NCS01538_2022Permit_Initial

2022
Permit and Registration
Mountain Poo Septic Pumping
is hereby issued a Septage Management Firm Permit,
tszArr of
Permit Number NCS-01538
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o and registered as a e:-e DE
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A Q
` 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. Mebane Bridge WWTP, Eden 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
Wm Perry Sugg
Date: 2022.10.02
20:53:28-04'00'
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*
Mountain Poo Septic Pumping
The "Firm name" must be exactly as it is shown on your vehicle(s).
Septage Management Firm permit number (NCS #)
NCS-01538
Enter the five digits following the NCS #
Street address of office*
Street Address
3270 Spainhour Mill Rd
Address Line 2
City State / Province / Region
Tobaccoville NC
Postal / Zip Code Country
27050 Usa
County*
Forsyth
Mailing address same as street address of office?*
• Yes No
Phone* Fax
3364073601
Email*
[e-mail]
Owner Info
Firm owner's name*
Darrell Rogers
Mailing address same as street address of office?*
• Yes No
Phone* Fax
3364073601
Operator Info
Firm operator's name* Firm operator's title
Darrell Rogers Owner
Mailing address same as street address of office?*
0 Yes No

Phone* Fax
3364073601
Type and amount of septage pumped in the last 12 months
Amount in gallons*
Domestic 1,500
Portable Toilet Waste 0
Grease (Restaurant) 0
Treatment Plant 0
Industrial/Commercial 0
North Carolina counties of operation}
List each county you plan to do business in:
Stokes, Forsyth,surry
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
��l�ey
Date*
12/9/2021
Title*
Owner
Choose how to add vehicle descriptions*
• Add vehicles individually Upload List
Pumper Vehicles
Usage* License Tag #* Vehicle Identification #* Tank Capacity*
Domestic Septage KB-5933 1FdPD74N8FVA61315 1,500
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
City of Eden waste Water Treatment 12/31/2022 image.jpg 2.94MB
Plant
Septage Land Application Sites (SLAS)*
Yes • No
Septage Detention or Treatment Facility (SDTF)*
Yes • No
Other disposal method*
Yes • No
Septage Management Firm Operator Training Completed
Date* Hours*
12/4/2021 4
Location*
NC State Fair Grounds
Training Sponsored or Provided by*
NC Pumper Group & NC Portable Toilet Group
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
,�2t oe�l�OLd
Date
12/9/2021
12:37:05 AM
Print Name* Title*
Darrell Rogers 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
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, Chris Powell -- City of Eden Wastewater Treatment Plant Chief Operator/ ORC
(Plant Operator and Name of Plant)
204 Mebane Bridge Road -- _ Eden, NC 27288 _
(Address)
336-627-1009 ext. 130 do hereby authorize Darrell Rogers _
(Phone Number) (Owner/Operator of Septage Management Firm)
of Mountain Poo Septic Pumping NCS#
f Septage Management Firm Name and NCS number)
to dispose of: domestic septage
portable toilet waste X ,
grease septage (grease trap pumpings) NIA commercial/industrial septage NIA from
Rockingham County and surrounding counties
(County or other Geographic Area)
at the above named wastewater treatment facility. Septage shall be discharged at:
Mebane Bridge Wastewater Treatment Plant -- 204 Mebane Bridge Road Eden, NC 27288
(Location) —
between the hours of 7:00 a.m. —4:00 p.m. Monday — Friday -- Septage will be accepted after hours by appt. onl
After hours & emergencies call: 336.627.1009 ext. 4
Reintroducing partially treated liquid into a grease trap is acceptable Yes X No
This authorization shall be valid until December 31 2022
Signed Date Z
(Facility Operator)
Swom to and subscribed before me this L4 4�2 day of N wcen,,r. 20 Z f
�t u X �..
(Notary Public)
My Commission expires:
Note: Falsification of this document by the septage management firm shall lead to permit revocation.

PAID
FIRM NAME: Mountain Poo Septic Pumping
PERMIT #: NCS-01538
AMOUNT: $550
PAID BY: E-Check
DATE: 12/13/2021
Adam Ulishney