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HomeMy WebLinkAboutNCS01476_2021Permit_Initial 2021 Permit and Registration Elegant Johns is hereby issued a Septage Management Firm Permit, Permit Number NCS-01476 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 Slier City WWTP, Siler City 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?** Mailing Address** Phone**Fax Firm Info Elegant Johns The "Firm name" must be exactly as it is shown on your vehicle(s). NCS-01476 Enter the five digits following the NCS # City CHAPEL HILL State / Province / Region NC Postal / Zip Code 27517-8031 Country United States Street Address 1224 OLD LYSTRA RD Address Line 2 Orange Yes No 9198195258 amanda@elegantjohns.com Owner Info David Schwartz/Amanda Mckee Yes No City CHAPEL HILL State / Province / Region NC Postal / Zip Code 27517 Country United States Street Address 77016 miller Address Line 2 9198195258 Firm operator's name**Firm operator's title Mailing address same as street address of office?** 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?** 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)** Septage Detention or Treatment Facility (SDTF)** Operator Info David Schwartz owner Yes No 9198195258 Type and amount of septage pumped in the last 12 months 0 0 0 0 0 North Carolina counties of operation Orange, Wake, Alamance, Durham, Chatham Vehicle Info Yes No Septage Disposal Method For each method, indicate whether you plan to use it by checking yes or no. Yes No Town Of Siler City 12/31/2021 Yes No If you are not the permit holder for the septage detention/treatment facility, you must have a signed detention/treatment authorization form for each site. SDTF #*Expiration Date*Authorization 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 Yes No SDTF-12/31/2021 Yes No Septage Management Firm Operator Training Completed 11/17/2020 4 Web ex NC DEQ - New Operator Training Septage Land Application Site Operator Training Completed 11/17/2020 4 Webex NC DEQ - New Operator Training Registration Type Registered Portable Sanitation Firm Registered Septage Management Firm Registered Portable Sanitation and Septage Management Firm Comments and Notes All trailers are pumped by permitted septage firm. 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. 11/17/2020 01:00:00 PM Print Name**Title** Amanda Mckee Owner PAID INVOICE #: NCS‐01476‐2021  PERMIT #: NCS‐01476  AMOUNT: $550  PAYMENT METHOD: e‐card  DATE: 12/16/2020    Chester Cobb