HomeMy WebLinkAboutNCS01151_2022Permit_Initial2022
Permit and Registration
Atlantic OBX
is hereby issued a Septage Management Firm Permit,
Permit Number NCS-01151
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-27-22 2. Elizabeth City WWTP, Elizabeth City 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
Atlantic OBX INC
The "Firm name" must be exactly as it is shown on your vehicle(s).
NCS-01151
Enter the five digits following the NCS #
City
Powells Point
State / Province / Region
North Carolina
Postal / Zip Code
27966
Country
United States
Street Address
8490 Caratoke HWY
Address Line 2
Currituck
Yes No
City
Kitty Hawk
State / Province / Region
North Carolina
Postal / Zip Code
27949
Country
United States
Street Address
P.O Box 2560
Address Line 2
2522552030
Brooke@atlanticsewage.com
Owner Info
Bryan Lincoln
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
Kitty Hawk
State / Province / Region
North Carolina
Postal / Zip Code
27949
Country
United States
Street Address
P.O Box 2560
Address Line 2
2522552030
Operator Info
Bryan Lincoln
Yes No
City
Kitty Hawk
State / Province / Region
North Carolina
Postal / Zip Code
27949
Country
United States
Street Address
P.O Box 2560
Address Line 2
2522552030
Type and amount of septage pumped in the last 12 months
6,389,425
243,835
1,934,510
4,252,700
1,015,666
North Carolina counties of operation
Camden, Chowan, Currituck, Dare, Hyde, Pasquotank, Perquimans, Tyrrell
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)*
If you are not the permit holder for the septage land application site, you must have a signed land application authorization form for each site.
SLAS #*Expiration Date *Authorization
12/14/2021
President
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.
Pumper Vehicles[343].docx 26.69KB
Septage Disposal Method
For each method, indicate whether you plan to use it by checking yes or no.
Yes No
Elizabeth City 12/31/2022
Yes No
SLAS-27-18 4/1/2024 Updated Field
Permits
[345].docx
30.87KB
SLAS-27-19 6/1/2022
SLAS-27-20 4/1/2024
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
SLAS-27-21 2/1/2026
SLAS-27-22 5/18/2031
Yes No
SDTF-27-19 4/17/2022
SDTF-27-22 4/17/2022
SDTF-27-17 4/17/2022
Yes No
Septage Management Firm Operator Training Completed
5/12/2021 6
Washington, NC
NC Septic Tank Association
Septage Land Application Site Operator Training Completed
10/21/2021 6
Granville Farms INC. Oxford, NC
NC Septic Tank Association
Registration Type
Registered Portable Sanitation Firm
Registered Septage Management Firm
Registered Portable Sanitation and Septage Management Firm
Comments and Notes
Elizabeth City WWTP will be sending a scanned copy of the UTD Authorization
to Discharge Form. Once received I will email the form.
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
Signature
Date
Print Name*Title*
the permit and that there are criminal penalties for knowingly making a false statement, representation, or certification.
12/13/2021
09:47:07 AM
Bryan Lincoln President
PAID
FIRM NAME: Atlantic OBX
PERMIT #: NCS-01151
AMOUNT: $800
PAID BY: E-Check
DATE: 12/17/2021
Adam Ulishney
ATLANTIC OBX, INC. PUMPER VEHICLE LIST
No.# Year 0BMake Model Vin No. Tank size Tag
5 2002 MACK 4X2 117 BBC STEEL 1M2P267C72MO62322 4,000 YA121974
6 1995 FORD 6X4LTS SERIES 1 1FDZY90T7SVA71938 4,000 YA121971
9 2004 MACK 6X4 GRANITE SERIES 1M2AG11C04MO12335 4,000 YA121969
10 2006 MACK 6X4 GRANITE SERIES 1M2AG11CO6MO33947 4,000 YA121972
11 2012 MACK GU713 1M2AZ07C4M012838 4,650 YA145971
13 1999 VOLVO 6X4 WG SERIES11 4VHJCBPE9XN866501 4,000 YA121968
27 2017 PETERBILT 337 2NP2HM6X5HM414119 1,500 JV9887
28 2016 INTERNATIONAL PORT A POTTY 1HTMMMML8GH226464 2,500 HS7934
29 2002 INTERNATIONAL PORT A POTTY 1HTMMAAL12H534894 1,100 EE8622
30 2002 INTERNATIONAL PORT A POTTY 1HTMKAALX2H552123 1,600 DC3011
32 2019 PETERBILT 389 1NPXL40X4KD638525 4,750 YA145972
41 2007 INTERNATIONAL Pump truck 1HTXRSCT87J479703 4,500 YA126896
42 2001 STERLING Pump truck 2FZHAZBD71AH49152 4,000 YA126855
44 2011 MACK GU700 1M2AX07C1BM010561 4,750 YA137316
45 2013 MACK GU713 1M2AX07C9DM014988 4,750 YA137315
2019 CHEVY SILVERADO 5500 1HTKHPVKXKH324147 1,000 KF8955
2019 CHEVY SILVERADO 5500 1HTKHPVK0KH604286 1,000 KF8952