NCS00107_2023Permit_Initial

ZNti. 0"
0. i7]y
�E� punvtu�
NORTH CAROLINA
Environmental Quality
2023
Permit and Registration
Bennie A Moore Septic Tank Service Inc.
is hereby issued a Septage Management Firm Permit,
Permit Number NCS-00107
and registered as a
Septage Management Firm
(PUMPER)
in the State of North Carolina.
PlORTH CAROLiNA �EQ
wll�pl
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. Greenville Utilities Commission, Greenville, NC
2. Septage Land Application Sites (SLAS), SLAS-59-02, SLAS-59-05
3. Septage Treatment or Detention Facilities (SDTF), SDTF-59-02, SDTF-59-05
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.
11 /28/2022
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*
BENNIE A. MOORE SEPTIC TANK SERVICE INC.
The "Firm name" must be exactly as it is shown on your vehicle(s).
Septage Management Firm permit number (NCS #)
NCS-00107
Enter the five digits following the NCS #
Street address of office*
Street Address
1150 Eli Bowen Road
Address Line 2
City
State / Province / Region
Willaimston
NC
Postal / Zip Code
Country
27892
United States
County*
Martin
Mailing address same as street address of office?*
• Yes No
Phone* Fax
2527925978 2527921074
Email*
[e-mail]
Owner Info
Firm owner's name*
BENNIE A. MOORE SEPTIC TANK SERVICE INC.
Mailing address same as street address of office?*
• Yes No
Phone* Fax
2527925978 2527921074
Operator Info
Firm operator's name* Firm operator's title
RUSS AYERS PRESIDENT
Mailing address same as street address of office?*
0 Yes No

Phone* Fax
2527997461 2527921074
Type and amount of septage pumped in the last 12 months
Amount in gallons*
Domestic 484,500
Portable Toilet Waste 0
Grease (Restaurant) 423,500
Treatment Plant 8,000
Industrial/Commercial 0
North Carolina counties of operation
List each county you plan to do business in: *
BEAUFORT-MARTIN-BERTIE-CHOWAN-TYRELL-HYDE-WASHINGTON-CRAVEN-WILSON-GREEN
EDGECOMBE-PASQUOTANK-NASH-PERQUIMANS-CAMDEN-DARE-HERTFORD-HALIFAX-DUPLIN
LENIOR
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
Date*
11/10/2022
Title*
PRESIDENT
Choose how to add vehicle descriptions*
• Add vehicles individually Upload List
Pumper Vehicles
Usage*
License Tag #*
Vehicle Identification #*
Tank Capacity*
Grease
(restaurant)
YA163145
3HAEKTAT4NL297483
4,000
Grease
(restaurant)
YA78060
3HAEKTOK1405450
4,100
Grease
(restaurant)
YA156773
3HTEKTAT7MN616479
4,200
Domestic Septage
YA44344
1HTSDAAN8YH52173
2,500

Domestic Septage YA44345 1HTSDNUN8NH418138 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
GREENVILLE UTLITIES 12/31/2023 Scan_0873.pdf 366.67...
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.
SLAS # * Expiration Date* Authorization
SLAS-5902 8/5/2021
SLAS-5905 8/5/2021
Septage Detention or Treatment Facility (SDTF)
• Yes No
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-5902 10/7/2021
SDTF-5905 8/5/2021
SDTF-class 9/8/2022 Scan_0874.pdf 355.23...
Other disposal method*
Yes • No
Septage Management Firm Operator Training Completed
Date* Hours*
9/8/2022 6
Location*
WASHINGTON,NC

Training Sponsored or Provided by*
NC Septic Tank Association
Septage Land Application Site Operator Training Completed^
Date Hours
9/8/2022 6
Location
WASHINGTON, NC
Training Sponsored or Provided by
NC Septic Tank Association
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
11/10/2022
09:01:07 AM
Print Name* Title*
RUSS AYERS PRESIDENT

FA I
Greenville
Utilities
TO
SEPTAGE TO A WASTEWATER
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.
i, RA I---- Mannin WW-415Z10 Greenville Utilities WWTP
(Plant Operator in Responsible Charge (ORC), ORC License Number, Name of Plant)
Z40 Aqua Lane PO Box 1847 Greenville, NC 27835
(Address)
252 551-1546 do hereby authorize Russ vers
(Phone Number) (Owner/Operator of Septage Management Firm)
Of Bennie A. Moore Se tic Tank Service NCS # 00107
(Septage Management Firm Name and NCS number)
to dispose of: domestic Septage i/ portable toilet wastes/
grease septage (grease trap pumpings) commercial/industrial septage_ from
Pitt County and Surrounding Areas
(County or other Geographic Area)
at the above -named wastewater treatment facility. Septage shall be discharged at:
Greenville Utilities WWTP
(Location)
between the hours of 8:30AM-4:30 PM Monday through Friday
Reintroducing partially treated liquid into a grease trap is acceptable Yes y No
This authorization shall be valid until
(Usually December 31, Year)
Signed / _
Date {F / J ZZ
cil' y0perator)
Note: Falsification of this document by the septage management firm shall lead to permit revocation.
S./Solid_Waste/CLA/SEPTAGE/FORMS/2018 Firm Application/WWTP Authorization Form 2018
Connected To You Post Office Box 1847 1 Greenville, North Carolina 27835-1847 1 guc.com 1 252-752-7166

m
MM�
c
�a
a
�
o
J
RS
A
x
m.

North Carolina Department of Environmental Quality
Division of Waste Management
NORTH CAROL KIA INVOICE
awa,UffiWmrQUoruy Solid Waste Section
Division of Waste Management
Solid Waste Section
1646 Mail Service Center
Raleigh, NC 27699-1646
Phone/Fax: [phone]
Email: [e-mail]
To: Russ Ayers
Bennie A Moore Septic Tank Service Inc
1150 Eli Bowen Road
Williamston, NC 27892
P
A I D
CK. NO,
DoF739
DATE
't
Do. o0
Date: 09/27/2022
Invoice #: NCS-00107-2023
Septage - Annual:
Bennie A Moore Septic Tank Service Inc (NCS-00107)
1150 Eli Bowen Road $800.00
Williamston, NC 27892
Number of Trucks: 4
Date Due: 1211SI2022
LATE FEES: i accordance with NC General Statutes GS 130A-291.1(e2), a late fee will be applied to any annual permit fees not submitted by January 1, 2023.
Payment Options:
E-check Available online at https://deg nc qov/swpay
Requires bank account and routing information. You will need to use the zip code in the description box and the invoice number
shown on this invoice to access your account. If a zip code is not listed, use the code: 99999 along with the invoice number.
Credit Card Available online at https://deq.nc.cloy/swpay
Accepts MasterCard, Visa, and Discover cards. You will need to use the zip code in the description box and the invoice number shown
on this invoice to access your account. If a zip code is not listed, use the code: 99999 along with the invoice number.
[*Convenience Fee of 2.65% added to amount invoiced.]
Paper check Make checks payable to N.C. Division of Waste Management, Solid Waste Section, include Permit Number and invoice number on
check. If you are paying by electronic transfer, include the invoice number with your electronic transfer. Please return a copy of this
invoice with your payment.
[G.S. 25-3-506: A $25.00 processing fee will be charged on all returned checks.)
Explanation of Invoice Amount is Based on Firm's Current Permit Status:
Pursuant to North Carolina General Statute 130A-291.1 you are required to pay fee(s) based on your solid waste management
activities. The fee(s) shall be used to support the septage management program.
For questions regarding:
Billing
Regulations or Technical Assistance
Jared Wilson [phone]
Chester Cobb [phone]
Jeffrey Bullard [phone]
More information available on the web:
North Carolina Department of Environmental Quality (DEQ) - https://deQ.nc.gov
North Carolina Solid Waste Program - h dea.nc.nov/aboutldivisions!waste-managemenVsolid-waste-section
North Carolina Septage Management Program - https!/dea.nc.:ioyZabout/divsions/waste-manaiemenLIsolid-waste-sectio `s& cial-wastes-and alt rnative
handling/septage