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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