NCS01263_2022Permit_Initial

2022
Permit and Registration
R & D Septic Tank Pumping
is hereby issued a Septage Management Firm Permit,
1szArr of
Permit Number NCS-01263
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o and registered as a e:,e DE
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` a= Septage Management Firm Department ofEnvironmental Quality
44 QIIAM
NORTH CAROLINA (PUMPER)
Environmental Quality
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. Johnnie Mosley Regional WRF, Kinston NC
2. Septage Land Application Site, SLAS-25-12
3. Septage Detention or Treatment Facility, SDTF-25-08
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
Wm Perry Sugg
Date: 2022.10.02
20:37:05-04'00'
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*
R&D Septic Tank Pumping
The "Firm name" must be exactly as it is shown on your vehicle(s).
Septage Management Firm permit number (NCS #)
NCS-1263
Enter the five digits following the NCS #
Street address of office*
Street Address
117 Davis Rd
Address Line 2
City
State / Province / Region
Cove City
NC
Postal / Zip Code
Country
28523
United States
County*
Craven
Mailing address same as street address of office?*
• Yes No
Phone* Fax
252 670-4031
Email*
[e-mail]
Owner Info
Firm owner's name*
Randy Register
Mailing address same as street address of office?*
• Yes No
Phone* Fax
252 670-4031
Operator Info
Firm operator's name* Firm operator's title
Randy Register owner
Mailing address same as street address of office?*
0 Yes No

Phone* Fax
252 670-4031
Type and amount of septage pumped in the last 12 months
Amount in gallons*
Domestic 342,000
Portable Toilet Waste 0
Grease (Restaurant) 83,000
Treatment Plant 0
Industrial/Commercial 0
North Carolina counties of operation}
List each county you plan to do business in: *
Craven,Jones,Lenoir,Pamlico,Carteret
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*
12/3/2021
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 YA113641 1GDM7J1C83F513098 2,500
Septage Disposal Method
For each method, indicate whether you plan to use it by checking yes or no.
Approved wastewater treatment plant*
0 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* Authorization
Johnnie Mosley Regional Water 12/31/2022 Scan0028.pdf 361.59...
Reclamation Facility
Septage Land Application Sites (SLAS)*
• Yes No
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
SLAS-2512 5/4/2025 Scan0030.pdf 340.38...
Septage Detention or Treatment Facility (SDTF)*
• Yes No
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
SDTF-00912 12/31/2022 Scan0032.pdf 271.41...
Other disposal method*
Yes • No
Septage Management Firm Operator Training Completed
Date* Hours*
6/26/2021 4
Location*
New Bern, NC
Training Sponsored or Provided by*
NC Pumper Group & NC Portable Toilet Group
Septage Land Application Site Operator Training Completed
Date Hours
6/26/2021 3
Location
New Bern,NC

Training Sponsored or Provided by
NC Pumper Group & NC Portable Toilet Group
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
Date
12/3/2021
04:16:17 PM
Print Name*
Randy Register
Title*
Owner,Operator

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.
I, Kenneth R. Stevens, Jr.- Wastewater License #21198 Johnnie Mosley -Regional Water Reclamation Facility__
(Plant Operator in Responsible Charge (ORC), ORC License Number, Name of Plant)
P. 0 Drawer 339, Kinston NC 28502
(Address)
252-939-3375 do hereby authorize Randy G. Register
(Phone Number) (OwnerlOperator of Septage Management Firm)
of R_& D Septic Tank Pumping _ _ _ NCS # 01263.
(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
Lenoir and surrounding counties
(County or other Geographic Area)
at the above named wastewater treatment facility. Septage shall be discharged at:
Johnnie Mosley Regional Water Reclamation Facility- 2101 Becton Farm Road
Briery Run Lift Station- Highway 55 East
(Location)
between the hours of 8:00 a.m. to 4:00 p.m. (Monday thru Friday)
Reintroducing partially treated liquid into a grease trap is acceptable Yes X No
This authorization shall be valid until December 31, 2022
Signed Date
(Facility Operator)
Sworn to and subscribed before me this day of _ _ I 20
My Commission expires:
(Notary Public) �"� + ART q�Ck
r
Note: Falsification of this document by the septage management firm shall lead to permit revocation.
C)
S:ISolid_Waste/CL.A/SEPTAGE/FORMS12013 Firm ApplicationANWTP Authorization Form 204
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f-*dG.ek}bilk i4h0

Landowner's Authorization to Operate a Sep#age Land Application Site
North Carolina Department of Environmental Quality
Division of Waste Management- Solid Waste Sectton
1646 Mail Service Center, Raleigh, NC 27699-1646
�ti that I am the owner of
1, g2(name of site owner) hereby certify
aS acres of land located _ G 3 L o-n c ��rm c . 'c�V t ,, N C _ t-9 anal and
identfied by 9-4 -6 pock and page of recorded deed or tax map
parcel) and that 1 agree to allow2 rn C �,�-- (site operator name) to use said land for
septage land application for a period of (length of fime), beginning _-- - c� C (give
date) and that 1 have read the North Carolina Septage Management Roles *, and I understand and agree to
maintain the restrictions on land use after septage land application ends'*. I finer understand that no septage
may be land applied until the Division of Waste Management has issued a permit for a septage land application
site. The above described property is owned solely by me or jointly with ` 4
(names of all co -owners, or state none).
%-- Date 3 - / (-P - a 0 °7 Q
Signature of landowner Date S, -- / 4, - 6210-2 a
Sworn to and subscribed before me this ! day of , 20 �2a
(Notary Public)
(OFFiC1AL SEAL)
My Commission expires:
* 15A N.C. Admin. Code 13B Section .0800
** As required by Rule .0843
Rev. 01-07-16

AUTHORIZATION TO DISCHARGE SEPTAGE AT A SEPTAGE TREATMENT OR
STORAGE FACILITY PERMITTED TO SOMEONE OTHER THAN YOURSELF
(This form is used by a detention or treatment facility permit holder to indicate that permission
has been given to a permitted Septage Management Firm to discharge septage into the permit
holders detention or treatment facility.)
do hereby authorize:
(Facility Operator)
(Operator Address)
(Owner of Septage Management Firm)
��ai� i C� NCS# 1-2��o3
(Name of Septage Management Firm)
��- C,
(Address of Septage Manage ent Firm)
to utilize septage detention or treatment facility for the treatment or storage of
septage *
in 2pT. The facility will be operated in accordance with the Septage Management Rules **.
Date:Signed
(Facility Operator)
* As defined in G.S. 130A-290(a)(32)
** As defined in 15A NCAC 13B .0800
Return the properly completed form to:
North Carolina Department of Environmental Quality
Division of Waste Management
Solid Waste Section
1646 Mail Service Center
Raleigh, NC 27699-1646

FIRM NAME: R&D Septic Tank Pumping
PERMIT #: NCS-01263
AMOUNT: $550
PAID BY: E-Check
DATE:
Adam Ulishney