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HomeMy WebLinkAboutNCS00986_2021Permit_Initial 2021 Permit and Registration Forever Clean is hereby issued a Septage Management Firm Permit, Permit Number NCS-00986 And by virtue of completing the annual training requirements is hereby registered as a Portable Sanitation 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. Neuse River Resource Recovery Facility, Raleigh NC 2. North Durham WRF, Durham NC 3. South Durham WRF, Chapel Hill NC 4. North Harnett Regional WWTP, Lillington NC 5. Central Johnston County Regional WWTP, Smithfield NC 6. Septage Detention or Treatment Facility, SDTF-43-08 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 Forever Clean Portable Toilets, Inc. The "Firm name" must be exactly as it is shown on your vehicle(s). NCS-00986 Enter the five digits following the NCS # City Fuquay-Varina State / Province / Region NC Postal / Zip Code 27526 Country United States Street Address 116 West Academy Street Address Line 2 Wake Yes No City Fuquay-Varina State / Province / Region NC Postal / Zip Code 27526 Country WAKE Street Address 122 Josh Drive Address Line 2 9195520200 scott@foreverclean.com Owner Info Scott Tart Yes No ----------------------Removed Portable Toilets Inc to match firm name on DWM records. JRB 2/11/2021 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 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 City Fuquay-Varina State / Province / Region NC Postal / Zip Code 27526 Country WAKE Street Address 116 West Academy Street Address Line 2 9196696006 Operator Info Scott Tart President Yes No City Fuquay-Varina State / Province / Region NC Postal / Zip Code 27526 Country WAKE Street Address 116 West Academy Street Address Line 2 9196696006 Type and amount of septage pumped in the last 12 months 0 3,862,087 0 0 0 North Carolina counties of operation Wake, Harnett, Johnston, Durham and Cumberland Vehicle Info Yes No there significant penalties for false certification including the possibility of fine and imprisonment." Signature Date** Title** Choose how to add vehicle descriptions** Upload vehicle list** 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 12/30/2020 President Add vehicles individually Upload List You can upload a file with a list of vehicles to be used. Please be sure to include the following information for each vehicle on your upload: Usage, License Tag #, Vehicle Identification #, and Tank Capacity. Pumper Vehicles 2020.pdf 386.41KB Septage Disposal Method For each method, indicate whether you plan to use it by checking yes or no. Yes No City of Raleigh (NRRRF)12/31/2021 CITY OF RALEIGH (NRRRF) Authorization… 355.75… Central Johnston 12/31/2021 Central Johnston Authorization… 374.81… NHRWWTP 12/31/2021 Harnett Authorization… 343.49… Durham 12/31/2021 Durham Authorization… 272.28… 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 Signature Date Cross Creek WRF/Rockfish Creek WRF 12/31/2021 Cumberland County Authorization… 355.84… Yes No Yes No Yes No Septage Management Firm Operator Training Completed 12/5/2020 6 Grantsboro 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 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. 12/30/2020 Print Name**Title** 12/30/2020 08:00:00 AM SCOTT TART PRESIDENT PAID INVOICE #: NCS‐00986‐2021  PERMIT #: NCS‐00986  AMOUNT: $800  PAYMENT METHOD: e‐check  DATE: 12/31/2020    Chester Cobb