NCS00185_2023Permit_Initial

2023
Permit and Registration
Thomas Septic Tank Service
is hereby issued a Septage Management Firm Permit,
ZNti STATE
Permit Number NCS-00185
o and registered as a
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NORTH
EQ
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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:
1. Septage Land Application Site, SLAS-74-18
2. Septage Detention or Treatment Facility, SDTF-98-08
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 12:20:46
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*
THOMAS SEPTIC TANK SERVICE
The "Firm name" must be exactly as it is shown on your vehicle(s).
Septage Management Firm permit number (NCS #)
NCS-00185
Please enter the complete NCS #, including the 5 end digits (NCS-XXXXX)
Street address of office*
Street Address
762 ROOSEVELT SPAIN RD
Address Line 2
City
State / Province / Region
GREENVILLE
NC
Postal / Zip Code
Country
27834
USA
County*
Pitt
Mailing address same as street address of office?*
Yes • No
Mailing Address*
Street Address
PO BOX 1643
Address Line 2
City
State / Province / Region
GREENVILLE
NC
Postal / Zip Code
Country
27835
United States
Phone* Fax
12525317489
Email*
[e-mail]
Owner Info
Firm owner's name*
BOBBY THOMAS
Mailing address same as street address of office?*
Yes 0 No

Mailing Address*
Street Address
PO BOX 1643
Address Line 2
City
GREENVILLE
Postal / Zip Code
27835
Phone*
12525317489
Operator Info
State / Province / Region
NC
Country
United States
Fax
Firm operator's name*
Firm operator's title
BOBBY THOMAS
OWNER
Mailing address same as street address of office?*
Yes • No
Mailing address*
Street Address
PO BOX 1643
Address Line 2
City
State / Province / Region
GREENVILLE
NC
Postal / Zip Code
Country
27835
USA
Phone*
Fax
2525317489
Type and amount of septage pumped
in the last 12 months
Amount in gallons*
Domestic 155,000
Portable Toilet Waste 0
Grease (Restaurant) 24,000
Treatment Plant 0
Industrial/Commercial 0
North Carolina counties of operation
List each county you plan to do business in: *
PITT, EDGECOMBE, GREEN, BEAUFORT, MARTIN, LENOIR
Vehicle Info
Do you plan to operate pumper vehicles?*
0 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*
12/17/2022
Title*
OWNER
Choose how to add vehicle descriptions*
• Add vehicles individually Upload List
Pumper Vehicles
Usage* License Tag #* Vehicle Identification #* Tank Capacity*
Domestic Septage YA99144 1HTSCAAN5YH231895 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* Authorization *
SLAS-74-18 12/31/2023 IMG_1743.jpg 3.26MB
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-98-08 12/31/2023 IMG_1744.jpg 3.27MB

Other disposal method*
Yes • No
Septage Management Firm Operator Training Completed
Date* Hours*
12/3/2022 4
Location*
RALEIGH, NC
Training Sponsored or Provided by*
NC Pumper Group & NC Portable Toilet Group
Septage Land Application Site Operator Training Completed
Date Hours
12/3/2022 3
Location
RALEIGH, NC
Training Sponsored or Provided by
NC Pumper Group & NC Portable Toilet Group
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
12/17/2022
09:58:25 AM
Print Name*
BOBBY THOMAS
Title*
[e-mail]

AUTHORIZATION TO DISCHARGE SEPTAGE AT A SEPTAGE LAND APPLICATION
SITE PERMITTED TO SOMEONE OTHER THAN YOURSELF
(This form is used by a land application site permit holder to indicate that permission has been
given to a permitted Septage Management Firm to Iand apply septage on the permit holders
land appicaltion site.)
It
do hereby authorize:
(.Operator Address)
Of
(Owner of Septage Management Firm)
a -.�
(Name of Septage Management Firm )
to use septage disposal site #
Date: `�� �S'
(Septage Management Firm Address)
4'19 for the disposal of 9
Signed
a &I
r17&10
N CS
gallons of septage* in 20 a 3
'/ fe Oper�16r)
As defined in GOS.130-A-290(a)(32). The site will be opera
ted in accordance with 15A NCAC 13B
.0800 - Septage Management Rules
Return the properly completed form to:
North Carolina Department of Environmental Quality
Division o Waste Management
Solid Waste Section
1646 Mail Serv'a
ice Center
Raleigh, NC 27699-1646
h.

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AUTHORIZATION TO DISCHARGE SEPTAGE AT A *Cl'
THAN YOURSELF
STOR14GE FACILITY PERMITTED TO SOMEONE hat ermission has been givento a peermt holder toindicaP
(This form is used by a detenton or treatment sept�11111ge into the permit holders detellbO-rl or treatment facility.)
Septage Management Firm tOdischarge
441 Buck Newsome Rd. Fremont, NC 27830
do hereby authorize:
Thomas Septic Tank Service
(Name of Septage Management Firm)
PO Box 1643 GreenVille, NC 27835
Daniel L Newsome
(Facility Operator)
(Operator Address)
Bobby Thomas
(Owner of Septage Management Firm)
00185
NCS #
(Address of Septage Management Firm)
(on.953)
98-08
ifted
to utilize se fa e detention or treatment facility # for the treatment or storage of septage
n 202 The facility will be operated in accordance with the Septage Management
I -i -22
Date:
* As defined in W a)(32}
** As defined in 15A NCAC 13B .0800
Signed
Return the properly completed form to:
North Carolina Department of Environment and Natural Resources
Division of Waste Management
Solid Waste Section
1646 Maii Service Center
Raleigh, NC 27699-1646
aci i Operator)
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