NCS00020_2023Permit_Initial

2023
Permit and Registration
Honey -Well Septic Tank Service
is hereby issued a Septage Management Firm Permit,
sTArE� _ Permit Number NCS-00020
oand registered as a
NORTH
A%L 12 t
-�� Septage Management Firm�� �� w� ��nffii�utr
4sr
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. Lower Creek WWTP, City of Lenoir, NC
2. Septage Land Application Site, SLAS 12-03
3. Septage Detention or Treatment Facility, SDTF 12-03
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 Perry Digitallysigned by Wm
Perry Sugg
023.02.01 12:01:59
Sugg 05'00'
Perry Sugg, Environmental Compliance Branch Head

APPLICATION FOR PERMIT TO OPERATE A SEPTAGE �iiANAGEMENT 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 vehicle(s)).
3.
Street address of office:
City: %X R rV! c .tJ State: Ali Or Zip:,,
Mailing address (if different):
City:
State: Zip
Ph on '7 Fax:
County: is « a ,X L Septage Management Firm permit number: NCS # D eCC20
(2.) Firm owner's name: -M A s k -S ZE lJ 6 L L 0 ea
Mailing address (if different):
City:
State: Zip
(3.) Firm operator's name:A0A R K mil% tj &A) (- e o /< Firm operators title: " A;k 0 SkA ®2
Mailing address (if different):
City: State:
Phone: t-ax:
(4.) Type(s) of septage pumped: Write in the number of aal- Ions nymoed in last 12 months (Example: Domestic: 50,000).
Domestic I Portable Toilet Waste I Grease
(5.) N.C. Counties of Operation:
you are authorized to
(6.) Total Number of Pumper Vehicles Operated: Q
Number used for: Domestic Septage: D AV 0 Grease (restaurant):
Other. Portable Toilet Waste:
Vehicle Information: (use additional paper if needed)
Plant I Industrial/Commercial
Fui
License Tag #
Vehicle Identification #
Tank Capacity
1
1 li3c-A
121A 4
2
3
4
5
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? (V�yes ( ) no Initial Date Jed -1v -,2Q.
(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#: ,a-A3Expiration Date: SLAS#: Expiration Date:
c) Septage Detention or Treatment Facility (SDTF) Permit Numbers: (use additional sheets if needed)
SDTF#: ja - Q-X Expiration Date: SDTF#: Expiration Date: _
(9.) Septage Management Firm Operator Training Completed: Y
Date: Location: C 6 ,rV ✓F V-S J 0.0 C 'r'� 'Hours: �T
Training Sponsored or Provided by: W . _ IIs, I * .
(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.
Sig, aaturre Signature of companyofficial required)
n,44R SIEVFk? eook
Print Name -
Other Comments:
Date
n �
Title
Rev.04-26-2021
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.
I, Donnie R. Hawkins ORC. WWTP Operator 4 (987625), City of Lenoir - Lower Creek WWTP (NC0023981
(Plant Operator in Responsible Charge (ORC), ORC License Number, Name of Plant)
1905 Broadland Road. Lenoir NC 28645 +P.O. Box 958. Lenoir_. NC 28645)
(Address)
281757-2198 do hereby authorize
(Phone Number)
Mark Steven Cook
(Owner/Operator of Septage Management Firm)
of Honey -Well Septic Tank Service NCS # 00020
(Septage Management Firm Name and NCS number)
to dispose of: domestic septage X , portable toilet waste
grease septage (grease trap pumpings) commerciallindustrial septage from
Caldwell. Burke. Catawba. Watauaa
(County or other Geographic Area)
at the above named wastewater treatment facility. Septage shall be discharged at:
Septage Receiving Station _zQ Lower Creek WWTP
(Location)
between the hours of 7:00 a.m. until 7:00_Lm- Monday through Saturday
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)
C �
Signed Date
(Facility Operator)
Subscribed and affirmed before me this
(Notary Public)
day of Ili eWcxe K 20 Z Z
My Commission expires: 2� Z023
,eexx EZH . Z
(0F,�L SEAL) G9oy
ZO
NOTARY ?=
J
Note: Falsification of this document by the septage management firm shall lead to permit revocation. PUBLIC 0=
S:/Solid Waste/CLA/SEPTAGE/FORMS/2016 Firm ApplicationMNlrrP Authorization Form 2016Cj ! Q e

AUTHORIZATION TO DISCHARGE SEPTAGE AT A SEPTAGE LAND APPLICATION
SITE PERMITTED TO SOMEONE OTHER THAN YOURSELF
(This form is used by a land application site permit holder to indicate that permission has been
given to a permitted Septage Management Firm to land apply septage on the permit holders
land application site.)
1, Cl- (/A QL--
(Site Operator)
z 0 0 f d L-{ /''i
(Operator Address)
Va/ fVc 2e �F
do hereby authorize: 60 A R f !S; I)e IJ ii' Ali Coo)
o)
(Owner of Septage Management Firm)
S4:-I lt- � A A-) k f= � r c 6 NCS # O O Q O
(Name of Septage Management Firm )
(Septage Management Firm Address)
to use septage disposal site # l Z— C�) for the disposal of /0 0, 0 c,0- gallons of septage* in 20 �3
Date: / �" 2 SignedL�97�
''
(Site Operator)
* As defined in G.S. 130-A-290(a)(32). The site will be operated in accordance with 15A NCAC 13B
.0800 - Septage Management Rules
Return the properly completed form to:
North Carolina Department of Environmental Quality
Division of Waste Management
Solid Waste Section
1646 Mail Service Center
Raleigh, NC 27699-1646

AUTHORIZATION TO DISCHARGE SEPTAGE AT A SEPTAGE TREATMENT OR
STORAGE FACILITY PERMITTED TO SOMEONE OTHER THAN YOURSELF
(This form is used by a detention or treatment facility permit holder to indicate that permission
has been given to a permitted Septage Management Firm to discharge septage into the permit
holders detention or treatment facility.)
L C' kl,
(Facility Operator)
(Operator Address)
do hereby authorize: A R K
(Owner of Septage Management Firm)
AV 1 LU l �S E 1 ��TAAj K 9► r i= N CS # O O- n
Name of Septage Management Firm)
(Address of Septage
to utilize septage detention or treatment facility # Z�G3
septage *
nt Firm)
for the treatment or storage of
in 20 2 ) . The facility will be operated in accordance with the Septage Management Rules **
Date:( 2' ` 7-1-"
* As defined in G.5.130A-290(a)(32)
** As defined in 15A NCAC 13B .0800
Signed
(Facility Operator)
Return the properly completed form to:
North Carolina Department of Environmental Quality
Division of Waste Management
Solid Waste Section
1646 Mail Service Center
Raleigh, NC 27699-1646

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C SEPTAGE MANAGEMENT FIRM
Zecertification of Pumper Vehicle(s)
Septage Firm Permit #: NCS- D 0 o? C.
Number of Pumper Vehicles:�' C "E
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."
��Z— �.
Signature (Signature of company official required) Date
k jEU6A) PQ C9 A d V4VEb 0 Z A a
Print Name Title
S:%Solid WastelcialseptagelformslPumper Vehicles Cetification.doc

North Carolina Department of Environmental Quality
Division of Waste Management INVOICE
NORTH �(QU� My Solid Waste Section
Division of Waste Management
To: Mark Steven Cook
Solid Waste Section Honey -Well Septic Tank Service
1646 Mail Service Center 2984 NC18 US64
Raleigh, NC 27699-1646 Morganton, NC 28655
Phone/Fax: [phone]
Email: [e-mail]
PAID
CK. NO. .?ILT`
DATE-LLf AZ
;i� S�'a. OD
Septage - Annual:
Honey -Well Septic Tank Service (NCS-00020)
2984 NC18 US64
Morganton, NC 28655
Number of Trucks:1
Date: 09/27/2022
Invoice #: NCS-00020-2023
$550.00
Date Due: E 12/15/2022
LATE FEES: • • +nr.e with INC General Statutes GS 130A-291.1(e2), a late fee will be applied to any annual permit fees not submitted by January t 2023.
Payment Options:
E-check Available online at httos://deq.nc.gov/swg_av
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 httos://deq.nc.gov/swg_ay
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) - httos://deq.nc.gov
North Carolina Solid Waste Program - rt=s;adeo.nc.00viabQui/divisions/waste-management/solid-waste-section
North Carolina Septage Management Program - htps7/dgg.ncnovlaboutldivisions/waste-management/solid-waste-sec ion.'sriecial-wastes-and-alternative-
handling seotaae