NCS00898_Permit2020_Initial

2020
Permit and Registration

Langston's Septic Tank Service
is hereby issued a Septage Management Firm Permit, Permit Number NCS-00898
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: 1. Town of Ahoskie 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
NCS-00898
APPLICATION FOR PERMIT TO OPERA TE A SEPT AGE MANAGEMENT FIRM
(CONTINUED FROM PAGE 1)
(7.)Septage Disposal Method: (check one) ��o�it<' a)Approved wastewater treatment plant: ( ,./}) yes ( ) no. If yes, submit Wastewater Treatment Authorizationfor each plant, as indicated in Subparag�ph .0833(c)(14) of the Septage Management Rules.
b)Septage Land Application Site (SLAS) Permtt Numbers: (use additional sheets if needed)SLAS#: ___ Expiration Date:____ SLAS#: ___ Expiration Date: ___ _
c)Septage Detention or Treatment Facility (SDTF) Permit Numbers: (use additional sheets if needed)SDTF#: ____ Expiration Date:____ SDTF#: · Expiration Date: ___ _
(8.) Septage Management Firm Operator Training Completed: Date: ______ Location: _______ _ Hours: Training Sponsored or Provided by: ____________________ _
(9.) Septage Land Application Site Operator Training Completed: Date: ______ Location: _______ _ Hours: Training Sponsored or Provided by: ____________________ _
(10.) Registration type requested: CHECK ONE Registered Portable Sanitation Firm: _ Registered Septage Management Firm: __ Registered Portable Sanitation and Septage Management Firm: __
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.
Title
Other Comments:
S:/Solid_ Waste:/CLA/SEPTAGE/FORMS/2018 Firm Application/FirmPermitApplication2018
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1/12/2019 NCPG
4
Permit Fee $550.00Late Fee $275.00Paid 10/20/2020 JRB