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Home My WebLink AboutNCS01537_2021Permit_Initial 2021 Permit and Registration Scott Septic Service is hereby issued a Septage Management Firm Permit, Permit Number NCS-01537 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. Robbins WWTP, Robbins NC (Bear Ridge Road) 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 Scott Septic Service The "Firm name" must be exactly as it is shown on your vehicle(s). NCS-01537 Enter the five digits following the NCS # City Robbins State / Province / Region North Carolina Postal / Zip Code 27325 Country United States Street Address 4151 NC 705 Hwy Address Line 2 Moore Yes No 9107835688 scottsepticservice@gmail.com Owner Info John Scott Yes No 9107835688 Operator Info John Scott Yes No 9107835688 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 53,500 0 0 0 0 North Carolina counties of operation Moore, Randolph, Chatham, Montgomery Vehicle Info Yes No 12/7/2020 Manager Add vehicles individually Upload List Domestic Septage JT-3553 1GDM7DIY4GV513513 2,000 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 Signature Robbins Waste Water Treatment Plant 12/31/2021 DOC120720- 1207202022160… 436.5KB Yes No Yes No Yes No Septage Management Firm Operator Training Completed 10/20/2020 4 5834 Bur-Mil Club Rd, Greensboro, 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 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. Date Print Name**Title** 12/7/2020 10:22:03 PM John Scott Manager PAID INVOICE #: NCS‐01537‐2021 PERMIT #: NCS‐01537 AMOUNT: $550 PAYMENT METHOD: e‐card DATE: 12/9/2020 Chester Cobb