NCS01262_2021Permit_Initial

June 11th, 2021 Michael Holsomback Paradise Cove Marina 1242 Paradise Shores Rd Merritt NC 28556
Re: Permit to Operate a Septage Management Facility Paradise Cove Marina NCS-01262
Dear Mr. Holsomback:
The Division of Waste Management, Solid Waste Section, has received your “Application for a Permit to Operate a Septage Management Facility” and payment in the amount of $200.00.
You are hereby issued a 2021 Permit to Operate a Septage Management Facility for the following facilities: Septage Detention or Treatment Facility, SDTF-69-03 This permit is valid from January 1, 2021 until December 31, 2021. If you have any questions or need to make any changes to this permit, please feel free to contact Mr. Chester Cobb at 919-707-8283 or Mr. Jeffrey Bullard at 919-707-8285.
Sincerely,
Adam Ulishney Environmental Compliance Branch Head
Solid Waste Section
cc: John Farnell Wilmington Regional Office
State of North Carolina
Environmental Quality
Waste Management
Non-Pumper Application for a Permit
to Operate a Septage Management
Facility
NON-PUMPER - $200 FEE PER FACILITY
Facility Name:**
Street address:**
Street address - City:**
Street address - State:**
Street address - Zip:**
Street address - County:**
Mailing address same as Street
address:**
Facility Owner's Name:**
Mailing address:**
Mailing address - City:**
Mailing address - State:**
Mailing address - Zip:**
Phone:**
Email:**
Facility Operator's Name:**
Mailing address:**
Mailing address - City:**
Mailing address - State:**
Mailing address - Zip:**
Phone:**
Email:
Type(s) of septage managed:**
Facility Types:
Provide the permit numbers for all that are applicable.
Facility
Paradise Cove Marina
1242 Paradise Shores Rd
Merritt
NC
28556
Pamlico
Yes No
Owner
Michael Holsomback
1242 Paradise Shores Rd
Merritt
NC
28556
3365543043
[e-mail]
Operator
Michael Holsomback
1242 Paradise Shores Rd
Merritt
NC
28556
3365543043
Septage
(check all that apply)
Domestic Portable Toilet Waste Grease (restaurant)
Treatment Plant Industrial/Commercial
a. Septage Land Application Site
b. Boat Pump-Out Storage
c. Septage Storage Tanks
d. Septage Treatment
e. Grease Treatment
Septage Management firms using facility:
Provide name and permit number of all permitted septage management firms using facility.
Permit Number Firm Name
11
22
33
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.
Signature:
Date:
Title:
Email:**
X
Certification
(signature of company official required)
6/9/2021
[e-mail]
PAID Permit Fee
INVOICE #: NCS‐01262‐2021 
PERMIT #: NCS‐01262 
AMOUNT: $200 
PAYMENT METHOD: e‐card 
DATE: 2/19/2021 
Chester Cobb 
PAID Late Fee
INVOICE #: NCS‐01262‐2021LF 
PERMIT #: NCS‐01262 
AMOUNT: $100.00 
PAYMENT METHOD: e‐card 
DATE: 2/19/2021 
Chester Cobb