NCS00672_2021Permit_Initial

2021
Permit and Registration
Triple A Sanitation
is hereby issued a Septage Management Firm Permit, Permit Number NCS-00672
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.Town of Columbus WWTP, Columbus 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).
Street address of office**
County**
Mailing address same as street address of office?**
Mailing Address**
Phone**Fax
Email**
Firm owner's name**
Mailing address same as street address of office?**
Mailing Address**
Firm Info
Firm name**
Triple A Sanitation
The "Firm name" must be exactly as it is shown on your vehicle(s).
Septage Management Firm permit number (NCS #)**
NCS-00672
Enter the five digits following the NCS #
City
Mill Spring
State / Province / Region
NC
Postal / Zip Code
28756
Country
US
Street Address
475 Short Creek Drive
Address Line 2
Polk
Yes No
City
Mill Spring
State / Province / Region
NC
Postal / Zip Code
28756
Country
US
Street Address
PO Box 219
Address Line 2
828-894-8603
[e-mail]
Owner Info
Stacey E. Price
Yes No
Phone**Fax
Firm operator's name**Firm operator's title
Mailing address same as street address of office?**
Mailing address**
Phone**Fax
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
City
Mill Spring
State / Province / Region
NC
Postal / Zip Code
28756
Country
US
Street Address
PO Box 219
Address Line 2
828-894-8603
Operator Info
Stacey E. Price Owner
Yes No
City
Mill Sring
State / Province / Region
NC
Postal / Zip Code
28756
Country
US
Street Address
PO Box 219
Address Line 2
828-894-8603
Type and amount of septage pumped in the last 12 months
50,000
75,000
0
0
0
North Carolina counties of operation
Polk
Vehicle Info
Yes No
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.
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)**
Other disposal method**
Date**Hours**
12/30/2020
Owner
Add vehicles
individually
Upload List
Domestic Septage YA000599 2NKMHD7X81M87OO22 2,000
Portable Toilet Waste JP4758 3D6WD66AO8G214523 500
Portable Toilet Waste JP4787 1FDUF5HTXKDA22462 1,100
Septage Disposal Method
For each method, indicate whether you plan to use it by checking yes or no.
Yes No
Columbus WWTP 12/31/2020 IMG_0001.pdf 468.76…
Yes No
Yes No
Yes No
Septage Management Firm Operator Training Completed
1/30/2020 6
Location**
Training Sponsored or Provided by**
Date Hours
Location
Training Sponsored or Provided by
Select one**
Comments or notes
Signature
Date
Print Name**Title**
Hickory
NC Septic Tank Association
Septage Land Application Site Operator Training Completed
0
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.
12/30/2020
06:03:43 PM
Stacey E. Price Owner
Authorization sent with
application was missing
expiration date, revised
copy received 8/16/2021.
JRB 8/16/2021
PAID
INVOICE #: NCS‐00672‐2021 
PERMIT #: NCS‐00672 
AMOUNT: $800 
PAYMENT METHOD: e‐check 
DATE: 12/31/2020 
Chester Cobb 
2020 permit application received incomplete. Page 2 was never received, 2020 ended before page 2
could be obtained from firm, 2020 permit was not able to be issued with incomplete application. JRB
2/5/2020