NCS01055_2022Permit_Initial

2022
Permit and Registration
Steele Creek Marina

is hereby issued a Septage Management Firm Permit,
Permit Number NCS-01055
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. On-Site Dump Station that is connected to an on-site wastewater system.
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
Steele Creek Marina
The "Firm name" must be exactly as it is shown on your vehicle(s).
NCS-01055
Enter the five digits following the NCS #
City
Henderson
State / Province / Region
NC
Postal / Zip Code
27537
Country
United States
Street Address
1616 Townsville Landing Rd.
Address Line 2
Vance
Yes No
City
Henderson
State / Province / Region
NC
Postal / Zip Code
27537
Country
USA
Street Address
565 Satterwhite Point Rd
Address Line 2
2522134443
[e-mail]
Owner Info
Charles Robinson
Yes No
2522134443
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
Charles Robinson
Yes No
2522134443
Type and amount of septage pumped in the last 12 months
8,457
0
0
0
0
North Carolina counties of operation
Vance
Vehicle Info
Yes No
12/10/2021
Owner
Add vehicles individually Upload List
Approved wastewater treatment plant*
Septage Land Application Sites (SLAS)*
Septage Detention or Treatment Facility (SDTF)*
Other disposal method*
Description*Authorization
Date*Hours *
Location *
Training Sponsored or Provided by*
Date Hours
Location
Training Sponsored or Provided by
Select one*
Domestic Septage Boat NC 3235 AY 225
Septage Disposal Method
For each method, indicate whether you plan to use it by checking yes or no.
Yes No
Yes No
Yes No
Yes No
Foster Septic Tank Cleaning Service LLC NCS-00516
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
Comments or notes
Signature
Date
Print Name*Title*
We are a marina and pump waste from customer boats into a waste tank on a
pump boat. The waste is transferred into a tank and disposed of at the dump
station on the marina property, which is a convention in-ground septic system
built for boat and camper waste dumping. When necessary, Foster Septic Tank
Cleaning Service LLC NCS-00516 will pump the septic system and be the end
user. Feel Free to call if there are any questions. 252-213-4443
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.
12/10/2021
11:48:47 AM
Charles Robinson Owner
PAID
FIRM NAME: Steele Creek Marina
PERMIT #: NCS-01055
AMOUNT: $550
PAID BY: Check
DATE: 10/28/2021

Adam Ulishney