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 o ce*
County*
Mailing address same as street address of o ce?*
Mailing Address*
Phone*Fax
Email*
Firm owner's name*
Mailing address same as street address of o ce?*
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 o ce?*
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
Certi cation 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