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Home My WebLink AboutNCS00028_2023Permit_Initial2023 Permit and Registration Al's Septic Tank Cleaning is hereby issued a Septage Management Firm Permit, STATE,, Permit Number NCS-00028 o and registered as a e:,e D NORTH EQ�J A%L 12. 9* -�� Septage Management Firm�� w� ��nffii�utr E,%r Q'M 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. Cross Creek WRF/Rockfish Creek WRF, Fayetteville, NC 2. Septage Detention or Treatment Facility, SDTF 92-12 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, 2023. Wm Perry Sugg Digitally signed by Wm Perry Sugg Date: 2023.02.01 15:47:53-05'00' 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* Al's Septic Tank Cleaning & Repair The "Firm name" must be exactly as it is shown on your vehicle(s). Septage Management Firm permit number (NCS #) NCS-00028 Please enter the complete NCS #, including the 5 end digits (NCS-XXXXX) Street address of office* Street Address 2460 Sandhill Road Address Line 2 City State / Province / Region Fayetteville North Carolina Postal / Zip Code Country 28306 United States County* Cumberland Mailing address same as street address of office?* • Yes No Phone* Fax 910 850 3547 Email* patrishawashing@gmail.com Owner Info Firm owner's name* Alton Washington Mailing address same as street address of office?* • Yes No Phone* Fax 910 850 3547 Operator Info Firm operator's name* Firm operator's title Alton Washington Owner Mailing address same as street address of office?* 0 Yes No Phone* Fax 910 850 3547 Type and amount of septage pumped in the last 12 months Amount in gallons* Domestic 250,000 Portable Toilet Waste 0 Grease (Restaurant) 26,000 Treatment Plant 0 Industrial/Commercial 0 North Carolina counties of operation List each county you plan to do business in: * Cumberland, Hoke, Robeson, Harnett 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 Date* 12/30/2022 Title* Owner Choose how to add vehicle descriptions* • Add vehicles individually Upload List Pumper Vehicles Usage* License Tag #* Vehicle Identification #* Tank Capacity* Domestic Septage YA134436 1HTMMAA63H557407 2,500 Grease (restaurant) YA135059 1HTMMAAN09HO68841 2,000 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* Cross Creek WRF/ Rockfish Creek WRF Septage Land Application Sites (SLAS) * Expiration Date* Authorization* 12/31/2023 PWC 102.68... Authorization Wastewater 1.3peg Yes ! No Septage Detention or Treatment Facility (SDTF) • Yes No Permit Verification I certify that I AM the permit holder for this SDTF. If unchecked, please attach a signed detention/treatment authorization form for each site. 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-92-12 12/31/2023 2023 Al's 1.98MB Septic Tank Cleaning Authorization to Discharge.pdf Other disposal method* Yes • No Septage Management Firm Operator Training Completed Date* Hours* 10/19/2022 6 Location* Greensboro,NC 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 Certif 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 the permit and that there are criminal penalties for knowingly making a false statement, representation, or certification. Signature Date 12/30/2022 01:51:25 AM Print Name* Title* Alton Washington Owner AUTHORIZATION TO DISCHARGE SEPTAGE AT A SEPTA E TREATMENT OR STORAGE FACILITY PERMITTED TO SOMEONE OTHER THAN YOURSELF (This form is used by a detention oir treatment facility permit holder to indcate 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: I j ty Operator) j I �hw . 4 L (Opeator Address) 00 (Owner of Septage Management Firm) (NYme of Septage Management Firm) to utilize septage deters septage in 20 NCS # I a (Address of Septage Manage en '0 tion or treatment facility # _E PENEW , The facility will be operated in accord Date: * As defined in G.S. 13OA-290(a)(32) ** As defined in 15A NCAC 13B .0800 Return the property completed form to.. Signed North Carolina Department of Environmental quality Division of Waste Management Solid Waste Section 1646 Mail Service Center Raleigh., NC 27699-1646 t Firm) l L ( 60 s 3D for the treatment or storage of with the Septage Management Rules **. (Fat ifity Operato r) AUTHORIZATI0N TO D ISC HARGE SEPTAG E TO A WA STEVVATER TREATMENT FACILITY Nor h Carolina DepartmeRt of Erivimneevwtal Quaky Division of Wast,� Mertagement - Solld Waste Sep bn T M6 Mail Service Center, Raleigh, K.G. 27699-1646 Fee wr,,-�t end waFb� dvtan+ninekions will Ne rfquired at the diwrfftkn Qf the wasWwatcr ti-eatmQnf facility. The facil" 4as the ultimate pr+e•Togatiye to deny dischargers of any wastes to the incming wastewa5erstyearyl_ I, Scoff MuCa #24382_. Cris$ Crwk WRF I Roi*fi$h Greek WIP jPan1 0peri63r n Rasp --- rdbiB ChaQe PKR . 0K UmNu-nt-Br, Num of Flanfa P.O. Box 1089 Fayete-yille, NC A302-1899 (A m) �MQJ 223•4700 dL)1wreby mh4ete Alton Washington {F 4p. Nllplm�r; (rM� rAICF N L*.r%W� Ala d Finn) of AI's ,Septic Tank CJean ina NCUOOM f,cffpqe 10snnge enI Firrn HwPL awl NC. rrun&.rI to dispase of: dont,�tic septage X , portable t.Dilet Yjaste grease seataec �graase [rap. purnpings i OoM aMaVirrdustlial seotage ,1l W Cu mboeMaisd & salxau ndiinp Counties Pnnlp cy o-ier Gn7w*, Areal at the above named wnsb�%'ater 1rezbnefA faift. shall be dLschaiged all Faci ty 'Influent Pump Static rLu_-m' - between tie ktaurs of Sunrise to Sunset Rei ntred-join g rartialfyr treated liquid into a grease trap is acceptable Yes X No This aub'-,Ddz d &hall he valid u. it<d December 3l, 2 3 Signed Date, N b 1,12 :+. 1)d iIY Ukao.I S&Wnl€rd aml aiTrmW fom me 1ti'N day of 20 Mg C,wrrassion exp.ras: ;Neta-) Flmhcj Y.1••=Fe ��ii OT i i Nom Fi3elOca np W this d€,cummi by we Eep agt manayffl tit I-wm am lead k- pwum MVKA5�m ; • PURL -" S �'as�1;LA, eMA F�] 'F�9MUa Firm App9cadm' Th-TF1 �4�trrr~r, fai Farrn �3 � -~ r ti +"��tl�fil lr�tii4;#}x;