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HomeMy WebLinkAboutNCS01277_2022Permit_Initial2022 Permit and Registration Royal Flush LTD is hereby issued a Septage Management Firm Permit, Permit Number NCS-01277 and registered as a Septage Management Firm (PUMPER) 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. Hampton Roads Sanitation District, Virginia Beach VA 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, 2022. __________________________________________________ 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 oce* County* Mailing address same as street address of oce?* Mailing Address* Phone*Fax Email* Firm owner's name* Mailing address same as street address of oce?* Phone*Fax Firm Info Royal Flush LTD The "Firm name" must be exactly as it is shown on your vehicle(s). NCS-01277 Enter the five digits following the NCS # City Virginia Beach State / Province / Region VA Postal / Zip Code 23453 Country United States Street Address 2821 Crusader Cir Address Line 2 Out-of-State Yes No City Virginia Beach State / Province / Region Va Postal / Zip Code 23457 Country United States Street Address PO Box 7123 Address Line 2 757-377-3603 royalflush3603@aol.com Owner Info Jason Gentry Yes No 757-377-3603 Firm operator's name*Firm operator's title Mailing address same as street address of oce?* Phone*Fax Amount in gallons* Domestic Portable Toilet Waste Grease (Restaurant) Treatment Plant Industrial/Commercial 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 .0835(a) and vehicle lettering as required by 15A NCAC .0835(b). Furthermore, I also certify that a log is maintained of each septage pumping event as required by 15A NCAC 13B .0836(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* Operator Info Jason Gentry Yes No 757-377-3603 Type and amount of septage pumped in the last 12 months 0 125,000 0 0 0 North Carolina counties of operation Currituck, South Mills, Grandy Vehicle Info Yes No 11/18/2021 Vice 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. NC 2022.pdf 1.34MB 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 * Location * Training Sponsored or Provided by* Date Hours Location Training Sponsored or Provided by Select one* Septage Disposal Method For each method, indicate whether you plan to use it by checking yes or no. Yes No HRSD 12/31/2022 NC 2022.pdf 1.34MB Yes No Yes No Yes No Septage Management Firm Operator Training Completed 4/22/2021 4 On Line NC DEQ - New Operator Training 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 or notes Signature Date Print Name*Title* Comments and Notes Certication 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. 11/18/2021 09:03:16 AM Jason Gentry Vice President PAID FIRM NAME: Royal Flush LTD PERMIT #: NCS-01277 AMOUNT: $800 PAID BY: E-Check DATE: 11/5/2021 Adam Ulishney