HomeMy WebLinkAboutNCS01437_2021Permit_Initial 2021
Permit and Registration
Hulin Septic Tank
is hereby issued a Septage Management Firm Permit, Permit Number NCS-01437
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. Town of Denton WWTP, Denton NC 2. City of Asheboro WWTP, Asheboro 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
Paul Allen Hulin
The "Firm name" must be exactly as it is shown on your vehicle(s).
NCS-01437
Enter the five digits following the NCS #
City
Lexington
State / Province / Region
NC
Postal / Zip Code
27292
Country
USA
Street Address
128 J Nettie Dr.
Address Line 2
Davidson
Yes No
3364422360
hulinseptictank@gmail.com
Owner Info
Paul Allen Hulin
Yes No
3364422360
Operator Info
Paul Allen Hulin Owner/Operator
Yes No
3364422360
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.
Type and amount of septage pumped in the last 12 months
41,000
0
0
0
0
North Carolina counties of operation
Davidson
Randolph
Vehicle Info
Yes No
12/22/2020
Owner
Add vehicles
individually
Upload List
Domestic Septage YA141904 2FZAAKBV31AH62952 2,000
Septage Disposal Method
For each method, indicate whether you plan to use it by checking yes or no.
Yes No
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)**
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**
Town of Denton 12/31/2021 Town of
Denton.pdf
64.81KB
Recertificati…
of Pumper
Vehicle.pdf
26.85KB
City of Asheboro 12/31/2021 City of
Asheboro.pdf
76.45KB
Yes No
Yes No
Yes No
Septage Management Firm Operator Training Completed
10/14/2020 4
Wilkesboro 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
Comments or notes
Signature
Date
Print Name**Title**
I uploaded my Recertification of Pumper Vehicle Form with the Town of Denton
WWTF Authorization Form.
Thanks
Paul
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.
12/22/2020
02:35:00 PM
Paul Allen Hulin Owner
NC SEPTAGE MANAGEMENT FIRM
Recertification of Pumper Vehicle(s)
Septage Firm Permit #:NCS-01437
Number of Pumper Vehicles:__.__
CERTIFICATION:
"I certify,under penalty of law,that the pumper vehicle or vehicles listed in the
submitted permit application meet the requirements for safe and sanitary
transportation of septage as required by15A NCAC 138 .0844 (a)and vehicle
lettering as required by 15A NCAC 138 .0844 (b).I also certify that a log is
maintained of each septage pumping event as required by 15A NCAC 138 .0839
(a).I am aware that there are significant penalties for false certification including
the possibility of fine and imprisonment."
12/22/20
Date
12/22/20
i9I1atUre(Signature of companyofficial required)
Paul Allen Hulin
Print Name Title
S:\Solid_Waste\cla\septage\fonns\Pumper Vehicles Cetlflcatlon.doc
AUTHORIZATION TO DISCHARGE SEPTAGE TO A WASTEWATER TREATMENT FACILITY
North Carolina Department of Environment and Natural Resources
Division of Waste Management -SolidWaste Section
1646 Mail ServiceCenter,Raleigh,NC27699-1646
Feeassessmentsand 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.
"Ml~hael R.Wisem~!1.ORC....WW4#987680.City of Asheboro Wastewater Treatment Plant
(Plant Operator in Responsible Charge (ORC),ORCUcense Number,Name of Plant)
1032 Bonkemeyer Drive,Randleman,NC27317
(Address)
.~33~6",---,,-6!-,72=-.--,,-08=.:9:<.:2,___~_doherebyauthorize PaulAllen Hulin "Allen"
(Phone Number)(Owner/Operator of Septage Management Firm)
of Hulin Septic...!T~a!.!.!nk~,____:.N.:.!C~S:!!#01437
(Septage Management Firm Name and NCSnumber)
to dispose of:domestic septage _-"X:!..__-,portable toilet waste _
grease septage (greasetrap pumpings)_...:.X':____commercial/industrial septage ,"_,from
Randolph County
(County or other GeographicArea)
at the above named wastewater treatment facility.,Septage shall be discharged at:
1032 Bonkemeyer Drive,Randleman,NC27317
(location)
between the hours of 7:00 a.m.to 5:00 p.m.Monday -FridavOnly
Reintroducingpartiallytreated liquidIntoa greasetrap isacceptable _Yes _X_No
This authorization shall be valid until December 31,2021
(Usually December 31,Year)
Subscribed and affirmed before me this _--1..'\.::::!It':.__.day of Ceu..u....b-c
_~~:4.i--~A.'."~
~-PUblic).
.20 2'0
My Commission expires:~~:&.~",
\\,\"II,,"~..iE-NO\,r II,~.:'",,'~~
(OFFICIAti_l)""0 ~~~'"r..;.(.:
:~-<1 ~rn=:CJ G'J :a:
;~~{/C $
"'-0.(J~Note:Falsification of this document by the septage management firm shall lead to permit revocatrtt,iY C ~.$
S:/Solid_Waste/CLA/SEPTAGE/FORMS/2019Firm Application/WWTP Authorization Form 2019 "'"OUN't"",\\""
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AUTHORIZATION TO DISCHARGE SEPTAGE TO A WASTEWATER TREATMENT FACILITY
North Carolina Department of Environment and Natural Resources
Divisionof Waste Management -SolidWaste Section•1646 MailServiceCenter,Raleigh,NC27699-1646
~
Fee assessments and waste determinations willbe required at the discretio,,"of the wastewater
treatment facility.The facility has the ultimate prerogative to deny dischargls of any wastes to the
incoming wastewater stream.
•
I,lSo~13CQ.N'b.997S\J ""1Own ~D~n-toY\~r w-r2
(Plant operat~r in Responsi61eCharge(ORC),ORCLicenseNumber,Name of Plant)
(Address)
1~!.uIqIl...-_!-a!!!.!5::....q.l--_4~4.J,;(.,IIR:()~__do hereby authorize A \\er"\\tu \iV\
(Phone Number)(Owner/Operator ofS~ptage Management Firm)
of \\J.~n SepTLc.TUj\k
(SeptageManagement Firm Name and NCSnumber)
NCS#Q\4.3,
to dispose of:domestic septage -..,/portable toilet waste ____!!V",-'___oJ
grease septage (grease trap pumpings)commercial/industrial septage _'from
(County or other Geographic Area)
at the above named wastewater treatment facility.Septage shall be discharged at:
(Location)
between the hours of __
Reintroducing partially treated liquid into a grease trap is acceptable _Yes V No
Thisauthorization shall be valid until DeC-¬ Ynter3 \,to2l
(Usually December 31,Year)
Date /W 7/Lt)2..0
Subscribed and affirmed before me this ~1_1~-tV\day of DeCfmbe/,20 0<..0
~p_Q 1{_~turr2 MyCommissionexpires:1:V()3<r44~?h;;;{f.'.
i~~;aryP¥C)'..\':","-I;
(OFF~!8l SEAt'{~~>:-:::-'/'~~~"
--~J '.l'!:--.',_.",-,,!....
-:-,.j,(""..'.r)-:
j;.".f"'_/\......~l~':,~.
"",~"'~.-"".:~"",--....
Note:Falsification of this document by the septage management firm shall lead to permit revo~~~i~n.'·/",",~.:
S:/Solid_Waste/CWSEPTAGE/FORMS/2014 FirmApplication/WWTP Authorization Form 2014 'I t ,r i ,\',\I J i ~j ~
PAID
INVOICE #: NCS‐01437‐2021
PERMIT #: NCS‐01437
AMOUNT: $550
PAYMENT METHOD: e‐check
DATE: 12/24/2020
Chester Cobb