NCS00404_2023Permit_Initial

2023
Permit and Registration
Gann Brothers Septic Tank Service, Inc.
is hereby issued a Septage Management Firm Permit,
STATE,,
Permit Number NCS-00404
o and registered as a
e:,e D E
-�� Septage Management Firm ��en� f� w� nmenta�llty
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 Eden WWTP, Eden, NC
2. Septage Detention or Treatment Facility, SDTF-79-04
3. Septage Land Application Site, SLAS-79-04
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 Perr Digitally signed by
Y Wm Perry Sugg
Sugg Date: 2023.02.02
13:10:37-05'00'
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*
Gann Brothers Septic Tank Service
The "Firm name" must be exactly as it is shown on your vehicle(s).
Septage Management Firm permit number (NCS #)
NCS-00404
Enter the five digits following the NCS #
Street address of office*
Street Address
191 Percy Lane
Address Line 2
City
State / Province / Region
Mayodan
North Carolina
Postal / Zip Code
Country
27027
United States
County*
Rockingham
Mailing address same as street address of office?*
• Yes No
Phone* Fax
3365482971
Email*
[e-mail]
Owner Info
Firm owner's name*
Eric C. Gann
Mailing address same as street address of office?*
• Yes No
Phone* Fax
3365482971
Operator Info
Firm operator's name* Firm operator's title
Eric Gann pres
Mailing address same as street address of office?*
0 Yes No

Phone* Fax
3365482971
Type and amount of septage pumped in the last 12 months
Amount in gallons*
Domestic 774,000
Portable Toilet Waste 0
Grease (Restaurant) 21 500
Treatment Plant 71 , 000
Industrial/Commercial 0
North Carolina counties of operation
List each county you plan to do business in: *
Rockingham, Stokes, Guilford, Forsyth, Caswell
Vehicle Info
Do you plan to operate pumper vehicles?*
• 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*
12/14/2022
Title*
Pres
Choose how to add vehicle descriptions*
• Add vehicles individually Upload List
Pumper Vehicles
Usage* License Tag #* Vehicle Identification #* Tank Capacity*
Domestic Septage YA151537 5PVNV8JV7L5S60337 2,500
Septage Disposal Method
For each method, indicate whether you plan to use it by checking yes or no.
Approved wastewater treatment plant*
0 Yes No

If yes, list the facilities below and upload or submit by mail a copy of Wastewater Treatment Authorization for each plant as indicated in
subparagraph .0833(c)(14) of the Septage Management Rules.
Mail forms to:
NC DEQ
Division of Waste Management - Solid Waste Section
1646 Mail Service Center
Raleigh, NC 27699-1646
Wasterwater Treatment Facility Name*
City of Eden
Expiration Date* Authorization
12/31/2023 Eden 109.91...
Authorization
to dump.pdf
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.
SLAS # *
SLAS-79-04
Expiration Date*
3/8/2023
Authorization
Septage Detention or Treatment Facility (SDTF)
• Yes No
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 #*
SDTF-79-04
Other disposal method*
Yes • No
Expiration Date*
1/30/2025
Authorization
Septage Management Firm Operator Training Completed ^
Date* Hours*
10/18/2022 6
Location*
Greensboro
Training Sponsored or Provided by*
NC Septic Tank Association
Septage Land Application Site Operator Training Completed
Date Hours
10/18/2022 3
Location
Greensboro

Training Sponsored or Provided by
NC Septic Tank Association
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
12/14/2022
12:37:08 AM
Print Name* Title*
Eric Gann Pres

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, Chris Powell -- City, of Eden Wastewater Treatment Plant Chief Operator / ORC
(Plant Operator and Name of Plant)
204 Mebane Bridge Road -- Eden NC 27288
(Address)
336-627-1009 ext.130 do hereby authorize Eric Gann
(Phone Number) (Owner/Operator of Septage Management Firm)
of Gann Brothers Septic Tank Service Inc. NCS#
f Septage Management Firm Name and NCS number)
to dispose of: domestic septage X , portable toilet waste X
grease septage (grease trap pumpings) N/A commercial/industrial septage N/A from
Rockingham County and surrounding counties
(County or other Geographic Area)
at the above named wastewater treatment facility. Septage shall be discharged at:
Mebane Bridge Wastewater Treatment Plant -- 204 Mebane Bridae Road Eden, NC 27288
(Location)
between the hours of 7:00 a.m. - 4:00 p.m. Monday — Friday -- Septage will be accepted after hours by appt. only
After hours & emergencies call: 336-627-1009 ext. 4
Reintroducing partially treated liquid into a grease trap is acceptable Yes X` No
This authorization shall be valid until December 31 2023
Signed /� Date
(Facilit perator)
orn to and subscribed before me this !—n
(Notary Public) .
day of () 120 2-2--
My Commission expires:
UJ r
/
Note: Falsification of this document by the septage management firm shall lead to permit revocation.
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