NCS00052_2021Permit_Modify

2021
Permit and Registration
Sprinkle Septic Tank

is hereby issued a Septage Management Firm Permit, Permit Number NCS-00052
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. Archie Elledge WWTP, Winston-Salem NC 2. Septage Detention or Treatment Facilities, SDTF-34-01 and SDTF-34-02 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
AUTHORIZATION TO DISCHARGE SEPTAGE AT A SEPTAGE TREATMENT OR STORAGE FACILITY PERMITTED TO SOMEONE OTHER THAN YOURSELF
(This form is used by a detention or treatment facility permit holder to indicate that permission has been given to a permitted Septage Management Firm to discharge septage into the permit holders detention or treatment facility.) I, Rodney Sides (Environmental Relief Technology, Inc.
(Facility Operator) 617 Waughtown Street, Building 350, Winston-Salem NC 27107 (Operator Address) do hereby authorize: Mark Sprinkle
(Owner of Septage Management Firm) Sprinkle Septic Tank Company NCS # 00052
(Name of Septage Management Firm) 4900 Murray Road, Winston-Salem, NC 27106
(Address of Septage Management Firm) to utilize septage detention or treatment facility # 34-02 for the treatment or storage of septage * in 2021 . The facility will be operated in accordance with the Septage Management Rules **.
Date: 12/1/20 Signed (Facility Operator) * As defined in G.S. 130A-290(a)(32) ** As defined in 15A NCAC 13B .0800 Return the properly completed form to: North Carolina Department of Environment and Natural Resources Division of Waste Management Solid Waste Section 1646 Mail Service Center Raleigh, NC 27699-1646