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Home My WebLink AboutNCS01321_2020Permit_Initial 2020 Permit and Registration Artis Septic Tank Service is hereby issued a Septage Management Firm Permit, Permit Number NCS-01321 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. Hampton Roads Sanitation District 2. Elizabeth City 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). 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 Artis Septic Tank Cleaning Service The "Firm name" must be exactly as it is shown on your vehicle(s). NCS-01321 Enter the five digits following the NCS # City Suffolk State / Province / Region VA Postal / Zip Code 23434 Country United States Street Address 1821 Nansemond Pkwy Address Line 2 Out-of-State Yes No City Carrollton State / Province / Region VA Postal / Zip Code 23314 Country United States Street Address PO Box 21 Address Line 2 7575381480 zartisseptic@yahoo.com Owner Info Zebedee Artis Jr Yes No 7572858800 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 Operator Info Zebedee Artis Jr Owner/Operator Yes No 7572858800 Type and amount of septage pumped in the last 12 months 100,000 0 25,000 0 0 North Carolina counties of operation Hampton Roads area, Ch, Vb, Su, No, NC. Gates, Camden, E.C. Northeastern, NC Vehicle Info Yes No 11/21/2019 Owner/Operator Add vehicles individually Upload List 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 Training Sponsored or Provided by Domestic Septage 42141P R10107VA 3,000 Grease (restaurant)42143P 1FV6HLBA7WH909720 3,200 Septage Disposal Method For each method, indicate whether you plan to use it by checking yes or no. Yes No Elizabeth City 12/31/2019 Elizabeth City auth..pdf 357.09… All authorized HRSD locations 12/31/2019 HRSD auth..pdf 378.12… Yes No Yes No Yes No Septage Management Firm Operator Training Completed 6/23/2019 5 Newbern, NC NC Pumper Group & NC Portable Toilet Group Septage Land Application Site Operator Training Completed 0 Select one** Comments or notes Signature Date Print Name**Title** 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. 11/21/2019 09:33:11 AM Zebedee Artis Jr Owner/Operator Received 9/4/2020 JRB PayPoint Payment Receipt Application: Solid Waste Merchant: NDENR-Solid Waste Merchant City/State: Raleigh, North Carolina Payment Status: Settled Result Message: Payment completed and settled successfully. Confirmation Number: 19123060902655 Payment Date: 12/30/2019 Posting Date: 12/30/2019 Billing Information: Zebedee Artis, Jr PO Box 21 Carrollton, VA 23314 7574878503 zartisseptic@yahoo.com Payment Arnount: 800.00 USD Page 1 of 1 Account Type: Checking Reference Information: ncs-01321-2020,23314,Artis Septic Tank Service,PO Box 21,Carrollton,VA,NCS-01321,$800.00 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 12/31/2019