NCS00072_2022Permit_Initial

2022
Permit and Registration
Ivey's Septic Tank Service, Inc.

is hereby issued a Septage Management Firm Permit,
Permit Number NCS-00072
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. City of Durham, North and South WRF 2. East Burlington WWTP 3. Siler City WWTP
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 aSeptage 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?*
Phone*Fax
Email*
Firm owner's name*
Mailing address same as street address of oce?*
Phone*Fax
Firm operator's name*Firm operator's title
Mailing address same as street address of oce?*
Firm Info
Ivey's Septic Tank Service, Inc.
The "Firm name" must be exactly as it is shown on your vehicle(s).
NCS-00072
Enter the five digits following the NCS #
City
EFLAND
State / Province / Region
NC
Postal / Zip Code
27243
Country
United States
Street Address
1122 BROOKHOLLOW ROAD
Address Line 2
Orange
Yes No
9197325592
[e-mail]
Owner Info
Toby Davis Ivey
Yes No
9197325592
Operator Info
Ivey's Septic Tank Service, Inc.
Yes No
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*
Pumper Vehicles
Usage*License Tag #*Vehicle Identification #*Tank Capacity*
9197325592
Type and amount of septage pumped in the last 12 months
400,000
0
0
0
0
North Carolina counties of operation
Orange, Durham, Alamance & Chatham
Vehicle Info
Yes No
11/22/2021
President
Add vehicles individually Upload List
Domestic Septage YA113902 2F2HANBS52AJ98211 3,200
Domestic Septage KL2089 2NKHHM6X4DM343120 1,600
Septage Disposal Method
For each method, indicate whether you plan to use it by checking yes or no.
Approved wastewater treatment plant*
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*
Comments or notes
Signature
Date
Yes No
Yes No
Yes No
Yes No
Septage Management Firm Operator Training Completed
12/4/2021 4
Bob Martin Building, Raleigh NC
NC Pumper Group & NC Portable Toilet Group
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
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.
11/22/2021
04:18:57 AM
X --------City of Durham, North and South WRF
East Burlington WWTP
Siler City WWTP JRB 3/1/2022
Print Name*Title*
Toby Davis Ivey President
CITY OF DURHAM
Department of Water Management
AUTHORIZATION TO DISCHARGE
Ivey's Septic Tank Service
hereby is granted pennission to discharge domestic septage waste into City of Durham's
North and South Water Reclamation Facilities. This discharge shall be between the hours
of7:30 a.m. and 4:00 p.m., five days a week. Pennission to discharge is restricted to
waste collected in the state of North Carolina. The maximum discharge volume of each
load is 1600 gallons.
Ivey's Septic Tank Service shall comply with all provisions of City of Durham's Sewer
Use Ordinance. If any provision of the City's Sewer Use Ordinance is violated, this
authorization may be tenninated.
Fee assessment and waste detennination may be required at the discretion of the City of
Durham, Department of Water Management.
This authorization shall be valid from January I, 2022 until December 31, 2022.
John Dodson -Date
urham Water Reclamation Facility
1900 East Club Boulevard
Durham, North Carolina 27704
(919)S60-4384
& d //-9-$.)
Charles Cocker -Date
South Durham Water Reclamation Facility
660S Farrington Road
Chapel Hill, North Carolina 27S 17
[phone]
PAID
FIRM NAME: Ivey’s Septic Tank Service, Inc.
PERMIT #: NCS-00072
AMOUNT: $800
PAID BY: E-Check
DATE: 12/20/2021

Adam Ulishney