NCS00308_2023Permit_Initial

2023
Permit and Registration
Bradsher & Son Septic Tank Cleaning Inc.
is hereby issued a Septage Management Firm Permit,
STATE,,
Permit Number NCS-00308
oand registered as a
-�� Septage Management Firm ��en� �� w� nmental Ouallty
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. East Burlington WWTP, Burlington, 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.
Wm Perry Digitally signed by
Wm Perry Sugg
Sugg 112:33 44-05''00'2
Perry Sugg, Environmental Compliance Branch Head

NewSthnissi n
State of North Carolina ,application for Permit to operate a
Environmental Quality
Waste Management Septage Management -Firm
For questions regarding this forma or ft onum aWlicaftil process. Please cont'ar# JeffreyBullard #ft:11maitto.
Je*eyJ3ulland@rx derrrgov)(819-707-8283) or Chester Comb (hilPAnai! tomhosbrcobb@ncdemgov)(919-707-8283).
Firm info
Firm name*
Bradsher & Son Septic_Tank Cleaning
The "Firm name" must be exactly as it isshown on your vehide(4 ' —
a
Septage Management Firm permit number (NCS #)
NC5-003@$Lj� A
Enter the five digits following the IGS # �d
CK. N0. � 1
Street address of office*DATE L 2
Stiaet Address
5409 RtNC 119 7
Address Line 2
_ I
city S18te ! Province
Burlington North Carolina
Postal IZip Code Countiy
27217 jAlamance
County*
Alamance
Ma&g address same as street address of office?*
Yes Q No
Phone*
336-421-3842
Emall*
[e-mail]
Fax
Owner Info I

9/23/2=
New Submission
Firm owner's name*
Lawrence L. Bradsher Sr.
Mailing address same as street address of office?*
(f Yes 0 No
Phone*
336 421 3842
Operator Info
Firm operator's name*
Lawrence L. bradsher Sr.
Mailing address same as street address of office?*
Yes 0 No
Phone*
Fax
Firm operator's title
Owner
Fax
Type and amount of septage pumped in the last 12 months
Domestic
Portable Toilet Waste
Grease (Restaurant)
Treatment Plant
I ndustrial/Commercial
Amount in gallons *
0 90 000
0
0
0
0
North Carolina counties of operation

9QUAM NewSutressian
Approved wastewatertreatrnent plant*
* Yes O No
lives, listthe iadlilies below and upload or submit bymail a copyof Waster TreatmentAuthomation
(htips:/Mies.nagoWhcdaWDWA&SW)Composft%252oand%252oLam%2520Appficatior Nvwrp%2ak* odmem.pdQ for each plant
as indicated in subparagraph _0833(c)(14) ofM a Septage Management Rules_
Mail forms to:
NC DEQ
Division of Waste Management -solid Waste Section
1646 Mail Service carrier
Raleigh, NC 27699-1646
WasterwaterTreatment FacililyName*
East Burlington Wastewater Treatlaen
+ Add another WWTP
Septage Land Application Sites (SLAB)
O Yes 0 No
Septage Detention or Treatment Facr'ky (SDTF) *
0 Yes O No
Other disposal method
O Yes O No
F-,;irafm Oath* Authorization
12/31 /0,52 P Upload
Septage Management Firm Operator Training Completed
Date*
Location*
eigh, North Carolina
Training Sponsored or provided by*
INC Pumper Group & NC Portable Toilet Gl%-
Hours*
4
Septage Land Application Site Operator Training Completed

Newsubnission
List each county you plan to do business in:*
Alamance
Vehicle Info
Do you plan to operate pumper vehicles?
Q Yes Q No
"I certify under penalty of law, that the pumper veltide or vehicles listed in the submitted permit application meets the requirements for
safe and sanitarytransporthtion of septage as required by lsANCAC 13B .0844(a) and vehicle lettering as required by 15A NCAC
.0844(b). Furthermore, I also cerfifythata log is maintained of each seplage pumping eventas required by 15A NCAC 13B 4839(a} I
am aware that there significant penalties for raise won including the possiWityoffine and imprisonment'
Signature*
Sign
Date* ,td-
Date captured on form submission
rule*
r L ^
Choose how to add vehicle descriptions*
N Add vehicles individual] O Upload List
Pumper Vehicles
Usage * Lime Tag #* Vehicle Identfication #* Tank Caparxty*
Domestic Septage [YA85735 1HTSOAANXWH535267 2,860 x
Domestic Septage YA15643 11HTSOAANXH232375 2,500 x
+ Acid more vehicles
Septage Disposal Method
For esch method, indite v*wdwryvu prsn fo us3 it by dWCWf yM or no.

Nerrsebidssion
Date Hours
Location
r — -
Training Sponsored or Provided by
v
Registration Type
SeW one*
0 Registered Portable Sanitation First
10 Registered Septage Management Firm
0 Registered Portable Sanitation and Septage Management Firm
Comments and Notes
Comments or notes
Certification Statement
1 cer* that the kfomnation wo represem fflomin thisapplication fora Permit are tore, axmPlate. and ac unde b the best army kKn dedge and belief. I
am aware 9W a Permit maybe suspended or revoled upon a fimdkV that Usismance wasbased upon ftwoffect orinadequate imfomration that materially
affected the decision to awe the permit and that them are aiminat penafties for knowingly nw%nq a false statement, repam entatiom, or eertificition.
Signature*
�r $lgil
D to
Date can not be empty
F AM
Print Name*

AUTHORIZATION TO DISCHARGE SEPTAGE TO A WASTEWATER
TREATMENT FACILITY
North Carolina Department of Environment and Natural Resources
Division of Waste Management - Solid Waste Section
401 Oberlin Rd., Ste.150, Raleigh, N.C. 27605
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, Damn Allred, Chief Onerator of the East Burlington Wastewater Treatment Plant
(Plant Operator and Name of Plant)
225 Stone Quarry Rd., Burlington NC 27217
(Address)
32 578-0515 do hereby authorize Buck Bradsher
(Phone Number) (Owner/Operator of Septage Management Firm)
Of Bradshers Se�)tic Tank CleaninL, NCS # S00308
(Septage Management Firm Name and NCS number)
to dispose of: domestic septage X _, portable toilet waste N/A
grease septage (grease trap pumpings) _ N/A commercial/industrial septage N/A ,
from Alamance Countv Only _ at the above named wastewater treatment facility.
(County or other Geographic Area)
Septage shall be discharged at: The Influent Septaue dumD D it of the East Burlington Wastewater Treatment Plant.
(Location)
between the hours of 8:00 -11:30 am / 12:00 - 5:00• m Monday - Saturday
Reintroducing partially treated liquid into a grease trap is acceptable Yes X No
This autho ' 'on shall be valid until December 31, 2023
(Usually December 31, Year)
Signed Date �-2-
(Facility pera r)
Sworn to and subscribed before me this day of (oer 200L Z Z
—� My Commission expires: -12Ap
(Notary Public)
/�� NOTARY
7�
`LL ,
Note: Falsification of this document by the septage management firm shall lead to permit revocation.
H:CLA/FORMS/2009 Firm Application/WVTrPAuthorizationForm2010