NCS01566_2022Permit_Initial

NORTH CAROLINA
Environmental Quality
2022
Permit and Registration
Barrett Environmental & Septic
is hereby issued a Septage Management Firm Permit,
Permit Number NCS-01566
and registered as a
Septage Management Firm
(PUMPER)
in the State of North Carolina.
CIA�
PIORTH 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. Archie Elledge WWTP, Winston-Salem, NC
2. Rocky River Regional WWTP, Concord, NC
3. Town Creek WWTP, Spencer, 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. 11 d b
Digita y signe y
Wm Perry Sugg
Date: 2022.10.02
20:57:46-04'00'
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*
BARRETT ENVIRONMENTAL AND SEPTIC
The "Firm name" must be exactly as it is shown on your vehicle(s).
Septage Management Firm permit number (NCS #)
NCS-01566
Enter the five digits following the NCS #
Street address of office*
Street Address
7620 JONES ROAD
Address Line 2
City
State / Province / Region
SALISBURY
NC
Postal / Zip Code
Country
28147
United States
County*
Rowan
Mailing address same as street address of office?*
• Yes No
Phone* Fax
7042396691 7044626116
Email*
[e-mail]
Owner Info
Firm owner's name*
JEFFREY COX
Mailing address same as street address of office?*
• Yes No
Phone* Fax
7042396691 7044626116
Operator Info
Firm operator's name* Firm operator's title
JEFFREY COX OWNER
Mailing address same as street address of office?*
0 Yes No

Phone*
Fax
7042396691 7044626116
Type and amount of septage pumped in the last 12 months
Amount in gallons*
Domestic 20,000
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: *
ROWAN
CABARRUS
FORSYTH
Vehicle Info
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
A%t�a7 p ceX
Date*
12/15/2021
Title*
OWNER
Choose how to add vehicle descriptions*
• Add vehicles individually Upload List
Pumper Vehicles
Usage* License Tag #* Vehicle Identification #* Tank Capacity*
Domestic Septage KF-1194 1FDNR64N5EVA51097 2,100
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* Authorization
Archie Elledge Wastewater Facility, 12/31/2021 Archie.pdf 152.95...
Winston-Salem NC
Town Creek WWTP, Spencer NC 12/31/2021 Spencer.pdf 57.27KB
Rocky River Regional WWTP, Concord, 12/31/2021 Rocky.pdf 180.23...
NC
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*
11/8/2021 6
Location*
ASHVILLE, NC
Training Sponsored or Provided by*
NC Septic Tank Association
Septage Land Application Site Operator Training Completed h
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
THIS IS OUR FIRST RENEWAL; SO IF ANYTHING IS INCORRECT PLEASE LET ME KNOW. WE
WILL ALSO SUBMIT UPDATED LETTERS OF AUTHORIZATION AS SOON AS THOSE ARE
RECEIVED. PAYMENT ($550) SUBMITTED ONLINE EARLIER.
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
12/15/2021
03:22:02 AM
Print Name* Title*
JEFFREY D. COX OWNER

AUTHORIZATION TO DISCHARGE SEPTAGE TO A WASTEWATER TREATMENT FACILITY
North Carolina Department of Environment and Natural Resources
Dlvislon of Waste Management - Solid Waste Sectlon
1646 Mall 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 u)tlmate prerogative to deny discharges of any wastes to the
incoming wastewater stream,
t, Matthew Lavigne- WWA997822-Archie Elledge Wastewater Facility
(Plant Operator In Responsible Charge (ORC), OAC License Number, Name of Plant)
2801 Griffi[h Rd. Winston-Salem NC 27103
(Address)
336-765-0130 do hereby authorize Jeffrey Cox
(Phone Number)
(Owner/Operator of 5eptage Management Firm
of Barrett Environmental & 5e tic NC5 a 01566
(5eptage Management Firm Name and NCS number}
to dispose of, domestic septage x portable toilet waste X
grease septage (grease trap pumpings) NO commercial/industrial septage from
Winston-Salem Fors th County and Ad'acent Counties Aowan & Cabarrus Counties not Allowed
(County or other Geographic Area)
at the above named wastewater treatment facility. Septage shall be discharged at:
Archie Elledge Wastewater Facility _
(Location)
between the hours of 6:00 am until 6:00_pm Monday Through Saturday
Reintroducing partially treated liquid into a grease trap is acceptable Yes x No
This authorization shall be valid until December 31 2021
(Usually December 31, Year)
Signed Date
(Facility ator}
Subscribed and affirmed before me this I ";') day of _ IPL� 20?1�
(Notary Public)
E
a Morman
RY PUBLIC
County, NC
xpires hlarch 2l, 2024
My Commission expires: D. a 1
(OFFICIAL SEAL)
Note: Falsification of this document by the septage management firm shall lead to permit revocation.
S,/solid_WASIO/CLA/SEPTACCIFORMS/2018 F,rm Applicalbn/wwTP Autharintion Form 2018
Scanned with CamScanner

AUTHORIZATION TO DISCHARGE SEPTAGE TO A WASTEWATER TREATMENT FACILIT f'
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.
Towt1 W-ak
(Plant Operator in Responsible Charge (ORC), ORC License Number, Name of Plant)
so AVQA,A�� Ql , SO�;ncQ-r NL a('
(Address))
-Ic�AAv7S%-534`-4 do hereby authorize :Se fY"2:j
(Phone Number) (Owner/OperatoV of Septage Management Firm)
of Q ((Q.y` � Syy L, NCS # (D(S�p�P
(Septage Management Firm Name and NCS number)
to dispose of: domestic septage portable toilet waste
grease septage (grease trap pumpings) �Alp— commercial/industrial septage �0 from
(County or other geographic Area)
at the above named wastewater treatment facility. Septage shall be discharged at:
(Location
between the hours of �C�c��4 � M
Reintroducing partially treated liquid into a grease trap is acceptable Yes I/ No
- This authorization shall be valid until _b2co\&�
(Usually December 31, Year)
Signed Date
(Facility Operator)
frs
bed and affirm d b re me this t1 day of
k%� —
My Commission expires:
(Notary Public)
(OFFICIAL SEAL) a"
Note: Falsification of this document by the septage management firm shall lead to permit revocation.
........ppEication/1M1AlrP Authorization Form 2018

VAUTHORIZATION 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, NC27699-1646
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, James Christian Sims. #999309, Rocky River Regional Wastewater Treatment Plant
(Plant Operator in Responsible Charge (ORC), ORC License Number, Name of Plant)
6400 Breezy Lane, Concord, North Carolina 28025
704-788-4164. x118 do hereby authorize Jeffery Cox (704-239-6691)
(Phone Number) (Owner/Operator of Septage Management Firm)
of Barrett Environmental & Septic NCS # 01566
(Septage Management Firm Name and NCS number)
to dispose of: domestic Septage YES , portable toilet waste YES ,
grease septage (grease trap pumpings) NO commercial/industrial septage NO from
Cabarrus and surrounding counties.
(County or other Geographic Area)
at the above named wastewater treatment facility. Septage shall be discharged at:
6400 Breezy Lane, Concord, NC 28025
(Location)
between the hours of 6AM and 9PM Monday -Friday; 7AM and 7PM Saturday; Sunday upon request.
Reintroducing partially treated liquid into a grease trap is acceptable Yes V No
This authorization shall be valid until December 31, 2021
(Usually December 31, Year)
Signed 1' +
.lames Christian Sims, Facility ORC
ncribed and affirmed before me this 7th
1
Date April 7, 2021
day of April 20 21
My Commission expires: may i t3- kk a,..
Angela HIII, hotary Public \��`��'
GE111 k �ti,,�
P. T tire'
O A,Q
c. ?
�B LAG .• Q,�
Note: Falsification of this document by the septage management firm small lead to permit
S:/Solid Waste/GLA/SEPTAGE/FORMS/2016 Firm Application/W WTP Authorization Form 2016

AUTHORIZATION'TO-DISCHARGE SEPTAG£ 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 dlscretion of the -wastewater
treatment facility_ The facility has? the ultimate prerogative to deny discharges of any wastes -to the
'incoming wastewater.stream.
Robert Loper. of Town 'Creek
-(Plant Operator in -Responsible Charge (ORC), ORC License Number, Name of.Plant)
850 Heiligltown Rd. E. Spencer NO 28039
(Address)
[phone] do Hereby authorize
(((Phone NUrrriber)� (Owner1/Operato�eptage Management Firm)
of _l: ,,(c++(V V� f ionM. 4P_NjCkj 41. %P—O+ c t- NCS #
.(Septage Management. Firm Name and NCS number)
to dispose of: domestic septage Yes portable toilet waste Yes
grease septage (greasetrap pu.mpings) No commercial/industrial septage No . from
ROWANCOUNTY ONLY
. (County or other Geographic Area)'
at the above named wastewater treatment facility. Septage shall be discharged at:
Town Creek WVYTP- Influent Installation
(Location)
between the hours of 7 am to 5 pm
Reintroducing partially treated liquid into a grease trap is alccept_able2 Yes'.No
[1
This authorization shall be valid until pmuyV_644- 7� 1. 2� �,Y2.1rVluJ 00.nY1�10. /
(Usually December 31,:Year)
Signed C�1� Date— V"t7ar
(Facility Operator)
S bs gibed and.aff)rm d b e me this day of
My Commission expires: _ 1
(Nbta� Estic
Dbprkll?
(OFFICIAL SEAL)
Note: Falsification of this document by the septage managementfrrm.shall lead to permit revocation.
S:/Solid_Waite/tLA/SEF?AGE/FORMS/2018 F1rm Applicatton/wWTP Authorization Form 2018

k-t� S\�
Firs me Last Name
Received
Credit Hours
of Continuing Education
This Certificate of Attendance Presented By:
�'��) rd CSTA
NORTH CAROLI NA SEPTIC TANK ASSOCIATION
Hours Accredited by:
NCOWCICB
NC Division of Waste Mgmt
Septage Firm Mgmt 4 Hours
REHS Board
WPCSOCC CE03191906 (Subsurface Operator
❑ Other:
Date:
Signed: f
Jerry O. Pearce, NCSTA President
Important: Keep this in a safe place. Duplicates are not available.
2021

PAID
FIRM NAME: Barrett Environmental and Septic
PERMIT #: NCS-01566
AMOUNT: $550
PAID BY: E-Check
DATE: 12/17/2021
Adam Ulishney