NCS00516_2023Permit_Initial

2023
Permit and Registration
Foster Septic Tank Cleaning
is hereby issued a Septage Management Firm Permit,
ZNti STATE
Permit Number NCS-00516
o and registered as a
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NORTH
EQ
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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. City of Oxford WWTP, Oxford, NC
2. Warren County WWTP, Warrenton, NC
3. Louisburg WRF, Louisburg, 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 Perr Digitally signed by
Y Wm Perry Sugg
Sugg 113 15 09-050'00'Z
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*
FOSTER SEPTIC TANK CLEANING LLC
The "Firm name" must be exactly as it is shown on your vehicle(s).
Septage Management Firm permit number (NCS #)
NCS-00516
Enter the five digits following the NCS #
Street address of office*
Street Address
625 Lake View Rd
Address Line 2
City
State / Province / Region
Henderson
NC
Postal / Zip Code
Country
27537
USA
County*
Franklin
Mailing address same as street address of office?*
Yes • No
Mailing Address*
Street Address
PO Box 2386
Address Line 2
City
State / Province / Region
Henderson
NC
Postal / Zip Code
Country
27536
United States
Phone* Fax
252-438-5750
Email*
[e-mail]
Owner Info
Firm owner's name*
Donna Bullock / Wanda Foster
Mailing address same as street address of office?*
Yes 0 No

Mailing Address*
Street Address
PO Box 2386
Address Line 2
City
Henderson
Postal / Zip Code
27536
State / Province / Region
NC
Country
United States
Phone* Fax
252-438-5750
Operator Info
Firm operator's name* Firm operator's title
J. Donald Foster Operator
Mailing address same as street address of office?*
Yes • No
Mailing address*
Street Address
PO Box 2386
Address Line 2
City State / Province / Region
Henderson NC
Postal / Zip Code Country
27536 United States
Phone* Fax
252-438-5750
Type and amount of septage pumped in the last 12 months
Amount in gallons*
Domestic 892,824
Portable Toilet Waste 0
Grease (Restaurant) 0
Treatment Plant 0
Industrial/Commercial 0
North Carolina counties of operation
List each county you plan to do business in: *
Franklin, Granville, Warren, Person, Vance, Halifax, Nash, Wake, Durham,
Vehicle Info
Do you plan to operate pumper vehicles?*
0 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
Pcw A aeq
Date*
12/12/2022
Title*
Co -Owner
Choose how to add vehicle descriptions*
• Add vehicles individually Upload List
Pumper Vehicles
Usage* License Tag #* Vehicle Identification #* Tank Capacity*
Domestic Septage YA157608 2NP3LJOX8MM733664 3,500
Domestic Septage YA015701 5PVNV8JV182S50993 2,500
Septage Disposal Method
For each method, indicate whether you plan to use it by checking yes or no.
Approved wastewater treatment plant*
• 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* Expiration Date* Authorization
WARREN COUNTY WWTP 12/31/2023 FSTC WARREN 972.48...
COUNTY WWTP
AUTHORIZATION
FORM 2023.pdf
TOWN OF LOUIIBURG WRF 12/31/2023 FSTC TOWN OF 1.09MB
LOUISBURG
WWTP
AUTHORIZATION
FORM 2023.pdf

CITY OF OXFORD WWTP 12/31/2026 FSTC CITY OF 1.08MB
OXFORD WWTP
AUTHORIZATION
FORM VALID
TIL 2026.pdf
Septage Land Application Sites (SLAS)
Yes • No
Septage Detention or Treatment Facility (SDTF)
Yes • No
Other disposal method*
Yes • No
Septage Management Firm Operator Training Completed
Date* Hours*
12/3/2022 4
Location*
1025 Blue Ridge Rd, Raleigh, NC 27607
Training Sponsored or Provided by*
NC Pumper Group & NC Portable Toilet Group
Septage Land Application Site Operator Training Completed
Date Hours
0
Location
Training Sponsored or Provided by
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
I submitted class certificate to Jared Wilson at [e-mail].
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
kma, A04
Date
12/11/2022
09:14:54 PM
Print Name* Title*
Donna Bullock Co -Owner

AUTHORIZATION TO DISCHARGE SEPTAGE TO ►4 WASTEWATER TREAT MENT FACILITY
North Carolina C]epartrr'mernt of tnvirorrnental {duality
Division of waste Management - Solid Waste Seetlon
1646 Mail Service Center, Rateigh, NC 27649-160
Fee assessments and waste d etermirsati ons will be required at the discretion of the wastewater
treatment facility, The facil ty ha.s the ultimate prerogative to deny discharges of any wastes trj the
tncomhg vvastewater stream.
(Plant Operator in Responsible Charge (09C), C License Number, Name of Plant)
�l U a }AI.' ---L`'PiJ3F"� J.J
(Addrexs}
ej '? ?9 - y -19 4 da herebvau#hod ze � ,�. �.�ztir�:lr�r ��/I -- _ --
(Phone Number) (owner/Operator of 5eptage Management Farm)
of _ / y ter— t �'t ;r 1�1 `.s 4 6 C s e-
f5eptage Management Flrm Name aAd NCS riumhLrj
to,dispose af: domestic septage _ N'- poi table toliet waste
grease septage (grease trap purnpirsus) T commercial/industrial septage . from
---- (Cointy or ether Geagraphk Area)
at the above named wastewater treatment facility. Septage shall be discharged at:
�,. f i
�L.00t3ti0ii}
bQtwoon this hours of ' fp. --
Reintroducing partially treated liquid into a grease trap is acceptable Yes No
This authorization shall be valid until .� L -;YD _ —_
(L7sually December 31, Year)'
Signed - - -� pate {
{FaClity Operatw) i.l�i
. '�i
Sub5crloed and affirmed before me this _ -_ day of �•�~��� 20 I
Ivey comrnISSion expires: �'�.x°.4 ' 1 ° � j ' S
;Notary Pubflcr
Nolte; Falsification of this document by the septage manaVmeAt firm shad leaf to
S;j:4litf-:Waste/c1A/5EPr40Ffr0RMill U].8..i aaApalis�tii?ri rWWPAutherizaftviform2018
4
0111thlflile Ill,,..
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1OFFICIAL SEA ' ! " ° '"s.
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permit (ervocation t :to. Af,,,IBL'�

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. .
.rO 46A G, T
�E/Llj-o -1
{'Vans UPerator and arse of Plant)
p� ,t -`-)Uii -b",r
vKY
(Address)
�.I t( -a167
do hereby authorize �n
(Phone Nurnberj
- _ (0merloperator of Septage Management Firm)
Of n"fif 1 r �I k f / /'
(septage Management Firm Name Td NC nnumber)
0(X- I
to dispose of: domestic septage portable toilet waste 42�
grease septage (grease trap pumpings) &C7 commercial/industrial septage /t/ 0 -, from
75
r— 0
(County or other Geographic Area)
at the above named wastewater treatment facility. Se Cage shall Pe disci arged. at:
i
between the hours of
r2 — _� cle Iri -
Reintroducin 9 p . p r • ZNOg partially treated liquid into a rease tra is aces table Yes
This authorization shall bAalid until 16� —YI — ;oaj
Signed
Operator)
[Usually 0ecernber31, Year)
Date L� `J — -X P,;'
Nom❑ and subs 'bed re day of 20
My Commission expires:
(Notary Public)
Err
.A
Nate: Falsification 0Fthis document by the septage management firm shall lead to permit rev ocaticiIA
h:dalseptagefformslauthorizlaIW4%wwtp auth-2006 �'yy ,� e"o C► +
." ouK r`t

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, Raieigh, 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, William R. Perkinson ORC License Number 987831
(Plant Operator in Responsible Charge (ORC) and ORC License Number)
Warren Count WWTP, 73$ t}S Hw 401 S. PC BMX 2$1 Warrenton NC 27589
(Address)
252-257-1776 do hereby authorize J. Donald Foster
{Phone Number} (Owner/Operator of Septage Management Firm)
of Foster 5e tic Tank Cleaninp, LLC NCS 900516
(Septage Management Firm Name and NC number)
to dispose of: domestic septage X portable toilet waste X
grease septage (grease trap pumpings) commercialAndustrial septage from
Warren Vance Granville and surrotindin counties
(County or other Geographic Area)
at the above -named wastewater treatment facility. Septage shall be discharged at:
Influent works
(Location)
between the hours of 8:00 AM - 3:30 PM Monday - Friday
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)
Signed l Date [� _ _ Z—Z'
{Fardi(y Operator)
Sworn to and subscribed before me this day of �I]� .20 ),1
Z t - My Commission expires: -S
(Notary Public)
���►1i4E1�001i,®
(O�����
Dote, Falsification of this document bythe septage management firm shall lead to permit revocation, 1;7 T— y
5 !Solid Waste/CLAPSEPTAGEIFGFtMS12013 Firm Application7WWTP Authorization Form 2013
/o1111 f§100 �

2022 EDUCATIONAL TRAINING
51~MINAR
CONDUCTED BY
NORTH CAROLINA PUMPER GROUP
NORTH CAROLINA PORTABLE TOILET GROUP
THIS CERTIFICATE IS AWARDED TO
Foster Septic Tank Cleaning LLC
Donna Bullock
NCS# 516
IN RECOGNITION OF COMPLETION OF ANNUAL EDUCATIONAL TRAINING
FOR SEPTAGE MANAGEMENT AND PORTABLE SANITATION FIRMS
❑N SATURDAY, DECEMBER 3, 2022 IN RALEIGH, NC
4 CREDIT HOURS
K. JACKSON STANCIL, EXECUTWE DIRECTOR
NC PUMPER GROUP & NC PORTABLE TOILET GROUP