NCS01245_2022Permit_Initial

NORTH CAROLINA
Environmental Quality
2022
Permit and Registration
Granville Septic Service
is hereby issued a Septage Management Firm Permit,
Permit Number NCS-01245
and registered as a
Septage Management Firm
(PUMPER)
in the State of North Carolina.
,:����D E
PfORTH CAROLINA :;.�
Department of Environmental quality
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. City of Oxford, Oxford NC
2. Warren County WWTP, Warren 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. Digitally signed by
—6�Z5� Wm Perry Sugg
Date: 2022.10.02
20:36:26-04'00'
Perry Sugg, Environmental Compliance Branch Head

For questions regarding this form or the online application process, please contact Jeffrey Bullard (919-707-8285) or Chester Cobb (919-707-
8283).
Firm Info
Firm name*
Granville Septic Service
The "Firm name" must be exactly as it is shown on your vehicle(s).
Septage Management Firm permit number (NCS #)
NCS-01245
Enter the five digits following the NCS #
Street address of office*
Street Address
2320 Wilkins Farm Rd
Address Line 2
City
State / Province / Region
Oxford
NC
Postal / Zip Code
Country
27565
USA
County*
Granville
Mailing address same as street address of office?*
• Yes No
Phone* Fax
9196912434
Email*
[e-mail]
Owner Info
Firm owner's name*
Holden Wilkins
Mailing address same as street address of office?*
• Yes No
Phone* Fax
9196912434
Operator Info
Firm operator's name* Firm operator's title
Holden Wilkins Owner Operator
Mailing address same as street address of office?*
0 Yes No

Phone* Fax
9196912434
Type and amount of septage pumped in the last 12 months
Amount in gallons*
Domestic 430,000
Portable Toilet Waste 3,500
Grease (Restaurant) 0
Treatment Plant 0
Industrial/Commercial 0
North Carolina counties of operation}
List each county you plan to do business in: *
Granville, Vance, Person, Warren, Wake, Durham, Orange, Franklin
Vehicle Info^j
Do you plan to operate pumper vehicles?*
• 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*
12/14/2021
Title*
Owner Operator
Choose how to add vehicle descriptions*
• Add vehicles individually Upload List
Pumper Vehicles
Usage*
License Tag #* Vehicle Identification #* Tank Capacity*
Domestic Septage
YA149780 2NKHHM7X5LM398463 2,500
Domestic Septage
YA130493 1FV6HFAA5TL657963 2,500
Septage Disposal Method �^
For each method, indicate whether you plan to use it by checking yes or no.

Approved wastewater treatment plant*
• Yes No
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*
CITY OF OXFORD WWTP 12/31/2024
WARREN COUNTY WWTP 12/31/2022
Septage Land Application Sites (SLAS)*
Yes • No
Septage Detention or Treatment Facility (SDTF)*
Yes • No
Other disposal method*
Yes • No
Authorization
Warren County 48.14KB
WWTP 2022.pdf
Septage Management Firm Operator Training Completed ^
Date* Hours*
4/22/2021 4
Location*
ONLINE
Training Sponsored or Provided by*
NC Septic Tank Association
Septage Land Application Site Operator Training Completed
Date Hours
0
Location
Training Sponsored or Provided by
Registration Type
Select one*
Registered Portable Sanitation Firm
Registered Septage Management Firm
• Registered Portable Sanitation and Septage Management Firm
Comments and Notes

Comments or notes
Certification 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.
Signature
Hvawd w 4, is
Date
12/14/2021
04:42:56 PM
Print Name*
Holden Wilkins
Title*
Owner Operator

AUTHORIZATION TO DISCHARGE SEPTAGE TO A WASTEWATER TREATMENT FACILITY
North Carolina Department of Environmental Quality
Division of Waste Management -Solid Waste Section
1646 Mail Service Center, Raleigh, NC 27699-1646
Fee 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.
(Plant Operator in Responsible Charge (ORC),
Name of Plant)
32.5 New Commerce 0�;,>Q
(Address)
'KIK3 do hereby authorize riNjcA1 L,, ky_,;
tks
(Phone Number) (Owner/Operator of Septage Management Firm)
of 0VCAt4%N.AkP '�4[L1:r Ga
Firm Name and NCS number)
to dispose of: domestic septage ✓ portable toilet waste
grease septage (grease trap pumpings) commercial/industrial septage , from
(County or other Geographic Area)
at the above named wastewater treatment facility. 5eptage shall be discharged at:
(Location)
between the hours of
Reintroducing partially treated liquid into a grease trap is acceptable Yes •✓No
This authorization shall be valid until 2�21✓�7Q( 1 ZO Zy
(Usually December 31, Year)
Signed Date O Z O -1
Facility Operator)
Subscribed a d ffir a before me this
•1
(Notaryblic)
day of 20 (A -
My Commission expires:
Note: Falsification of this document by the septage management firm shall lead
5:/Solid_Waste/CLA/SEPTAGE/FORMS/2016 Firm Application/W WTP Authorization Form 2016
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AUTHORIZATION TO DISCHARGE SEPTAGE TO A WASTEWATER
TREATMENT FACILITY
North Carolina Department of Environment and Natural Resources
Division of Waste Management - Solid Waste Section
1646 Mail Service Center, Raleigh, NC 27699-1646
Fee 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.
William R. Perkinson, ORC License Number 987831
(Plant Operator in Responsible Charge (ORC) and ORC License Number)
Warren Coun WWTP 738 US HIM 401 S. PO BOX 281 Warrenton NC 27589
(Address)
252-257-1776 do hereby authorize Holden Wilkins
(Phone Number) (OwnerlOperator of Septage Management Firm)
of _ Granville Septic Service NCS #01245
(Septage Management Firm Name and NCS number)
to dispose of: domestic septage X portable toilet waste X
grease septage (grease trap pumpings) commercial/industrial septage from
Warren Vance Granville and surrounding counties
(County or other Geographic Area)
at the above named wastewater treatment facility. Septage shall be discharged at:
Influent works
(Location)
between the hours of 8:00 AM - 3:30 PM Monday - Friday
Reintroducing partially treated liquid into a grease trap is acceptable Yes X No
This authorization shall be valid until _ _ December31, 2022
a (Usually December 31, Year)
5
Signed��- ��1~ Date
(Facility Operator)
Sworn to and subscribed before me this lk' day of t� ? CA C tiyX ti 20 1
L'U10'C� \J C6 LJ1I My Commission expires: Q�rfu4.,
(Notary Public)����'
I
ICIAL SEAL)
w 4PSAR�- L
Note: Falsification of this document by the septage management firm shall lead to permit reeocatio %�L pt16L\G 0=
S:/Solid_Waste/CLA/SEPTAGE/FORMS/2013 Firm Application/WW fP Authorization Form 2013

PAID
FIRM NAME: Granville Septic Service
PERMIT #: NCS-01245
AMOUNT: $800
PAID BY: E-Check
DATE: 12/15/2021
Adam Ulishney