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HomeMy WebLinkAboutNCS00276_2021Permit_Initial 2021 Permit and Registration WRB Rentals is hereby issued a Septage Management Firm Permit, Permit Number NCS-00276 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 Murfreesboro, Murfreesboro, NC 2. Town of Woodland, Woodland NC 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, 2021. __________________________________________________ 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?** Phone**Fax Firm operator's name**Firm operator's title Mailing address same as street address of office?** Phone**Fax Firm Info WRB RENTALS, INC The "Firm name" must be exactly as it is shown on your vehicle(s). NCS- Enter the five digits following the NCS # City MURFREESBORO State / Province / Region NC Postal / Zip Code 27855 Country US Street Address POST OFFICE BOX 607 Address Line 2 Northampton Yes No 2523983028 2523983088 bmhsinc@centurylink.net Owner Info wayne brown Yes No 2523983028 2523983088 Operator Info kevin brown manager Yes No 2523983088 2523983088 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 subparagraph .0833(c)(14) of the Septage Management Rules. Mail forms to: Type and amount of septage pumped in the last 12 months 75,000 0 0 0 0 North Carolina counties of operation hertford and northampton Vehicle Info Yes No 10/9/2020 president Add vehicles individually Upload List Domestic Septage bn4000 1gdm7hic2x5506322 1,000 Septage Disposal Method For each method, indicate whether you plan to use it by checking yes or no. Yes No 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 Select one** Comments or notes town of murfresboro 12/31/2021 TOWN OF MURFREE SETPIC .pdf 162.36… town of woodland 12/31/2021 TOWN OF WOOLAND SEPTIC.pdf 140.44… Yes No Yes No Yes No Septage Management Firm Operator Training Completed 10/8/2020 4 nags head, nc NC Septic Tank Association 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 Signature Date Print Name**Title** 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. 10/9/2020 11:40:32 AM Wayne Brown President AUTHORIZATION TO DISCHARGE SEPTAGE TO A WASTEWATER TREATMENT FACILITY North Carolina Department of Environmental Quality Division of Waste Management - Solid Waste Section 1646 Mail 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. -5- c + i)trrI?c3 (Plant Operator in Responsible Charge (ORC), ORC License Number, Name of Plant) PCo J, /)rRccckv lAddEe .5L4 do hereby authorize R \b' (Phone Number) (Owrer/Opc-3tor of Septage Management Frm) of i. 15. n±3_. NCS 7C (Septagc Management Firm Name 81nd C5 number) to dispose of: domestic septage portable toilet waste grease septage (grease trap pumpings) commercial/industrial septage , from t4tf-,~,tl Co COIL CmnW'6r other Geograprc Area) at the above named wastewater treatment facility. Septage shail be discharged at: In ) (j) N CoreL`Ci (Locaten) between the hours of 1 Q Reintroducing partially treated liquid into a grease trap is acceptable Yes No This authorization shall be valid until TTC((C / (Usaiy December 3., Vearl / Facil;ty Operator) T . 3& Subscribed and affirmed before me this CAI ('Jotv Puocj (OFFICIAL SEAL) Note: Falsification of this document by the septage management firm shall lead to permit revocation. ;j d rr :to' "WtP A 3t:.tt'- cr 2LE Date -,;,I -2C2O day of'i._Tk,2O Q)J My Commission expires: 69 S2 '2( 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. F oi TTo o-P Woc Operator In Responsible Charge (ORC), ORC License Number, Name of Plant) t tD Woodôrc{Na 1 T7 (Address) 31 -11 (ôi do hereby authorize ,t*...on (Phone Number) (Owner/Opator of Septage Manager'ert Firm) of NCS#CXOJte (Septage Management Firm Name and NCS number) to dispose of: domestic septage W., , portable toilet waste grease septage (grease trap pumpings) commercial/industrial septage from _4 C0 4L. Nc r4bct ryj*ci (o ,j 4unty or other Geographic rea) at the above named wastewater treatment facility. Septage shall be discharged at. //,/ :s1n1eA;tYh 41ey 13ocjd/ana 'YC &7 (Location between the hours of 7.00 am . - ,Qrn. Reintroducing partially treated liquid into a grease trap is acceptable Yes No This authorization sh I be valid until ) t V December 31 Year) 01 -75gred (Usuall y Date _____ (Facility Operator) Subscribed and affirmed before me this Sf?,O1eIV?b.L1r day of 7YU2.LIL 11 2.LL222 - My Commission expires: 'e Mco \• 7_ i Q4 (Notary Public) j (OFFICIAL SEAL) 0 BL Note: Falsification of this document by the septage management firm shall lead to permit revocation. TON Go, .1Solld_WaJCL.A/5EPTAGE/FORM5/2018 Frm AppUctiori/WWTP Authcrizao rcrm 2018 PAID INVOICE #: NCS‐00276‐2021  PERMIT #: NCS‐00276  AMOUNT: $550  PAYMENT METHOD: Credit Card  DATE: 10/14/2020    Chester Cobb