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Home My WebLink AboutNCS00188_2021Permit_Initial 2021 Permit and Registration Cumberland Septic is hereby issued a Septage Management Firm Permit, Permit Number NCS-00188 And by virtue of completing the annual training requirements is hereby registered as a Portable Sanitation 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. Cross Creek WRF, Fayetteville, NC 2. Spring Lake Regional WWTP 3. Moore County Water Pollution Control Plant 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 CUMBERLAND SEPTIC The "Firm name" must be exactly as it is shown on your vehicle(s). NCS-00188 Enter the five digits following the NCS # City FAYETTEVILLE State / Province / Region NC Postal / Zip Code 28303 Country USA Street Address 319 MIKE ST Address Line 2 Cumberland Yes No City FAYETTEVILLE State / Province / Region NC Postal / Zip Code 28303 Country USA Street Address PO BOX 35192 Address Line 2 9108683830 9108679044 CUMBERLANDSEPTIC@AOL.COM Owner Info AUDREY STANCIL 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 FAYETTEVILLE State / Province / Region NC Postal / Zip Code 28303 Country USA Street Address PO BOX 35192 Address Line 2 9108683830 9108679044 Operator Info MIKE STANCIL VICE PRESIDENT Yes No City FAYETTEVILLE State / Province / Region NC Postal / Zip Code 28303 Country USA Street Address PO BOX 35192 Address Line 2 9108683830 9108679044 Type and amount of septage pumped in the last 12 months 145,872 889,915 0 0 0 North Carolina counties of operation CUMBERLAND, LEE, HOKE, HARNETT, SCOTLAND, SAMPSON, MOORE, ROBESON, BLADEN 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** Upload vehicle list** 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)** Other disposal method** Date**Hours** Location** 12/2/2020 PRESIDENT Add vehicles individually Upload List You can upload a file with a list of vehicles to be used. Please be sure to include the following information for each vehicle on your upload: Usage, License Tag #, Vehicle Identification #, and Tank Capacity. CSSISepticTrucksVinNumbers.xlsx 9.33KB Septage Disposal Method For each method, indicate whether you plan to use it by checking yes or no. Yes No cross creek 12/31/2020 CrossCreekWWT…171.73… SPRING LAKE REGIONAL WASTE WATER 12/31/2021 SLWWTP.pdf 158.12… MOORE CUONTY WPCP 12/31/2021 Yes No Yes No Yes No Septage Management Firm Operator Training Completed 2/10/2020 4 RALEIGH NC Training Sponsored or Provided by** Date Hours Location Training Sponsored or Provided by Select one** Comments or notes Signature Date Print Name**Title** RALEIGH 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. 12/2/2020 01:40:17 AM AUDREY STANCIL PRESIDENT TRUCK # TAG # GALLON TANK VIN# MAKE CS3 DX7578 1000 1HTHMAAL26H335887 INT CS4 JV9301 1000 3C7WRMBL3HG656041 DODGE CS5 EV3588 2200 1HTMXAAN73H578410 INT CS6 JV9302 1000 1HTMMAAL4DH416423 INT CS9 DX7562 1500 1HTMMMML6JH344908 INT CS10 DX75688 1500 1HTMMMML3KH395316 INT CS12 JP7939 450 1FDOW5HT9FEA99306 FORD CS13 JP7975 750 1FDUF5GT8CEB31676 FORD CS14 EJ9055 750 1FDUF5HTDEEA77307 FORD CS15 EX4490 750 1FDUF5HT7FEA20894 FORD CS17 JE3813 1800 1HT4MMML7JH714747 INT CS18 JE3814 1800 1HT4MMML7JH714748 INT CS19 JP7938 750 1FDUF5HT8KGE92094 FORD PAID INVOICE #: NCS-00188-2021 PERMIT #: NCS-00188 AMOUNT: $800 PAYMENT METHOD: e-card DATE: 12/3/2020 Chester Cobb