NCS00327_2023Permit_Initial

2023
Permit and Registration
Burke Portable Toilet Service
is hereby issued a Septage Management Firm Permit,
STATE,,
Permit Number NCS-00327
o and registered as a
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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. Catawba Water Pollution Control Facility, Morganton, 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
Wm Perry by Wm Perry
Sugg
S u g g Date: 2023.02.02
13:06:29-05'00'
Perry Sugg, Environmental Compliance Branch Head

APPLICATION FOR PERMIT TO OPERATE A SEPTAGE MANAGEMENT FIRM
DIVISION OF WASTE MANAGEMENT - SOLID WASTE SECTION —1646 MAIL SERVICE CENTER, RALEIGH, NC 27699.1646
(1.) Firm name: (The "Firm name" must be exactl as it is shown on your vehicle(s).
Street address of office: kSCCS
City: —State:.-MC- Zip: S
Mailing address (if different): _
City: State: [VC Zip:
Phone: - q - qqj 1Fax:
E-Mail: kurto
County: iCQ Septage Management Firm permit number: NCS # uC -2 %
(2.) Firm owner's name: r L e _ `F +
Mailing address (if different):
City:
State: Zip:
Phone: Fax:
(3.) Firm operator's name: A_ A-h� Lee Iseg 41_ Firm operator's title: -L w n�
Mailing address (if different):
City: State: Zip:
Phone: Fax:
(4.) Type(s) of septage pumped: Write in the number of gallons pumped in 2015 (Example: Domestic: 50,000).
Domestic I Portable Toilet Waste I Grease (Restau
6 C 6- 1
6�3
0
r o
0
ZW
Ya
an U 0
Treatment Plant I industrial/Commercial
(5.) N.C. Counties of Operation: Z u K e - CcAG W u
(List each county you do business in)
(6.) Total Number of Pumper Vehicles Operated: —.i
Number used for: Domestic Septage: Grease (restaurant): _
Other: Portable Toilet Waste:
Vehicle Information: (use additional paper if needed)
APPLICATION CONTINUED ON PAGE 2
PAGE

APPLICATION FOR PERMIT TO OPERATE A SEPTAGE MANAGEMENT FIRM
(CONTINUED FROM PAGE 1)
(7.) Septage Disposal Method: (check one)
a) Approved wastewater treatment plant: yes no. If yes, submit Wastewater Treatment Authorization
for each plant, as indicated in Subparagrap 0833 cc 4) of the Septage Management Rules.
b) Septage Land Application Site (SLAS) Permit Numbers: (use additional sheets if needed)
SLAS#: Expiration Date: SLAS#: Expiration Date:
c) Septage Detention or Treatment Facility (SDTF) Permit Numbers: (use additional sheets if needed)
SDTF#: Expiration Date: SDTF#: Expiration Date: _
(8.) Septage Manager nt Firm Operator Training Completed:
Date: Location: Hours:
Training Sponsored or Provided by:
(9.) Septage Land Application Site Operator Training Completed:
Date: Location:
Training Sponsored or Provided by:
(10.) Registration type requested: CHECK ON
Registered Portable Sanitation Firm:
Registered Septage Management Firm:
Registered Portable Sanitation and Septage Management Firm:
Certification Statement
Hours:
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 (t- future of company offic 1 required)
Print Name
Other Comments:
c? 2
Date
� 1ti1 n e l^
Title
S:/Solid_waste:/CLAISEPTAGEIFORMSi2016 Firm Application,FirmPermilApplication20l6
PAGE 2

AUTHORIZATION TO DISCHARGE SEPTAGE TO A WASTEWATER TREATMENT FACILITY
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.
Elisha, Self 1002187 Catawba Water Pollution Control Facility
(Plant Operator in Responsible Charge (ORC), ORC License Number, Name of Plant)
1000 Vine Arden Rd / P.O Box 3448 Morganton, NC 28655
828-438-5285
(Phone Number)
of
do hereby authorize
(Address)
Anthony Lee Benfield
(Owner/Operator of Septage Management Firm)
Burke Portable Toilet NCS # 00327
(Septage Management Firm Name and NCS number)
X
to dispose of: domestic septage _, portable toilet waste _.
grease septage (grease trap pumpings) _ commercial/industrial septage from
Burke County
(County or other Geographic Area)
at the above named wastewater treatment facility. Septage shall be discharged at:
Catawba River Water Pollution Facility
between the hours of
7:00 AM - 7:00 PM (Location)
X
Reintroducing partially treated liquid into a grease trap is acceptable Yes No
This authorization shall be valid until
Signed '� '
Julf
(Facility 0 erator)
Subscribed and affirmed before me this
"P
(Notary Public)
December 31, 2023
(Usually December 31, Year)
Date 1 i1-Ll��a
7" day of IV OV•. 20,7-2—
My Commission expires:
(OFFICIALSEAL)
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