NCS00370_2023Permit_Initial

2023
Permit and Registration
Gerald Leonard Pumping Service
is hereby issued a Septage Management Firm Permit,
ZNti STATE
Permit Number NCS-00370
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. City of High Point Eastside WWTP, Jamestown, NC
2. City of Asheboro WWTP, Randleman, 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.
W M
Digitally signed
by Wm Perry
Perry
Sugg
Sugg
Date: 2023.02.02
13:09:08-05'00'
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 ggactiy as it is shown on your vehicle(s)).
/111 . ,r• A- I � Le 0 nj et r J PiA nL _g i ht * ScrYi C �.
Street address of office: J4 ke1 C5 P I i IV o r. 1 o
city: I-� i d two AL state: /VL. zip:
Mailing address (if different):
City:
State: Zip
Phone: -y ! y /��_Fax:
County:
Septage
(2.) Firm owner's name: n r r d 1 d MoLr
Mailing address (if different):
city:
Firm permit number. NCS # d Q 3 7 d
State: zip.
Phone:_ Fax:
(3.) Firm operator's name:
Mailing address (if different):
Phone:
F firm operator's title:
State: Zip:_
Fax:
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(4.) Type(s) of septage pumped: Write in the number of gallons IZWUgW in last 12 month_s (Example: Domestic: 50,000).
(5.) N.C. Counties of Operation:
(List each county you are authorized to do business in)
(6.) Total Number of Pumper Vehicles Operated: 61
Number used for: Domestic Septa ge: 41 Grease (restaurant):Other. Portable Toilet Waste:
Vehicle Information: (use additional paper if needed)
APPLICATION CONTINUED ON PAGE 2
o ,

APPLICATION FOR PERMIT TO OPERATE A SEPTAGE MANAGEMENT FIRM
(CONTINUED F OM PAGE 1)
` 7. Do you plan tooperate 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;138.0835(a}.and-vehicle lettering
as required by 15A NCAC .0835(b). Furthermore, I alsp 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 andlimprisonment."
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 A Ac)(14) of theSeptage Management Rules.
b) Septage Land Application Sife (SEAS) Permit Numbers: (use additional sheets if needed)
SLAS#: Expiration Date: SLAS#: Ekpiration Dater
c) Septage Detention or Treatment Facility (SDTF] Permit Numbers: (use additional sheets if needed)
SDTF#: Expiration Date: SDTF#: Expiration Date:
(9.) Septage Management Firm Operator Training Completed:
Date: /d - I if 2� Location: 01 r U Hours:
*� 14 c• Training Sponsored or Provided by: ir- 1�a Al 45 do i A l I'd J\(
(10.) Septage Land Application Site Operator Training Completed:
Date: Location:
Training Sponsored or Provided by:
(11.) Registration type requested: CHECK ONE
Registered Portable Sanitation Firm:
Registered Septage Management Firm:
Registered Portable Sanitation and Septage Management Firm:
Certification Statement
Hours:
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.
J
Signature (Signature ofeompanyofefaimquir" `
Cc I -a I d /Jej Al q r �
Print Name
Other Comments:
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Title
PAGE 2
Rev. 04-26-2021

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.
I, John Thomas Certification # 1000478 City of High Point Eastside WWTP
(Plant Operator in Responsible Charge (ORC), ORC License Number, Name of Plant)
5898 Riverdale Drive. Jamestown NC. 27282
(Address)
336-822-4730 do hereby authorize
(Phone Number)
Gerald Leonard
(Owner/Operator of Septage Management Firm)
of Gerald Leonard Pumping Service NCS # 00370
(Septage Management Firm Name and NCS number)
to dispose of: domestic septage Yes , portable toilet waste Yes
grease septage (grease trap pumpings) No commercial/industrial septage No from
Guilford, Randolph, Davidson Forsyth
(County or other Geographic Area)
at the above named wastewater treatment facility. Septage shall be discharged at:
Eastside W_ W_ _TP Septage Receiving Station _
(Location)
between the hours of 7:00 AM - 5:00 PM Monda,, - Sunday
Reintroducing partially treated liquid into a grease trap is acceptable . Yes X No
This authorization shall be valid until December 31, 2023
Signed' r,r}•�
LJ (Facility Operator)
Su bsc 'bed and affirmed before me this
(Usually December 31, Year)
Date raIL5-/ ZZ
day of & — 20 2-7—
Z4 ' My Commission expires:
(Notar Publi) ,�t111111f1/��
(Ce��•��NOA
L SEAL)
2 #OTgy!-
4 'OU8L1G V
Note: Falsification of this document by the septage management firm shall lead to permiISM-cation. ._
5:/Solid_Waste/CLA/SEPTAGE/FORMS/2018 Firm Application/WWTP Authorization Form 2018 �j �Q �, ��

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.
I, Michael R. Wiseman, ORC, WW4#987680, City of Asheboro Wastewater Treatment Plant
(Plant Operator in Responsible Charge (ORC), ORC License Number, Name of Plant)
1032 Bonkeme er Drive Randleman. NC 27317
(Address)
336-672-0892 do hereby authorize Gerald Leonard
(Phone Number) (Owner/Operator of Septage Management Firm)
of Gerald Leonard, Inc. NCS# 00370
(Septage Management Firm Name and NCS.number)
to dispose of: domestic septage X . portable toilet waste
grease septage (grease trap pumpings) X commercial/industrial septage �, from
Randolph County
(County or other Geographic Area)
at the above named wastewater treatment facility. Septage shall be discharged at:
1032 Bonkemever Drive:_ Randleman, NC 27317
(Location)
between the hours of 7:00 a.m. to 5:00 p.m. Monday - Friday Only
Reintroducing partially treated liquid into a grease trap is acceptable Yes X No
This authorization shall be valid until December 31,
(Usually December 31, Year)
Signed Date�2-2—
(Facility Operator)
Subscribed and affirmed before me this 5-vi­ day of 20 22
W My Commission expires:
( tary Public)
Note: Falsification of this document by the septage management firm shall lead to p
S:/Solid_Waste/CLA/SEPTAGE/FORMS/2019 Firm Application/WWTP Authorization Form 2019

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NC SEPTAGE MANAGEMENT FIRM
Recertification of Pumper Vehicle(s)
Septage Firm Permit #; NCS- 0 0 4
Number of Pumper Vehicles: 0 (
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."
Signature (Signature of company official required Date
r s-1) x- s11--
Print Name Title
S:ISolid WastelclalseptagelformslPumper Vehicles Cetification.doc