NCS00128_2022Permit_Initial

2022
Permit and Registration
Elvis Service Co., Inc

is hereby issued a Septage Management Firm Permit,
Permit Number NCS-00128
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-78-22
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.

______________________________________________ Perry Sugg, 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
Elvis Service Company
The "Firm name" must be exactly as it is shown on your vehicle(s).
NCS-00128
Enter the five digits following the NCS #
City
Myrtle Beach
State / Province / Region
SC
Postal / Zip Code
29577
Country
USA
Street Address
2200 Executive Ave
Address Line 2
Out-of-State
Yes No
843-448-5019
[e-mail]
Owner Info
Phillip Elvis
Yes No
843-448-5016
Operator Info
Matthew Haselden Manager
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*
Upload vehicle list*
Approved wastewater treatment plant*
843-448-5016
Type and amount of septage pumped in the last 12 months
25,000
25,000
25,000
0
0
North Carolina counties of operation
Brunswick, Columbus, New Hanover
Vehicle Info
Yes No
12/20/2021
Manager
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.
Untitled spreadsheet.xlsx 6.62KB
Septage Disposal Method
For each method, indicate whether you plan to use it by checking yes or no.
Yes No
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
SDTF-78-22 8/24/2023 CCF12202021_…645.98…
Yes No
Septage Management Firm Operator Training Completed
9/23/2021 4
Newbern, NC
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
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.
Signature
Date
Print Name*Title*
12/20/2021
08:46:27 AM
Matthew Haselden Manager
Eqmt
Number Year Make Model Type Capacity
License
Plate #VIN #
1 2020 WEST STAR 4700sf GREASE TRUCK 4500 P679878 5KKHAXFM7PLH8180
2 1993 INTERNATIONAL 4900 GREASE TRUCK P797239 1HTSHPCR4PH505722
3 2013 INTERNATIONAL 4300 SEPTIC TRUCK 2300 P738141 1HTMMAAN8EH485618
4 2006 INTERNATIONAL 7600 GREASE TRUCK 5000 P741739 1HTWYAHTX6J341371
5 2000 INTNERNATIONAL 4900 SEPTIC TRUCK 2500 P566914 1HT5DAAN6YH299281
6 2015 WEST STAR 4900SF GREASE TRUCK 5500 P744183 5KKMAEBGXGPHJ1312
7 2016 INTERNATIONAL 4300 Grease TRUCK 2800 P747584 1HTMMMMNXHH475660
9 1998 INTERNATIONAL 4300 SEPTIC TRUCK 900 P533028 1HTSCAAL8WH546590
11 2017 WEST STAR 4700SD SEPTIC TRUCK 3500 P766247 5KKHAXDV2HPJC0670
12 2018 WEST STAR 4700SB GREASE TRUCK 4000 P763569 5KKHAXDV4JLJP7132
14 1999 INTNERNATIONAL 4700 TOILET 1000 P628399 1HTSCAAL2XH655290
20 2006 INTNERNATIONAL 4300 TOILET 1200 P530024 1HTMMAAL96H196408
24 2018 INTNERNATIONAL 4300 TOILET 1,200 P661006 1HTMMMML4JH344907
25 2015 INTNERNATIONAL 4000 TOILET 1000 P692859 3HAMMMML8FL709056
26 2002 INTNERNATIONAL 4300 TOILET 1000 P566909 1HTMMAAL92H548946
27 2006 INTNERNATIONAL 4300 TOILET 1200 P603223 1HTMMAAL66H345583
40 2017 DODGE 5500 TOILET 800 P659509 3C7WRMCL8HG753864
45 2007 FORD F550 Grease TRUCK 900 P599613 1FDAF57P27EB50784
47 2018 DODGE 5500 TOILET 800 P667370 3C7WRNCL0JG391685
48 2015 FORD F550 TOILET 750 P679807 1FDUF5GT7FEA14322
50 2016 DODGE RAM 5500 TOILET 750 P679810 3C7WRMBL8GG193876
53 2019 FORD F750 TOILET 850 P673805 1FDWF7DC0KDF00687
54 2019 HINO 155 TOILET 300 P679800 JHHUDM1H1KK003690
56 2020 WEST STAR 4700SB GREASE TRUCK P766606 5KKMAXDV7LLMA2236
58 2021 FORD F550 TOILET 850 P803548 1FDUF5GT6MEC65832
59 2021 FREIGHTLINER M2106 TOILET 1200 1FVACWD24MHMX6676
PAID
FIRM NAME: Elvis Service Co., Inc.
PERMIT #: NCS-00128
AMOUNT: $800
PAID BY: Check
DATE: 10/29/2021

Adam Ulishney