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HomeMy WebLinkAboutNCS01395_2021Permit_Initial 2021 Permit and Registration George's Grading & Septic Tank Service, LLC is hereby issued a Septage Management Firm Permit, Permit Number NCS-01395 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. City of Hickory WWTP, Hickory NC 2. Septage Detention or Treatment Facility, SDTF-36-15 3. Taylorsville WWTP, Taylorsville 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 George's Grading & Septic Tank Service, LLC The "Firm name" must be exactly as it is shown on your vehicle(s). NCS-01395 Enter the five digits following the NCS # City Taylorsville State / Province / Region North Carolina Postal / Zip Code 28681 Country United States Street Address 545 School Dr Address Line 2 Alexander Yes No 8283122197 georgesgrading@gmail.com Owner Info P. Anthony George Yes No 8283122197 Operator Info P. Anthony George Yes No 8283122197 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 113,650 0 6,367 0 0 North Carolina counties of operation Alexander, Catawba, Iredell, Caldwell, Burke, Wilkes Lincoln Vehicle Info Yes No 12/14/2020 Owner/Operator Add vehicles individually Upload List Domestic Septage YA137137 1XPCDR9X0PN329332 3,500 Grease (restaurant)YA137137 1XPCDR9X0PN329332 3,500 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)** 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** Town of Taylorsville WWTP 12/31/2021 Town of Tay for 2021.pdf 392.23… City Of Hickory WWTP 12/31/2021 Catawba for 2021.pdf 332.05… Yes No Yes No SDTF-36-15 12/31/2021 Earth Farms for 2021.pdf 269.13… Yes No Septage Management Firm Operator Training Completed 1/30/2020 6 Hickory Metro Convention Center, Hickory, NC NC Septic Tank Association Septage Land Application Site Operator Training Completed 0 Registration Type Comments or notes Signature Date Print Name**Title** 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. 12/14/2020 07:09:00 AM Paul A George Owner/Operator PAID INVOICE #: NCS‐01395‐2021  PERMIT #: NCS‐01395  AMOUNT: $550  PAYMENT METHOD: e‐check  DATE: 12/16/2020    Chester Cobb