NCS00334_2023Permit_Initial

2023
Permit and Registration
Pearce Concrete
is hereby issued a Septage Management Firm Permit,
sTArE� _ Permit Number NCS-00334
oand registered as a
NORTH
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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 42-05
2. Septage Detention or Treatment Facility, SDTF 42-05
3. Roanoke River WWTP, Weldon, 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.
6&�, A S 12/15/2022
Perry Sugg, Envir nmental Compliance Branch Head

SEPTAGE MANAGEMENT FIRM PERMIT APPLICATION CHECKLIST
North Carolina Department of Environmental Quality
Division of Waste Management
Solid Waste Section
Vcomplete all questions on both pages of the application, including:
r Contact information, including email
—/ o Estimate of gallons pumped within the calendar year
L� Enclose all disposal authorizations for wastewater treatment plants (WWTP), Septage
Land Application Sites (SLAS), Septage Detention or Treatment Facilities (SDTF), compost
1 facilities, or landfills where you plan to dispose of waste.
YJ Be sure any Wastewater Treatment Plant Authorization forms included are signed,
notarized original documents.
VMake check payable to: DIVISION OF WASTE MANAGEMENT
o $550 if you operate one truck
o $800 if you operate two or more trucks
❑ To pay online with a credit card, debit card, or checking account, you will need the
oice for instructions.
Remember to include the "Recertification of Pumper Vehicle(s)" form enclosed for
compliance certification of all pumper vehicles previously inspected by the Division.
VMail payment (unless you are paying online) and all application materials to:
Division of Waste Management, Solid Waste Section
Attn: Septage Management Program
1646 Mail Service Center
Raleigh, NC 27699-1646
❑ If you have any questions, we are here to help! Call or email us:
Environmental Compliance Branch, Septage Management Program Staff �t
Raleigh Central Office
Chester Cobb [phone] [e-mail]
Jeffrey Bullard [phone] [e-mail]
Fayetteville Regional Office
Connie Wylie [phone] [e-mail]
Asheville Regional Office
Troy Harrison [phone] [e-mail]
Wilmington Regional Office
John Farnell [phone] john.farnell@ncdenr.,
A copy of the NC Septage Management Rules and program forms are available at:
https:l/deg.nc.gov/about. divisions/waste-management/waste-management-rues/septage

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 exactly as it is shown on your vehkie(s)).
Street address of office: C Q
City: State:Ll CZip:2— 7 S 7d `
Mailing address (if different):
City: State: Zip
Phone: 1-241 b Fax: 2- Jr 3 -7' 2— 4) 1)
E-Mail: 77P.Q1T_e (- Utz mil)-Hr'', /,�5) \1 (2Vl , G nyYl
County:
(2.) Firm owner's name:
Mailing address (if different):
Management Firm permit number: NCS,
G
City: State: Zip
Phone: ?)7 Fax:
(3.) Firm operator's name: �ay—c�e._Firm operator's title: CQ#'I?r
Mailing address (if different):
City:_
Phone:
___State: _Zip:
Fax:
(4.) Type(s) of septage pumped: Write in the number of gallons oumoed in last 12 months (Example: Domestic: 50,000).
Portable Toilet Waste I Grease (Restaurant) I Treatment Plant Ind
(5.) N.C. Counties of Operation: i " r iD
(List each county you are authorized to do business in)
(6.) Total Number of Pumper Vehicles Operated: l
Number used for: Domestic Septage: I Grease (restaurant):
Other: Portable Toilet Waste:
Vehicle Information: (use additional paper if needed)
APPLICATION CONTINUED ON PAGE 2
PAGE 1

APPLICATION FOR PERMIT TO OPERATE A SEPTAGE MANAGEMENT FIRM
(CONTINUED FROM PAGE 1)
(7.) Do you plan to operate pumper vehicles? (check one) ( ) yes ( ) no.
If you checked yes above, you must attest to the following statement before a permit may be issued.
"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 are significant penalties for false certification including the
possibility of fine and imprisonment."
Do you attest to the statement above? ( ) yes ( ) no Initial Date
(8.) Septage Disposal Method: (check one)
a) Approved wastewater treatment plant: () yes ( ) no. If yes, submit Wastewater Treatment Authorization for each
plant, as indicated in Subparagraph .0834(c)(14) of the Septage Management Rules.
b) Septage Land Application Site (SLAS) Permit Numbers: (use additional sheets if needed)
SLAS#:�Z-OY Expiration Date:
�sLAs#:Expiration Date: ��
c) Septage Detention or Treatment Facility (SDTF) Permit Numbers: (use additional sheets if neededl
SDTF#:LP--05Expiration Dater SDTF#: { D5 Expiration Date: S
(9.) Septage Management R m Operator Training Completed:
Date: Oat, 01 Location: jCI'V (_ Hours:-11
Training Sponsored or Provided by:
(10.) Septage Land Applicatiog Site Operator Training Comple d -
Date: Location: Hours: - _ '-.
Training Sponsored or Provided by: _ __
(11.) Registration type requested: CHECK ONE
Registered Portable Sanitation Firm:
Registered Septage Management Firm:
—X-
Registered Portable Sanitation and Septage Management Firm:
Certification 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.
rio�ture (Signatur f companyofficial required) Date v
Print Name V Tifte
Other Comments:
PAGE 2
Rev. 04-26-2021

NC SEPTAGE MANAGEM"I,NT F IR1VI
Recertification of Pumper Vehicle(s)
Septage Firm Permit #: NCS. Ott .3 .3
Number of Pumper Vehicles:
CERTIFICATION:
" I certify, under penalty of law, that the pumper vehicle or vehicles listed in the
submitted permit application meet the requirements for safe and sanitary
transportation of septage as required by15A NCAC 13B .0844 (a) and vehicle
lettering as required by 15A NCAC 13B .0844 (b). I also certify that a log is
maintained of each septage pumping event as required by 15A NCAC 13B .0839
(a). I am aware that there are significant penalties for false certification including
the possibility of fine and imprisonment."
natu:(Signa4)M
tu f co pany official required)
Print ame
title* I
09" Mra
Date If
/wa. .I
S:lSolid_WastelclalseptagelformslPumper Vehicles Cetification.doc

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, NC27699-1646
Fee assessmentsand 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.
Roanoke River Wastewater Treatment Plant
(Plant Operator in Responsible Charge (ORC), ORC License Number, Name of Plant)
135 Aqueduct Rd, Weldon, NC 2890
(Address)
252-536-4884 do hereby authorize James.H Pearce or Jimmy Pearce
(Phone Number)
(Owner/Operator of Septage Management Firm)
of Pearce Concrete Works NCS # 00334
(Septage Management Firm Name and NCS number)
to dispose of: domestic septage _ x portable toilet waste
grease septage (grease trap pumpings) commercial/industrial septage _ _^ from
Halifax, Warren, and Northampton Counties
(County or other Geographic Area)
at the above named wastewater treatment. facility. Septage shall be discharged at:
135 Aqueduct Rd, Weldon, NC 2890
(Location)
between the hours of Sam - 5pm
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)
SignedRz,��LDate 9/28/2022
(Facility perator)
Subscribed and affirmed befor.rp me this
Y
otary Public) l
28th
day of September .20 22
My Commission expires: 12/06/2022
BRITTNEY MOSE LEY (OFFICIAL SEAL)
NOTARY PUBLIC
HALIFAX COUNTY, NC
Note: Falsification of this document by the septage management firm shall lead to permit revocation.
S:/Solld_Waste/CLA/SEPTAGE/FORMS/2016 Firm Application/WWTP Authorization Form Z017

f STATE
North Carolina Department of Environmental Quality
Division of Waste Management
INVOICE
fnvfranmvnmr Qudljly 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: James H Pearce
Pearce Concrete
5795 Hwy 903
Roanoke Rapids, NC 27870
PAI L)
CK NO. �y��
DATE 1?/Zz
ASsa ov
Date: 09/27/2022
Invoice #: NCS-00334-2023
Septage - Annual:
Pearce Concrete (NCS-00334)
5795 Hwy 903 $550.00
Roanoke Rapids, NC 27870
Number of Trucks: 1
Date Due: 12/15/2022
LATE FEES. I i ar arc? wa'• NC. r eneral "mit tes GS 13QA• a late tea will oe apol d i(, auy ..nnual r?enn+t iee . not :,u-)rnaterl t>y .a -ivary 1,
Payment Options:
E-check Available online at ,t!:!:,.>:i; rr!
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
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)
North Carolina Solid Waste Program ,_' w;. ,w µ„
North Carolina Septage Management Program t ,.; !., r_.__: t'_ _ _( 1"—.'