HomeMy WebLinkAboutNCS01489_2021Permit_Initial 2021
Permit and Registration
Septics-R-Us
is hereby issued a Septage Management Firm Permit, Permit Number NCS-01489
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. Rocky River Regional WWTP, Concord NC (Expires June 2021) 2. North Durham WFR, Durham NC
3. South Durham WRF, Durham 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?**
Mailing Address**
Phone**Fax
Email**
Firm owner's name**
Mailing address same as street address of office?**
Mailing Address**
Firm Info
Septics-R-US
The "Firm name" must be exactly as it is shown on your vehicle(s).
NCS-01489
Enter the five digits following the NCS #
City
Durham
State / Province / Region
NC
Postal / Zip Code
27713
Country
USA
Street Address
3822 S Alston Ave
Address Line 2
Durham
Yes No
City
MILTON
State / Province / Region
NC
Postal / Zip Code
27305
Country
United States
Street Address
480 Rock Creek Drive
Address Line 2
434-770-3460
septicsrusnc@gmail.com
Owner Info
Seth Robinson
Yes No
Phone**Fax
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
City
MILTON
State / Province / Region
NC
Postal / Zip Code
27305
Country
United States
Street Address
480 Rock Creek Drive
Address Line 2
4347703460
Operator Info
Nicholas Gisclair Forman
Yes No
City
Durham
State / Province / Region
NC
Postal / Zip Code
27701
Country
USA
Street Address
1600 N Alston Ave
Address Line 2
Apartment C
919-638-2087
Type and amount of septage pumped in the last 12 months
303,000
0
0
0
0
North Carolina counties of operation
Durham, Alamance, Guilford, Orange, Caswell, Person, Vance Granville,
Franklin, Chatham, Lee, Harnett, Johnston, Rockingham
Vehicle Info
Yes No
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:
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)**
10/13/2020
Owner
Add vehicles
individually
Upload List
Domestic Septage YA154616 2NKHHM7X3BM285867 1,500
Domestic Septage JZ-5122 JALC4B16667007582 1,200
Septage Disposal Method
For each method, indicate whether you plan to use it by checking yes or no.
Yes No
Durham's North And South Water
Reclaimation Facilities
12/31/2020 Durham Dump
Permit.pdf
301.32…
WSACC 6/30/2021 Concord Dump
Permit .pdf
845.91…
Winston Salem Dump 12/31/2020 Septics R Us
Winston Salem
2020
Permit.pdf
239.03…
Yes No
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
Signature
Date
Print Name**Title**
Yes No
Yes No
Septage Management Firm Operator Training Completed
9/11/2020 4
Morganton NC
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
I will Send the New Authorizations to Dump as Soon as I get them. Thanks
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.
10/6/2020
10:12:27 AM
Seth Robinson Owner