NCS00169_2023Permit_Initial

2023
Permit and Registration
McMahan Septic Tank
is hereby issued a Septage Management Firm Permit,
ZNti STATE
Permit Number NCS-00169
o and registered as a
e:,e D
E� M
-�� Septage Management Firm ��en� f� w� nmenta�llry
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. Archie Elledge WWTP, Winston-Salem, NC
2. Lexington Regional WWTP, Lexington, 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, 2023.
Digitally signed by Wm Perry
Wm Perry Sugg Sugg
Date: 2023.02.02 12:19:45-05'00'
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*
McMahan Septic Tank Inc
The "Firm name" must be exactly as it is shown on your vehicle(s).
Septage Management Firm permit number (NCS #)
NCS-00169
Enter the five digits following the NCS #
Street address of office*
Street Address
10 Paddington Drive Lexington NC 27295
Address Line 2
City
State / Province / Region
Lexington
NC
Postal / Zip Code
Country
27295
United States
County*
Davidson
Mailing address same as street address of office?*
• Yes No
Phone*
Fax
336-248-6575
Email*
[e-mail]
Owner Info
Firm owner's name*
Brett McMahan and Bobby McMahan
Mailing address same as street address of office?*
• Yes No
Phone* Fax
336-248-6575
Operator Info
Firm operator's name* Firm operator's title
Brett McMahan and Bobby McMahan Owner
Mailing address same as street address of office?*
0 Yes No

Phone* Fax
336-248-6575
Type and amount of septage pumped in the last 12 months
Amount in gallons*
Domestic 240,000
Portable Toilet Waste 0
Grease (Restaurant) 10,000
Treatment Plant 0
Industrial/Commercial 0
North Carolina counties of operation
List each county you plan to do business in: *
Davidson, Davie, Forsyth, Rowan, Guilford
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*
12/12/2022
Title*
Owner
Choose how to add vehicle descriptions*
• Add vehicles individually Upload List
Pumper Vehicles
Usage* License Tag #* Vehicle Identification #*
Tank Capacity*
Domestic Septage YA003555 1HTSDAAN8TH314646
2,500
Grease (restaurant) YA003556 1HTSDAANXTH275686
2,300
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*
City of Lexington
City of Winston
Septage Land Application Sites (SLAS)*
Yes • No
Septage Detention or Treatment Facility (SDTF)
Yes • No
Expiration Date*
12/31/2022
12/31/2022
Authorization
City Of Lex
Auth To
Discharge-
2022.pdf
City If
winston Auth
To Discharge
2022.pdf
Other disposal method*
Yes • No
Septage Management Firm Operator Training Completed
Date* Hours*
1/27/2022 4
Location*
Hickory
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
259.05...
256.72...
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
5"2111�7c1�1 6
Date
12/12/2022
01:39:00 PM
Print Name* Title*
Brett McMahan Owner

AUTHORIZATION TO DISCHARGE SEPTAGE TO A WASTEWATER TREATMENT FACILITY
North Carolina Department of Environment and Natural Resources
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.
, Matthew Lavigne- WW#997822-Archie Elledee Wastewater Facilit
(Plant Operator in Responsible Charge (ORC), ORC License Number, Name of Plant)
2801 Griffith Rd. Winston-Salem NC 27103
(Address)
336-765-0130 do hereby authorize Brett McMahan
(Phone Number) (Owner/Operator of Septage Management Firm)
of McMahan 5epticTanl< NCS # 00169 _
(Septage 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/Forsyth County and Adiacent Counties
(County or other Geographic Area)
at the above named wastewater treatment facility. Septage small be discharged at:
Archie Elled a 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, 2023
(Usually December 31, Year)
Signed y Date %,%_ .3— ;?
(Facilit erator)
Subscribed and affirmed before me this j day of _ OcAo 6cr , 20 a�
+ "A'L,.+ My Commission expires: 31 }3 /.h)
(Notary Public)
a fAARY G. 6; tUw'r�
46ft P
(OFFICIAL SEAL)
1 uhlir.. ". jr1h'v-6rn;lns
Pus
Note: Falsification of this document by the septage 51r�m YSall lead to permit revocation.
S:/Solld Waste/CLA/SEPTAGE/FORMS/2018 Firm Appsicatim. wW rl AL.uke r+tatlon Form 2018

AUTHORIZATION T4 DISCHARGE SEPTAGE TO A WASTEWATER TREATMENT FACILITY
(North Carolina Department of Environmental quality
Division of Waste Management - Sotid Waste Section
1646 Mail Service Center, Raleigh, NC 27699-1646
Fee assessments and waste determinations wiB 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 strearn.
1, L �Q vxli' n0. '��VQ"rL- k n� ` C) rk I� sill
Plant operator in Responsible Charge (ORC), O License Numb , Name of Plant)
ww3
t4C-
�3 ; L-O.- 36 ID-Zd❑ hereby authorize I -i C- rl
(Phone Number) (O% ner/Operator of Septage Management Firm)
of
r� , v� �,,+
(Address)
(septage Management Firm Name and NC5 n
to dispose of. domestic septage portable toilet waste
grease septage (grease trap pumpings) ccmmercial/industr"sal septage from
(County or at11WGeographie At )
at the above named wastewater treatment facility. Septage shall be discharged at:
R.
between the hours of
C—
Reintroducing partially treated liquid into a grease trap is acceptable Yes —V No
This authorization shall be valid until �0 2�
(Usually December 31, Year)
Signed Date L
(Facility Operator)
Subscribed and affirmed before me this
roj-yan
(Notary Public)
EM
M
day of IIQ.Yn 120'20
My Commission expires: N _a -Qoa--�
Jamie R T �1613a'sEALj
Nota-, U
Davidson Caen , NC
Nate: FalsifIca tIon of this document by the septage management firm shall lead to permit revocation,
S:/Solid_Waste/CLA/SEPTAGE/FORMS/2018 Firm Appllcation/WWTP Authorization Form 2018
i