NCS01331_2022Permit_Initial

2022
Permit and Registration
Liquid Environmental Solutions

is hereby issued a Septage Management Firm Permit,
Permit Number NCS-01331
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. Septage Detention or Treatment Facility, SDTF-60-09, 26-05 & 34-06 2. Septage Detention or Treatment Facility, SDTF-92-12
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?*
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
Liquid Environmental Solutions
The "Firm name" must be exactly as it is shown on your vehicle(s).
NCS-01331
Enter the five digits following the NCS #
City
Charlotte
State / Province / Region
NC
Postal / Zip Code
28216
Country
United States
Street Address
4826 Worth Place
Address Line 2
Mecklenburg
Yes No
9102243119
[e-mail]
Owner Info
Liquid Environmental Solutions LLC
Yes No
9102243119
Operator Info
Manuel Perez Branch Operations Manager- Carolinas
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*
9102243119
Type and amount of septage pumped in the last 12 months
0
0
5,000,000
0
0
North Carolina counties of operation
All 100 Counties in North Carolina
Vehicle Info
Yes No
12/10/2021
Branch Operations Manager-Carolinas
Add vehicles individually Upload List
Grease (restaurant)Z13344 1T9TA322FR719036 6,000
Grease (restaurant)078C330 1L9BT41235G223486 4,800
Grease (restaurant)111K73 1L9BT41255G223487 4,800
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)*
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
Select one*
Comments or notes
Yes No
Yes No
Yes No
SDTF-60-09 9/30/2026
SDTF-34-05 6/30/2022
SDTF-26-05 12/31/2023
Yes No
Septage Management Firm Operator Training Completed
12/4/2021 4
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
Signature
Date
Print Name*Title*
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.
12/10/2021
10:42:39 AM
Manny Perez Branch Operations Manager-Carolinas
PAID
FIRM NAME: Liquid Environmental Solutions
PERMIT #: NCS-01331
AMOUNT: $800
PAID BY: Check
DATE: 10/4/2021

Adam Ulishney