NCS00061_2023Permit_Initial

2023
Permit and Registration
Swann Machine & Supply
is hereby issued a Septage Management Firm Permit,
STATE,,
Permit Number NCS-00061
o and registered as a
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-�� Septage Management Firm�� �� w� ��nffii�utr
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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:
City of Danville WWTP, Danville, VA
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.
Wrn Perry
Sugg
Digitally signed by
Wm Perry Sugg
Date: 2023.02.02
11:46:12-05'00'
Perry Sugg, Environmental Compliance Branch Head

APPLICATION FOR PERMIT TO OPERATE A SEPTAGE MANAGEMENT FIRM
DIVISION OF WASTE MANAGEMENT - SOLID WASTE SECTION —1646 MAIL SERVICE CENTER, RALEIGH, NC 27699-1646
(1.) Firm name: (The "Firm name" must be gLaLculy as it is shown on our vehicle(s .
_ V W 0- `t00 f
Street address of office: ` �t +� �-
City: lice Q %j l 'L State: Zip: S
Mailing address different):
City:
Phone:
E-Mail:
County:
State: Zip:
Fax:
i
� C Septage Management Firm permit number- NCS
(2.) Firm owner's name: S10 �
Mailing address (if different): , C '
City:
Phone:
State: Zip:
Fax:
(3.) Firm operator's name: , � '1 U_S Wck tj Firm operator's title:
Mailing address (if different): ; (rim t
City: _ _ _ State: Zip:
Phone:
Fax:
(4.) Type(s) of septage pumped: Write in the number of gallons pumped in 2015 (Example: Domestic: 50,000).
Domestic Portable Toilet Waste Grease (Restaurant Treatment Plant
006 1 H 2 ilc�(J i
(5) N.C. Counties of peration: Ul t rs CJ4
-C*At ,. CS C �1 &krt
(List each county you do business in)
(6.) Total Number of Pumper Vehicles Operated: -z— _
Number used for: Domestic Septage: l Grease (restaurant):
Other: Portable Toilet Waste: I
Vehicle Information: (use additional paper if needed)
Industrial/Commercial
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:' i fA( \ ark^
License Tart#
Vehicle Identification h
Tank Ca acit
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2( JC t t ? 7
z
3
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5
APPLICATION CONTINUED ON PAGE 2
PAGE 1

APPLICATION FOR PERMIT TO OPERATE A SEPTAGE MANAGEMENT FIRM
(CONTINUED FROM PAGE 1)
(7.) Septage Disposal Method: (check one)
a) Approved wastewater treatment plant: yes no. If yes, submit Wastewater Treatment Authorization
for each plant, as indicated in Subparagrap .0833 c 4) of the Septage Management Rules.
b) Septage Land Application Site (SLAS) Permit Numbers: (use additional sheets if needed)
SLAS#: Expiration Date: SLAS#: Expiration Date:
c) Septage Detention or Treatment Facility (SDTF) Permit Numbers: (use additional sheets if neeoe
SDTF#: Expiration Date{`k� r a—L' SDTF#: Expiration Da_
(8.) Septage Management Fir Operator Training Complet d:
Date: i t _ 3 Location:
Training Sponsored or Provided by:
(9.) Septage Land Application Site Operator Training Completed:
Date: Location:
Training Sponsored or Provided by:
(10.) Registration type requested: CHECK ON
Registered Portable Sanitation Firm:
Registered Septage Management Firm: —L
Registered Portable Sanitation and Septage Management Firm:
Certification Statement
Hcu.-Si L-'L
Hours:
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 there are criminal penalties for knowingly making a false statement, representation, or certification.
Signature (Signature of company official required) Date
via
Print'game Title
Other Comments:
S:/Solid_Waste:/CLA/SEPTAGE/FORMS12016 Firm ApplicationlFirmPermitApplication2016
PAGE 2

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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.
✓tR�y�S/trJPf' �, J V� CIASi 4/4Mq lah%S O 'FIAT f�L/C C'W6N /96500SS"13
(Plant Operator in Responsible Charge (ORC), ORC License Number, Name of Plant)
��,/i;%% /✓Cr'�si�(' C✓I✓T/� z�9 A/ iySir�PDR//�'� Q1;11;1 Vi4 2z/J410
(Address)
s i37 do hereby authorize
(Phone Number) (Owner/Operator of Septage Management Firm)
of
(Septage Management Firm NaanYandhCS number)
to dispose of: domestic septage f portable toilet waste
grease septage (grease trap pumpings)
_0UWCk I Perso^ 1 ock t ^j
# coo �? I
commercial/industrial septage from
c rV (MC, C
% (County or other Geographic Area)
at the above named wastewater treatment facility. Septage shall be discharged at:
pe- �E�/C W�`l� SuRCHKII€ iVAI► I, o� I�� ✓�zs r �� iN n2 iVo rriS�O�= Wu/%�
(Location) /
between the hours of 7'ODA/j� %Gb/'m%M-�=) /d,'dOf��i Z'00p" l/�.4iuJZ7�.Qy V /zbL✓�JfFV
Reintroducing partially treated liquid into a grease trap is acceptable Yes ✓ No
This authorization shall be valid until 51, 2-40Z3
(Usually December 31, Year) /
4
Signed Date
V0 (Facility Oper or)
Subscribed and affirmed before me this r d day of �Oanu(a(- 20 Q 3
A" My Commission expires: a-O a-(p
(Notary Public)
ALICIA LAVONNE CRUMPTON
NOTARY PUBLIC (OFFICIAL SEAL)
REGISTRATION 0 7800039
COMMONWEALTH OF VIRGINIA
MY COMMISSION EXPIRES
MAY31 2028
Note: Falsification of this document by the septage management firm shall lead to permit revocation.
S:/Solld Waste/ClA/SEPTAGE/FORMS/2016 Firm Application/WWTP Authorization Form 2016

NC SEPTAGE MANAGEMENT FIRM
Recertification of Pumper Vehicles)
Septage Firm Permit #: NC5- p
Number of Pumper Vehicles:_
CERTIFICATION:
"I certify, under penalty of law, that the pumper vehicle or vehicles listed in the
submitted permit application meet the requirements for safe and sanitary
transportation of septage as required by15A NCAC 13B .0844 (a) and vehicle
lettering as required by 15A NCAC 13B .0844 (b). I also certify that a log is
maintained of each septage pumping event as required by 15A NCAC 13B .0839
(a). I am aware that there are significant penalties for false certification including
the passibility, f fine and im ris nment."
Signature (Si atu compan offici ! required) Date
1 a.
Print Name Title
S:15vlld_Wastelalalseptagalforms%Pumper VehIcIas Cefi icatIon.doc