HomeMy WebLinkAboutNCS01090_2021Permit_Initial 2021
Permit and Registration
A & B Portable Toilets, Inc.
is hereby issued a Septage Management Firm Permit, Permit Number NCS-01090
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. T Z Osborne WRF, Mcleansville NC 2. Carolina Compost Inc., SWCD-29-10
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
A&B Portable Toilets, Inc.
The "Firm name" must be exactly as it is shown on your vehicle(s).
NCS-01090
Enter the five digits following the NCS #
City
Greensboro
State / Province / Region
NC
Postal / Zip Code
27406
Country
USA
Street Address
2544 Alamance Church Road
Address Line 2
Guilford
Yes No
336 669 7338 336 697 2909
ayoung@apbortabletoilets.com
Owner Info
William D Young
Yes No
336 669 7338 336 697 2909
Operator Info
William D Young President
Yes No
336 669 7338
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**
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:
Type and amount of septage pumped in the last 12 months
323,798
403,273
273,733
0
0
North Carolina counties of operation
Guilford, Alamance, Forsyth, Randolph, Rockingham, Chatham, Moore, Orange,
Durham, Lee, Wake
Vehicle Info
Yes No
12/11/2020
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.
Master Truck List 2020.xlsx 13.07KB
Septage Disposal Method
For each method, indicate whether you plan to use it by checking yes or no.
Yes No
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
TZ Osborne 12/31/2021 Permission to
Dump
Wastewater.pd…
96.45KB
East Burlington 12/31/2021 Permission to
Dump
Wastewater.pd…
96.45KB
Carolina Compost 12/31/2021 Permission to
Dump Septage
Treatment.pdf
33.21KB
Yes No
Yes No
SDTF-34-02 12/31/2021
Yes No
Septage Management Firm Operator Training Completed
10/20/2020 6
Greensboro, NC
NC Septic Tank Association
Septage Land Application Site Operator Training Completed
0
Select one**
Comments or notes
Signature
Date
Print Name**Title**
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.
12/10/2020
04:20:57 AM
William D Young President
Year Truck Tag Tag Exp Fresh Water Gallons Waste VIN Usage2007 Freightliner MZ HS‐7279 300 1000 1FVACWDCH7HY75671 Portable Toilet2002 Freightliner Classic YA‐107141 20‐Dec 120 3200 1FUJAHCG62LK25882 Septic/Grease2000 Freightliner FL80 YA‐133402 0 2500 1FU6J6BA5YNF92192 Septic/Grease2005 GMC 5500 FD‐2444 200 300 1GDE5C1255F5182262016 Ford F550 HC‐2653 21‐Apr 300 900 1FDUF5GT8GEC07547 Portable Toilet2015 International 4300 FD‐2443 400 1000 3HAMMMML6FL70905 Portable Toilet2016 Ford F550 JB4557 21‐Jun 200 900 1FDUF5GT9GED30404 Portable Toilet2018 Ford F550 JK3346 21‐Jan 350 1000 1FDUF5GTOJEC21059 Portable Toilet2019 International HV507 YA153121 100 4000 3HAEGTAT7KL332448 Septic/Grease2019 Chevrolet Silverado JP‐5259 250 350 1HTKHPVK6KH840702 Portable Toilet1988 Freightliner Classic YA153401 21‐Mar Dump Truck2019 Chevrolet Silverado HP‐6196 150 300 54dcw1bok5804287 Portable Toilet/Delivery 2019 International MV JX2847 21‐Jan 400 1000 1HTEUMML1KH406320 Portable Toilet2019 Chevy/Isuzu KC‐2404 350 800 1HTKHPVK6HI61982 Portable Toilet2019 International 4300 JX‐2846 250 500 1HTMMMMLoHH572865 Portable Toilet/Delivery 2012 Chevy 2500 JN‐5618Pick Up
Year Truck Tag Tag Exp Fresh Water Gallons Waste VIN Usage2007 Freightliner MZ HS‐7279 300 1000 1FVACWDCH7HY75671 Portable Toilet2002 Freightliner Classic YA‐107141 20‐Dec 120 3200 1FUJAHCG62LK25882 Septic/Grease2000 Freightliner FL80 YA‐133402 0 2500 1FU6J6BA5YNF92192 Septic/Grease2005 GMC 5500 FD‐2444 200 300 1GDE5C1255F5182262016 Ford F550 HC‐2653 21‐Apr 300 900 1FDUF5GT8GEC07547 Portable Toilet2015 International 4300 FD‐2443 400 1000 3HAMMMML6FL70905 Portable Toilet2016 Ford F550 JB4557 21‐Jun 200 900 1FDUF5GT9GED30404 Portable Toilet2018 Ford F550 JK3346 21‐Jan 350 1000 1FDUF5GTOJEC21059 Portable Toilet2019 International HV507 YA153121 100 4000 3HAEGTAT7KL332448 Septic/Grease2019 Chevrolet Silverado JP‐5259 250 350 1HTKHPVK6KH840702 Portable Toilet1988 Freightliner Classic YA153401 21‐Mar Dump Truck2019 Chevrolet Silverado HP‐6196 150 300 54dcw1bok5804287 Portable Toilet/Delivery 2019 International MV JX2847 21‐Jan 400 1000 1HTEUMML1KH406320 Portable Toilet2019 Chevy/Isuzu KC‐2404 350 800 1HTKHPVK6HI61982 Portable Toilet2019 International 4300 JX‐2846 250 500 1HTMMMMLoHH572865 Portable Toilet/Delivery 2012 Chevy 2500 JN‐5618Pick Up
PAID
INVOICE #: NCS‐01090‐2021
PERMIT #: NCS‐01090
AMOUNT: $800
PAYMENT METHOD: e‐check
DATE: 12/14/2020
Chester Cobb