid until -----=□~ec=e=rn=oe=r--"'3-"--;1 i7-2::'::02~.0~:::=;:-:--:-::::;-;--;---:---------~ if) (Usually December 31, Year)
Signed \jv (F . \M .. ·-···---.. ___ ... Date ( D /,~ l / (9
ac1lity Operator)
~\ dayoftc¼ob-Gc ,20-1.i-
My Commission expires: c/;)./ ±t oru., i
(OFFICIAL SEAL)
Note: Falsification of this d t b th ocumen Y e septage management firm shall lead to permit revocation.
ANGELA L YOUNG
NOTARY PUBLIC Wake County
North Carolina
My Commission Expires Februeiy 4, 2024
CITY OF
DURHAM
Department of Water Management
AUTHORIZATION TO DISCHARGE
Victory Septic Solutions LLC
hereby is granted permission to discharge domestic septage waste into City of Durham's
North and South Water Reclamation Facilities. This discharge shall be between the hours
of 7:30 a.m. and 4:00 p.m., five days a week. Permission to discharge is restricted to
waste collected in the state of North Carolina. The maximum discharge volume of each
load is 1600 gallons.
Victory Septic Solutions LLC shall comply with all provisions of City of Durham's
Sewer Use Ordinance. If any provision of the City's Sewer Use Ordinance is violated,
this authorization may be terminated.
Fee assessment and waste determination may be required at the discretion of the City of
Durham, Department of Water Management.
This authorization shall be valid from January 1, 2020 until December 31, 2020.
North Durham Water Reclamation Facility
1900 East Club Boulevard
Durham, North Carolina 27704
[phone]
<Zff a //·/2-/Y
Charles Cocker -Date
South Durham Water Reclamation Facility
6605 Farrington Road
Chapel Hill, North Carolina 27517
[phone]
AUTHORIZATION TO DISCHARGE SEPTAGE TO A WASTEWATER
TREATMENT FACILITY
North Carolina Department of Environment and Natural Resources
Division of Waste Management -Solid Waste Section
1646 Mail Service Center, Raleigh, NC 27699-1646
Fee assessments and waste detenninations will be required at the discretion of the wastewater treatment
facility . The facility has the ultimate prerogative to deny discharges of any wastes to the incoming
wastewater stream.
I, ---------!.W.!..!.!il.!.!..!:lia!.!..!.m.!...!.R..!!. . ..!...P~er.!!!ki:!..!!ns~o:!..!Jn,i....:,0:'...!,.R.!.:::C'....!L:!!ic=e~ns=e...!..:N=um=be::..:..r=98=7...:::.8=--31,.__ ______ _
(Plant Operator in Responsible Charge (ORC) and ORC License Number)
Warren County WWTP 738 US Hwy 401 S .• PO BOX 281. Warrenton. NC 27589
(Address)
__ -'2"""5=2--=2=57'---.;..:.17..:..7=-6 ____ do hereby authorize ______ """'M=A~R=L=O~N"""L=E~W~IS~-----
(Phone Number) (Owner/Operator of Septage Management Firm)
of _______ .;_;Vl=C_,_TO::...:R....:..;Y:......;S=E::..:..P..:..T=IC~S=O:.:::.L.:::..UT.!.!.IO~N~S~ _______ N:....:..C=S~#"--"0"'"'"1=-31:....:..7 ___ _
(Septage Management Firm Name and NCS number)
to dispose of: domestic septage __ X_~ portable toilet waste --"""'X __ ~
grease septage (grease trap pumpings) ____ commercial/industrial septage ___ _, from
Warren, Vance, Granville and surrounding counties
(County or other Geographic Area)
at the above named wastewater treatment facility. Septage shall be discharged at:
Influent works
(Location)
between the hours of ______ 8_:0_0 A_M_-_3_:3_0_P_M_M_o_n_da ...... v_-_Fn_·d_a,._y _________ _
Reintroducing partially treated liquid into a grease trap is acceptable __ Yes X No
This authorization shall be valid until December 31 2020 --------'~=="--.::....:.J.==-----------( Usu a II y December 31, Year)
Sworn to and subscribed before me this __ :J~q_--ll_, ____ day of (0Lf [Jtx_ v
tl1 tM ~tli, ( )n fed
,20J!t_
(Notary Public)
My Commission expires: ·3 _ 7'\ll:ul©11,i
,,,'n,1'H V,q/1~.,.,.
~
v ~~~ $ ICIAL SEAL) ~~ ... ----= ~ ~TA-9,L-z:
Note: Falsification of : ~ m : this document by the septage management firm shall lead to permit revocati~ ~ ~L\G C, j
S:/Solid_WaSle/CLNSEPTAGE/FORMS/2013 Firm Application/WWTP Authorization Form 2013 ~ ~ ~ ,:0
~•~I _A,,, ... ""~/v cou~ '...,,,, ,,,,,,,, .. ,,,,
PayPoint
Payment Receipt
Application: Solid Waste Credit
Merchant: NDENR-Solid Waste Credit
Merchant City/State: Raleigh, North Carolina
Merchant Location Code: 00001
Payment Status: Success
Result Message: Success
Confirmation Number: 19123061016970
Payment Date: 12/30/2019
Posting Date: 12/30/2019
Billing Information: Victory Septic Solutions 821 sid eaves road youngsville, NC 27596 9198184342 [e-mail]
Payment Amount: 550.00 USD
Card Type: MC
Method: Not Present
Page 1 of 1
Reference Information: ncs-01317-2020,27549,Victory Septic Solutions,186 EF Cottrell Rd,Louisburg,NC,NCS-01317,$550.00
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https://admin.thepayplace.com/epayadmin/paymentreceipt.aspx 12/31/2019