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HomeMy WebLinkAboutNCS00188_2022Permit_Initial2022 Permit and Registration Cumberland Septic is hereby issued a Septage Management Firm Permit, Permit Number NCS-00188 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. Moore County Water Pollution Control Plant, Aberdeen NC 2. Cross Creek WRF/Rockfish Creek WFR, Fayetteville 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, 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?* Mailing Address* Phone*Fax Email* Firm owner's name* Mailing address same as street address of oce?* Firm Info CUMBERLAND SEPTIC The "Firm name" must be exactly as it is shown on your vehicle(s). NCS-00188 Enter the five digits following the NCS # City Fayetteville State / Province / Region NC Postal / Zip Code 28303-3343 Country USA Street Address 319 Mike St Address Line 2 Cumberland Yes No City FAYETTEVILLE State / Province / Region NC Postal / Zip Code 28303-3343 Country USA Street Address PO BOX 35192 Address Line 2 9108683830 9108679044 CUMBERLANDSEPTIC@AOL.COM Owner Info AUDREY STANCIL Yes No Mailing Address* Phone*Fax Firm operator's name*Firm operator's title Mailing address same as street address of oce?* Mailing address* 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?* City Fayetteville State / Province / Region NC Postal / Zip Code 28303-3343 Country USA Street Address PO BOX 35192 Address Line 2 9108683830 9108679044 Operator Info MIKE STANCIL VICE PRESIDENT Yes No City FAYETTEVILLE State / Province / Region NC Postal / Zip Code 28303-3343 Country USA Street Address PO BOX 35192 Address Line 2 9108683830 9108679044 Type and amount of septage pumped in the last 12 months 144,000 860,000 0 0 0 North Carolina counties of operation CUMBERLAND, LEE, HOKE, HARNETT, SCOTLAND, SAMPSON, MOORE, ROBESON, BLADEN Vehicle Info Yes No "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* 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* 12/20/2021 owner 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. CSSISepticTrucksVinNumbers.xlsx 12.47KB Septage Disposal Method For each method, indicate whether you plan to use it by checking yes or no. Yes No CROSS CREEK 12/31/2021 CrossCreekWW…479.95… MOORE COUNTY WPCP 12/31/2021 MooreCountyW…78.13KB Yes No Yes No Yes No Septage Management Firm Operator Training Completed Date*Hours * Location * Training Sponsored or Provided by* Date Hours Location Training Sponsored or Provided by Select one* Comments or notes Signature Date Print Name*Title* 1/9/2021 4 PINEHILL, 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. 12/20/2021 10:20:18 AM AUDREY STANCIL OWNER 12 34 56 78 910 1112 13 14 15 16 17 1819 20 A B C D E F TRUCK # WASTE TANK VIN#YEAR MAKE MODEL CS3 1000 1HTHMAAL26H335889 2006 INTERNATIONAL 4300 CS4 700 3C7WRMBL3HG656041 2017 DODGE RAM 5500 CS5 2500 1HTMXAAN73H578410 INTERNATIONAL 4300 CS6 1000 1HTMMAAL4DH416423 2013 INTERNATIONAL 4300 CS9 1500 1HTMMMML6JH344908 2018 INTERNATIONAL 4300 CS10 1500 1HTMMMML3KH395316 2019 INTERNATIONAL 4300 CS11 700 JL6BNE1A5HOO3059 2017 MITSUBISHI MIFI FE160 CS12 450 1FDOW5HT9FEA99306 2015 FORD F550 CS13 750 1FDUF5GT8CEB31676 2015 FORD F550 CS14 750 1FDUF5HTDEEA77307 2015 FORD F550 CS15 750 1FDUF5HT7FEA20894 2015 FORD F550 CS17 1800 1HT4MMML7JH714747 2018 INTERNATIONAL 4300 CS18 1800 1HT4MMML7JH714748 2018 INTERNATIONAL 4300 CS19 750 1FDUF5HT8KGE92094 2019 FORD F550 CS20 1200 1FDUF5HT2LDA08816 2020 FORD F550 CS21 700 1FDUF5HT1LEE49816 2020 FORD F550 CS22 700 54DCDW1B9KS808516 2019 CHEVERLOLET 700 4UZBYE116KGKE4341 2019 MITSUBISHI MIFI FE140 700 54DC4W1B9FS801569 2015 ISUZU NPR HD PAID FIRM NAME: Cumberland Septic PERMIT #: NCS-00188 AMOUNT: $800 PAID BY: E-Card DATE: 12/28/2021 Adam Ulishney