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Home My WebLink AboutNCS01372_2021Permit_Initial 2021 Permit and Registration Liquid Environmental Solutions (Winston-Salem) is hereby issued a Septage Management Firm Permit, Permit Number NCS-01372 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-92-12 2. Septage Detention or Treatment Facility, SDTF-34-06 3. Septage Detention or Treatment Facility, SDTF-60-09 4. Septage Detention or Treatment Facility, SDTF-26-05 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 Liquid Environmental Solutions The "Firm name" must be exactly as it is shown on your vehicle(s). NCS-01372 Enter the five digits following the NCS # City Winston Salem State / Province / Region NC Postal / Zip Code 27107 Country United States Street Address 750 Palmer Lane Address Line 2 Forsyth Yes No 9102243119 336-893-7957 manuel.perez@liquidenviro.com Owner Info Liquid Environmental Solutions LLC Yes No 9102243119 Operator Info Manuel Perez Branch Operations Manager-Carolinas Yes No 9102243119 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 ** Septage Land Application Sites (SLAS)** Type and amount of septage pumped in the last 12 months 0 0 1,500,000 0 0 North Carolina counties of operation All 100 Counties in North Carolina Vehicle Info Yes No 11/11/2020 Branch Operations Manager-Carolinas Add vehicles individually Upload List Grease (restaurant)213343 1T9TA4324FR719037 6,500 Septage Disposal Method For each method, indicate whether you plan to use it by checking yes or no. Yes No Yes No 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** Date**Hours** Location** Training Sponsored or Provided by** Date Hours Location Training Sponsored or Provided by Select one** Comments or notes Signature Yes No SDTF-60-09 9/30/2021 SDTF-34-05 6/30/2020 SDTF-26-05 12/31/2020 Yes No Septage Management Firm Operator Training Completed 9/12/2020 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. Date Print Name**Title** 11/11/2020 01:46:03 PM Manny Perez Branch Operations Manager-Carolinas 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.