HomeMy WebLinkAboutNCS01515_2021Permit_Initial 2021
Permit and Registration
Express Jet Services
is hereby issued a Septage Management Firm Permit, Permit Number NCS-01515
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. Septage Detention or Treatment Facility, SDTF-98-08 2. Septage Detention or Treatment Facility, SDTF-92-12
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
Express Jet Services
The "Firm name" must be exactly as it is shown on your vehicle(s).
NCS-01515
Enter the five digits following the NCS #
City
Oxford
State / Province / Region
North Carolina
Postal / Zip Code
27565
Country
United States
Street Address
1111 Martin Luther King, Jr Ave
Address Line 2
Granville
Yes No
City
Oxford
State / Province / Region
North Carolina
Postal / Zip Code
27565
Country
United States
Street Address
P.O. Box 1399
Address Line 2
919-892-7107 919-690-1157
admin@expressjetnc.com
Owner Info
Jason Smith
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
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
Oxford
State / Province / Region
North Carolina
Postal / Zip Code
27565
Country
United States
Street Address
P.O. Box 1399
Address Line 2
919-892-7107 919-690-1157
Operator Info
Matthew Foster Supervisor
Yes No
City
Oxford
State / Province / Region
North Carolina
Postal / Zip Code
27565
Country
United States
Street Address
P.O. Box 1399
Address Line 2
919-892-7107 919-690-1157
Type and amount of septage pumped in the last 12 months
0
0
1,200,000
0
0
North Carolina counties of operation
all 100 counties
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**
Pumper Vehicles
Usage*License Tag #*Vehicle Identification #*Tank Capacity*
Approved wastewater treatment plant **
Septage Land Application Sites (SLAS)**
Septage Detention or Treatment Facility (SDTF)**
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**
12/15/2020
Owner
Add vehicles
individually
Upload List
Grease (restaurant)JT5224 1GBG6H1C3XJ102079 1,000
Grease (restaurant)AK48152 1T9TA4325C1867661 5,500
Grease (restaurant)AK14251 1M92M4025HT690079 4,500
Septage Disposal Method
For each method, indicate whether you plan to use it by checking yes or no.
Yes No
Yes No
Yes No
SDTF-92-12 6/23/2023 92-12
Authorization
Form 2021.pdf
462.39…
SDTF-98-08 12/31/2021 98-08
Authorization
Form 2021.pdf
436.19…
Yes No
Septage Management Firm Operator Training Completed
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**
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
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.
11/25/2020
11:08:24 AM
Jason Smith Owner
AUTHORIZATION TO DISCHARGE SEPTAGE AT A SEPTAGE TREATMENT OR
STORAGE FACILITY PERMITTED TO SOMEONE OTHER THAN YOURSETF
(This form is used by a detention or treatment facility permit holder to indicate that permission
has been given to a permitted Septage Management Firm to discharge septage into the permit
holders detention or treatment facility.)
5ce r/hntSc/#r Lk
(Facility Operator)
(Operator Address)
doherebyauthorize: - .lq,aln -S.ni.Hn -..__. ._ _
(Owner of Septage Management Firm)
f-' if;X(YZ6i , \€{ ,Sbruice;., LL C *., o' (Name of Septage Managemeni f irm)
o\bl5
' I I I rru K,' J' ty#= **::1,,#*.r3"oa'ft 6Po'--&*l 3?d
to utilize septage detention or treatment facility #
septage *7)-t>for the treatment or storage of
in zatZl-. The facility will be operated in accordance with the Septage Management Rules **
nate, .ll-:3-). O
* As defined ln G.S. 130.A-290(a)(32)** As defined in 15A NCAC 138 .0900
Return the properly completed form to:
North Carolina Department of Environmental euality
Division of Waste Management
Solid Waste Section
1546 Mail Service Center
Raleigh, NC 27599-1646
(Facility Operator)
: C. p-76 o
AUTHORIZATION TO DISCHARGE SEPTAGE AT A SEPTAGE TREATMENT OR
STORAGE FACILITY PERMITTED TO SOMEONE OTHER THAN YOURSELF(This form is used by a detention or treatunent facility permit holder to inrJicate that permission has been given to a permittedSeptage Management Firm to discharge ieptage into the permit holders detention or treatmeni facility.)
Daniel L Newsome
t,
(Facility 0perator)
44'l Buck Newsome Rd, Fremont, NC 27830
(Operator Address)
do hereby authorize: Jason Smith
(Owner of Septage Management Firm)
Express Jet Services 01515
(Name of Septage Management Firm)
NCS #
(Address of Septage Management Firm)
(00e53)
9B-08
to utllize septage detention or treatment facility #for the treatment or storage of septage *
in 2021-. The facility will be operated in accordance with the septage Management
1 0-01-20
Date:Signed
* As defined in G.S. 130A.290(a)(32)** As defined in 1SA NCAC 138 .0g00
Return the properly completed form to:
North carolina Department of Environment and Natural Resources
Division of Waste Management
Solid Waste Section
1646 Mail Service Center
Raleigh, NC 27699-1040
1
Cobb, Chester
From:G M <gm@greaseoutlet.com>
Sent:Wednesday, December 30, 2020 12:31 PM
To:Cobb, Chester; Wylie, Connie; Chip Haskell
Subject:[External] 2021 Authorization to discharge forms for Grease Outlet.com
Attachments:2021 permitted septage management firms using Grease Outlet.com LLC.pdf
CAUTION: External email. Do not click links or open attachments unless you verify. Send all suspicious email as an attachment to
Report Spam.
PAID
INVOICE #: NCS‐01515‐2021
PERMIT #: NCS‐01515
AMOUNT: $800
PAYMENT METHOD: e‐card
DATE: 1/15/2021
Chester Cobb