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HomeMy WebLinkAboutNCS00077_2023Permit_Initial2023 Permit and Registration Creech's Septic & Grease Trap Cleaning is hereby issued a Septage Management Firm Permit, STATE,, Permit Number NCS-00077 o and registered as aD E -�� Septage Management Firm ��en� f� w� nmenta�llty 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. Septage Land Application Site, SLAS 98-07 2. Septage Detention and Treatment Facilities, SDTF 98-07, SDTF 98-09 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 Digitally signed by Wm Perry Sugg Sugg a 00 023.02.02 11:54:00 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* Creech's Septic & Grease Trap Cleaning The "Firm name" must be exactly as it is shown on your vehicle(s). Septage Management Firm permit number (NCS #) NCS-00077 Please enter the complete NCS #, including the 5 end digits (NCS-XXXXX) Street address of office* Street Address 8973 Kirby Rd Address Line 2 City State / Province / Region Kenly NC Postal / Zip Code Country 27542 USA County* Wilson Mailing address same as street address of office?* • Yes No Phone* Fax 252-239-0016 Email* tcreech23@gmail.com Owner Info Firm owner's name* Myrtle R Creech Mailing address same as street address of office?* • Yes No Phone* Fax 252-239-0016 Operator Info Firm operator's name* Firm operator's title Myrtle R Creech Owner Mailing address same as street address of office?* 0 Yes No Phone* Fax 252-239-0016 Type and amount of septage pumped in the last 12 months Amount in gallons* Domestic 320,000 Portable Toilet Waste 0 Grease (Restaurant) 290,000 Treatment Plant 0 Industrial/Commercial 0 North Carolina counties of operation List each county you plan to do business in: * Wilson Wayne Johnston Nash Martin Green Edgecombe Pitt 7Vehicle 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 YA106828 1HTWCAAN3CJ625933 2,500 Domestic Septage YA111856 1HTMKAANO7H501934 2,500 Domestic Septage YA101011 1HTWCAANO85384167 2,500 Septage Disposal Method^ For each method, indicate whether you plan to use it by checking yes or no. Approved wastewater treatment plant* Yes • No 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. Permit Verification ✓ I certify that I AM the permit holder for this SLAS. If unchecked, please attach a signed land application authorization form for each site. SLAS #* Expiration Date* SLAS-98-07 9/20/2022 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* SDTF-9807 10/15/2022 SDTF-9809 10/15/2022 Other disposal method* Yes • No Septage Management Firm Operator Training Completed^] Date* Hours* 12/30/2022 1 Location* Did not attend had coved Training Sponsored or Provided by* NC Pumper Group & NC Portable Toilet Group Septage Land Application Site Operator Training Completed 111 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 Did not attend class had coved and had the flu the second time we were suppose to go to class 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 04:00:20 AM Print Name* Title* Myrtle R Creech Owner