NCS00916__2022Permit_Initial

2022
Permit and Registration
Bailey's Septic Tank Service

is hereby issued a Septage Management Firm Permit,
Permit Number NCS-00916
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. Town of Louisburg WRF, Louisburg NC
2. Neuse River Resource Recovery Facility, Raleigh NC 3. Septage Detention or Treatment Facility, SDTF-98-08
4. Septage Detention or Treatment Facility, SDTF-92-12
5. Central Johnston County Regional WWTP, Smithfield 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?*
Phone*Fax
Firm Info
Bailey's Septic Tank Service
The "Firm name" must be exactly as it is shown on your vehicle(s).
00916
Enter the five digits following the NCS #
City
Knightdale
State / Province / Region
NC
Postal / Zip Code
27545
Country
USA
Street Address
113 Neuse Harbor Dr
Address Line 2
Wake
Yes No
City
Knightdale
State / Province / Region
NC
Postal / Zip Code
27545
Country
USA
Street Address
PO Box 925
Address Line 2
9192661161
[e-mail]
Owner Info
Leroy glenn Bailey
Yes No
9198168446
Firm operator's name*Firm operator's title
Mailing address same as street address of oce?*
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*
Operator Info
Leroy Glenn Bailey Technican
Yes No
9198198446
Type and amount of septage pumped in the last 12 months
412,000
0
113,000
0
0
North Carolina counties of operation
Wake Nash Franklin Johnston Granville
Vehicle Info
Yes No
12/7/2021
Technican
Add vehicles individually Upload 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)*
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
Domestic Septage FD6453 1FVACWDC06HW60735 1,800
Domestic Septage CS1425 1FV3HFACXVL858054 1,700
Septage Disposal Method
For each method, indicate whether you plan to use it by checking yes or no.
Yes No
Neuse River Resource Recovery
Facility
12/31/2022 Doc - Dec 7
2021 - 8-48
AM.pdf
478.07…
Central Johnston County Regional
Wastewater Treatment Plant
12/31/2022 Doc - Dec 7
2021 - 8-51
AM.pdf
421.92…
Louisburg WRF 12/31/2022 Doc - Dec 7
2021 - 8-54
AM.pdf
478.07…
Yes No
Yes No
SDTF-98-08 12/31/2022 Doc - Dec 7
2021 - 8-56
AM.pdf
349.38…
SDTF-92-12 12/31/2022 Doc - Dec 7
2021 - 8-57
AM.pdf
471.37…
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
Print Name*Title*
Yes No
Septage Management Firm Operator Training Completed
4/22/2021 4
Online Virtual Class
NC DEQ - New Operator Training
Septage Land Application Site Operator Training Completed
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.
12/7/2021
08:27:14 AM
Leroy Glenn Bailey Owner
•
•
•
AUTHORIZATION TO DISCHARGE SEPTAGE TO A WASTEWATER
TREATMENT FACILITY
North Carolina Department of Environment and Natural Resources
Division of Waste Management -Solid Waste Section
401 Oberlin Rd., Ste. 150, Raleigh, N.C. 27605
F~. assessments and waste determinations will be required at the discretion of the wastewater treatment
facility. The facility has the ultimate prerogative to deny discharges of any wastes to the incoming
wastewater stream.
I, John D. Wall Central Johnston County Regional Wastewater Treatment Plant
(Plant Operator and Name of Plant)
Post Office Box 2263. Smithfield. North Carolina 275TT
(Address)
-'9~1=9)~9=89-50=".,_7~5 ,...,....,... ___ ,do hereby authorize ______ __,.,.....-....,NCS# _00916
(Phone Numbeo-) (Owner/Operator of Septage Management Firm)
of Bailey's Septic Tank Service. PO Box 925. Knightdale. NC 27545
(Septage Management Finn Name and address)
to dispose of: domestic septage __ X,.,__..., portable toilet waste __ ..!.x,__ _ _.
Johnston County does not accept grease traps and pumplngs.
Johnston County. North Carolina
(County or other Geographic Afl!a)
at the above named wastewater treatment facility. Septage shall be discharged at
Johnston County Sludge Handling Facility. 680 County Home Road. Smithfield. North Carolina
{Location)
between the hours of 8:00 AM. thru 4:45 P.M.-Monday through Friday.
Reintroducing partially treated liquid Into a grease trap Is acceptable __ Yes ~ No
lid until December 31. 2022
{Usually December 31, Year)
Date
Sworn to and subscribed before me this ____.'.')""'-L\-~_t-____ day of . /bA-j ,;io.;i ~
{\tll-'f> Se Nou ~ My Commission expires: ii-I-a.Dd-3
Nancy Hoose ~ (Notary Public)
'WHII generated In other counties wlll not be accepted.
All waste must be generated In Johnston County.
Note: Fallfflcallon of this document by the Hplage management firm
shall Ind to perrntt revocation.
(OFFICIAL SEAL)
NANCY HOUSE
NOTARY PUBLIC
JOHNSTON COUNTY, ,,.C.
My Commission Expires 4-1-2023.
PAID
FIRM NAME: Bailey’s Septic Tank Service
PERMIT #: NCS-00916
AMOUNT: $800
PAID BY: E-Check
DATE: 12/8/2021

Adam Ulishney