NCS00033_2023Permit_Initial

2023
Permit and Registration
Robinson Septic Tank Cleaning
is hereby issued a Septage Management Firm Permit,
�szArr of
"� Permit Number NCS-00033
o and registered as a e D, E
A Q
-�= Septage Management Firm �� fE wrnmentall llty
44 QIIAM
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. West Brunswick Regional WWTP, Supply, NC
2. Septage Detention or Treatment Facility, SDTF-10-13
3. Septage Land Application Site, SLAS-10-13
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
Sugg
Digitally signed by Wm
Perry Sugg
Date: 2023.02.01
15:48:42-05'00'
Perry Sugg, Environmental Compliance Branch Head

-_State: _ Zip:
Fax:
R) Firm operator's name: 9 Y Nc�✓+,� Firm operator's title:
Mailing address (if different):
city: State: Zip:
r) 4-J.
Phone: Fax:
zou
(4.) Type(s) of septage pumped: Write in the number of gallons pumtaed in AM (Example: Domestic: 50,000).
Domestic
°►b ao
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 vehicle(s).
Street address of office: ZI e b B i Ne�rc �N
City: ?` S!, State: N C Zip: Z f 4 z c
Mailing address (if different):
City: State: Zip:
Phone: 4( o— 7 SS'- 7 b*7 0 Fax:
E-Mail:
County: r Mts w t ek Septage Management Firm permit number: NCS # 61co3.3
(2.) Firm owner's name: R v o n 14 pwt T °'._CaS� ;jrrve N�-
Mailing address (if different):
City:
Phone:
Treatment Plant Industrial/Commercial
(5.) N.C. Counties of Operation:
Portable Toilet Waste I Grease
(List each county you do business in)
(6.) Total Number of Pumper Vehicles Operated: 3
Number used for: Domestic Septage:_ 3 Grease (restaurant):
Other: Portable Toilet Waste:
Vehicle Information: (use additional paper if needed)
License Tag # _ Vehicle Identification # Tank Ca a
1 I 1 1171 7-,�&G
2 161 1 ab C71 Z+S 35-vo
3 2cav
4 1 7 H 41 FZ 14 fl C v 4S l} t! Sl 4s7 3 6 re
APPLICATION CONTINUED ON PAGE 2
PAGE 1

APPLICATION FOR PERMIT TO OPERATE A SEPTAGE MANAGEMENT FIRM
(CONTINUED FROM PAGE 1)
(7.) Septage Disposal Method: (check one)
a) Approved wastewater treatment plant: [ yes no. If yes, submit Wastewater Treatment Authorization
for each plant, as indicated in Subparagrapr .08304) of the Septage Management Rules.
b) Septage Land Application Site (SLAS) Permit Numbers: (use additional sheets if needed)
SLAS#: 0-13 Expiration Date: W 712oa_ SLAS#: Expiration Date:
c) Septage Detention or Treatment Facility (SDTF) Permit Numbers: (use additional sheets if needed)
SDTF#: to-111 Expiration Date: —kLZI 42-5 SDTF#: Expiration Date:
(8.) Septage Management Firm Operator Training Completed:
Date: HIIIJ 7o2,2 Location: S, At 1, f-�z Hours: b
Training Sponsored or Provided by: NC sr
(9.) Septage Land Application Site Operator Training Completed:
Date: U ! 1 V 20,2-2 Location: S'h 41 i, i+c Hours:
Training Sponsored or Provided by: NC Sr
(10.) Registration type requested: CHECK ON
Registered Portable Sanitation Firm:
Registered Septage Management Firm:
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.
f" 4tc�- --
Signature (Signature of company official required)
Print Name
Other Comments:
II: b. 2oLL
Date
PreyIle't4-
Title
S"JS011d_Waste:/GLA/SEPTAGE/FORMS/2016 FPm Application/FomP@PmitApplication20l6
PAGE 2

North Carolina Department of Environmental Quality
Division of Waste ManagementINVOICE
-NORF,nr&Mm oQU Solid Waste Section
Division of Waste Management To: Ryan Hewett
Solid Waste Section Robinson Septic Tank Cleaning
1646 Mail Service Center 2166 Big Neck Rd NW
Raleigh, NC 27699-1646 As 28420
Phone/Fax: [phone]
Email: [e-mail] PA D
CK. NO.. (q72
DATE . t V15/z2 ,
g0o. o o Date: 09/27/2022
Invoice #: NCS-00033-2023
Septage - Annual:
Robinson Septic Tank Cleaning (NCS-00033)
2166 Big Neck Rd NW $800.00
Ash, NC 28420
Number of Trucks: 3
Date Due: 12/15/2022
LATE FEES: accordance with NC General Statutes GS 130A-2911(e2), a late fee ,ll be applied to any annual permit fees not submitted by January J. 2023.
Payment Options:
E-check Available online at https.//deo.nc. ov/swpay
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 https:Hdeq.nc.gov/sway
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 Jared Wilson [phone]
Regulations or Technical Assistance Chester Cobb [phone]
Jeffrey Bullard [phone]
More information vailable on the
North Carolina Department of Environmental Quality (DEQ) - https://deq.nc.aov
North Carolina Solid Waste Program - httas://deq nc.govlabouVdivisionslwaste-manaQemenL/solid-waste-section
North Carolina Septage Management Program - h s: d .nc. v abou divisions•'waste-manaaemen solid-waste-sectio s ial-wastes-and-alternative-
handlino/septaoe

AUTHORIZATION TO DISCHARGE SEPTAGE TO A WASTEWATER TREATMENT FACILITY
North Carolina Department of Environmental Quality
Division of Waste Management - Saiid 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 strearrk.
I, Matthew Henry, -0998880, West Brumwick Regional Wastewater Treatment Faci11ty
1Ptant Operator in Responsible Charge (ORC), ORC License Number, #Marne of Plant} - -
35 gmy Water Road, Supply, IBC 28462
(Address)
(910) 755-7 70 do hereby authorize Ryan Hewett
(phone Number} (Owner/operator of Septage Management Firm)
of Robin;on's Septic Tank Cleaning, LLB' NCS # 00013.
(Septage Management Firm Name and NCS number)
to dispose of. domestic septage . portable toilet waste
grease Septage (grease trap purnpings) commercial/industrial Septage _ , from
Brunswick Couo
(County or other Geographic Area)
at the above flamed wastewater treatment facility. Septage Shall be discharged at:
We' L t Brunswick Regional Waste atef Treatment Fac:ihty, 235 grey Water Road, Supply, 1ti C
3Location)
between the hours of Monday-Fniday 9 a.m - 6 p.m., Weekend-,, & Holidays 9 a.m. - 5 p.m.
Reintroducing partially treated liquid into a grease trap is acceptable Yes X No
This authorization shall be valid until December 31 023
(Usually December 31, Year)
Signed����
Date
(Facility Operator)
h4anlxw Hunry personally known uo me
Subscribed and affirmed before me this _ day of "t . 20 s
ftiAy commission expires:
(Notary Public)
N01=���a col i na
Brunswick County
My Co- issio pire5
Nate. Falsif kation of this dacu ment by the septage management rwrn shall WW to permit revixation.
S15olid Wa- [W/CWHFrAGU{ ORMS/20L9 Firm AW ica6Q 3fWV TP A thariza ian Farm 2M

NC SEPTASEPTAGE MANAGEMENT FIRM
Receirtification of Pumper ehid
eptage Firm Permit :_ N- Goa
Number of Pumper Vehicles;
CERTIFICATION:
`'I certify, under penalty of law, that the pumper vehicle or vehicles listed ire the
submitted permit application meet the requirements for safe and sanitary
transportation of septage as required by15A NCAC 1 3B -0844 (a) and vehicle
lettering as required by 15A N CAC 13 B .5544 (b). I also cer#i#y that a log is
maintained of each septage pumping event as required by 1 A NCAC 1 B .0839
(a)- I am aware that there are signlicant penalties for false certification including
the possibility of fine and imprisonment-':
L �
Signature (Signature of cmparry official mquired)
A- 14z%V et
Print Name
( i l 2-
Dift
pres;r�
Title
S-SSolid WastOkc Qo septagelforn,slPumper Vehicles Cetification-doe