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HomeMy WebLinkAboutNCS00310_2020Permit_Initial2020 Permit and Registration Pee Wee's Septic Tank Cleaning is hereby issued a Septage Management Firm Permit, Permit Number NCS-00310 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.East Burlington WWTP2.Town of Siler City WWTP3.Old Mason Farm WWTP, Chapel Hill NC 4.Septage Detention or Treatment Facility SDTF-34-02 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?** Mailing Address** Phone**Fax Firm Info Pee Wee’s Septic Tank Cleaning The "Firm name" must be exactly as it is shown on your vehicle(s). NCS-00310 Enter the five digits following the NCS # City Graham State / Province / Region NC Postal / Zip Code 27253 Country USA Street Address 1830 Almond Ln Address Line 2 Alamance Yes No 3362260329 mhill611@gmail.com Owner Info William Matthew Hill Yes No City Graham State / Province / Region NC Postal / Zip Code 27253 Country USA Street Address 1837 Swepsonville Rd Address Line 2 3362147967 Firm operator's name**Firm operator's title Mailing address same as street address of office?** Mailing address** 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** Operator Info William Matthew Hill Owner/operator Yes No City Graham State / Province / Region NC Postal / Zip Code 27253 Country USA Street Address 1837 Swepsonville Rd Address Line 2 3362147967 Type and amount of septage pumped in the last 12 months 130,000 0 30,000 0 0 North Carolina counties of operation Alamance Orange Chatham Vehicle Info Yes No 12/31/2019 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)** 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. 12/31/2019 Owner/operator Add vehicles individually Upload List Domestic Septage PUMPNP00 3FEXF8014XMA17497 2,000 Septage Disposal Method For each method, indicate whether you plan to use it by checking yes or no. Yes No Town of Siler City WWTP 12/31/2020 08689F1E- FD85-4DAC- 893A- C16C1162405F.… 3.53MB East Burlington WWTP 12/31/2020 53D1E453- 3694-4F93- B4CF- A5F4F89EDD5F.… 3.45MB OWASA-Old Mason Farm Plant 12/31/2020 788B63D1- DC85-469B- BDB2- E76F1DECE4DC.… 545.93… Yes No Yes No 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** Comments or notes Signature Date SDTF-34-02 12/31/2020 95395352- F10B-4643- 9659- 1E978DCBBD51.… 3.44MB Yes No Septage Management Firm Operator Training Completed 1/12/2019 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 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 04:30:13 PM Print Name**Title** William Matthew Hill Owner/operator 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: 19123161158867 Payment Date: 12/31/2019 Posting Date: 12/31/2019 Billing Information: William M Hill 1837 Swepsonville Rd Graham, NC 27253 3362147967 Mhi11611@gmail.com Payment Amount: 550.00 USO Card Type: VISA Method: Not Present Reference Information: NCS-00310-2020,27253,Pee Wees Septic Tank Cleaning,1830 Almond Lane,Graham,NC,NCS-00310,$550.00 Page 1 of 1 Disclaimer: A convenience fee is charged by a third-party provider for all online payments made by a credit or debit card. DEQ does not receive any portion of these fees associated with this service. The fee is currently 2.65% of the amount paid on all credit and debit card transactions, except for VISA debit, which has a flat fee of $3.95 per transaction. Your card will not be charged until after you have accepted the convenience fee amount. If you choose not to pay the fee, you may cancel the transaction and pay by another method. If you accept the convenience fee and elect to continue, your credit card statement will show two charges -one for the amount due to DEQ, and one for the convenience fee. The convenience fee is not refundable. https://admin.thepayplace.com/epayadmin/paymentreceipt.aspx 1/2/2020