HomeMy WebLinkAboutNCS01478_2020Permit_Initial2020
Permit and Registration
C's Septic Tank
is hereby issued a Septage Management Firm Permit, Permit Number NCS-01478
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.Central Johnston County WWTP
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).
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?**
Mailing Address**
Firm Info
Firm name**
C's Septic Tank Pumping LLC
The "Firm name" must be exactly as it is shown on your vehicle(s).
Septage Management Firm permit number (NCS #)**
NCS-10478
Enter the five digits following the NCS #
City
Four Oaks
State / Province / Region
NC
Postal / Zip Code
27524
Country
United States
Street Address
429 Go Cart Rd
Address Line 2
Johnston
Yes No
City
Four Oaks
State / Province / Region
NC
Postal / Zip Code
27524
Country
United States
Street Address
525 Go Cart Rd
Address Line 2
9192910865
rlewis9972@gmail.com
Owner Info
Robin M Daughtry
Yes No
--------------"Pumping LLC" removed to match firm name on record
JRB 6/2/2020
------- 01478
Phone**Fax
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 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**
City
Four Oaks
State / Province / Region
NC
Postal / Zip Code
27524
Country
United States
Street Address
525 Go Cart Rd
Address Line 2
9192910865
Operator Info
Coty lewis
Yes No
919-262-3045
Type and amount of septage pumped in the last 12 months
120,000
0
0
0
0
North Carolina counties of operation
Johnston
Vehicle Info
Yes No
11/19/2019
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:
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
Owner
Add vehicles
individually
Upload List
Domestic Septage JM 7962 1FVACWDC46HX01612 2,000
Septage Disposal Method
For each method, indicate whether you plan to use it by checking yes or no.
Yes No
JOHNSTON COUNTY 12/31/2020 1574165516843…4.09MB
Yes No
Yes No
Yes No
Septage Management Firm Operator Training Completed
6/29/2019 4
New Bern NC
NC Pumper Group & NC Portable Toilet Group
Septage Land Application Site Operator Training Completed
6/29/2019 3
New Bern Nc
Training Sponsored or Provided by
Select one**
Comments or notes
Signature
Date
Print Name**Title**
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.
11/19/2019
07:04:34 AM
Robin Daughtry Owner
X-------Discharge authorization only allows disposal of domestic septage<-----
JRB 6/2/2020
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: 19111953731333
Payment Oate: 11/19/2019
Posting Oate: 11/19/2019
Billing Information: Robin M Daughtry 525 Go Cart Rd Four Oaks, NC 27524 9192910865
Payment Amount: 550.00 USD
Method: Not Present
Page 1 of 1
Reference Information: NCS-01478-2020,27524,C"s Septic Tank,429 Go Cart Road,Four Oaks,NC,NCS-01478,$550.00
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https ://admin. thepayplace.com/epayadmin/paymentreceipt.aspx 11/19/2019