NCS00470_2023Permit_Initial

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NORTH CAROLINA
Environmental Quality
2023
Permit and Registration
Boswell & Son Septic Tank Service, Inc.
is hereby issued a Septage Management Firm Permit,
Permit Number NCS-00470
and registered as a
Septage Management Firm
(PUMPER)
in the State of North Carolina.
PlORTH CAROLiNA �EQ
wll�pl
Department of Environmental Quality
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. Septage Land Application Site, SLAS-33-06
2. Septage Detention or Treatment Facility, SDTF-33-06, SDTF-98-08
3. Tar River Regional WWTP, Rocky Mount, 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.
Digitally signed
Wm Perry by Wm Perry
Sugg
Sugg Date: 2023.02.02
13:13:40-05'00'
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
(11.) Firm name: (The "Rim name" must begge& as it is shown an your vehicle(s)).
Se_,tvtce_
Street address of office: 6 10 1 L 1 e--,' A& d
nkokv%_' Statw.-X _e- Zip: 2- 2 YO
Mailing address (if different);
City: el -I —State: Zip
Phone: ilrt Fax:
E-Mail:
County.--- Septage Management Firm permit number. NCS # #VD
(2.) Firm owner's name:
Mailing address (if different): ig
C:dy:— State: —Zip
Phone: —Fax:-
(3.) Firm opemilor's name: 610-k-e-&PS W f— I \ -Firm operator's title:
Mailing address (if different):
City: 4 state: — zip:
Phone: J,
Fax:
(4.) Typq(s) of septage pumped: Write in the number of gallons Round in last 12 month (Example: Domestic: 50,000).
Domestic
1-Tortable Toilet Waste I Grease (Restaurant) TreatmentPlant Industrial/Commercial
-VIL120 I PIZ 100
(5.) N.C. Counties of Operation: Ce_Q^bC
(List each county you are authorized to do business in)
(6.) Total Number of Pumper Vehicles Operated:
Number used for Domestic Septage: -2-
O#W.—
Vehicle Information: (use additional paper if needed)
7-
Grease (restaurant): '-7
Portable Toilet Waste:
APPLICATION CONTINUED ON PAGE 2
PAGE I

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 138.0838(a). I am aware that there are significant penalties for alse certification including the
possibility of fine and imprisonment"
Do you attest to the statement above? (�/) yes ( ) no Initial_fDate
(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 theSeptage Management Rules.
b) Septage land Application Site (SLAS) Penn' Numbers: (use additional sheets if needed)
SLAS#: 33-04, Expiration Date:J� tA i SLAS1f: _ __ ._ Expiration Date:
c) Septage Detention or Treatment Facility (ST�F)) Permit Numbers: (use additional sheets if needed)
SDTF#: 33-0b Expiration Dab 40 SDTF#: 0 T? Expiration Date: .
(9.) Septage Management Firm Operator Training Completed:
Date:.._ 9 — _) - 2-2- Location: Gt/�%o n Hours:
Training Sponsored or Provided by: Ale-5
(10.) Septage Land Application Site Operator Training Completed:
Date: T-I Location: 4.41 A.> -•, Hours:
Training Sponsored or Provided by:
Af el- S % 1 --
(11.) Registration type requested: CHECK ONE
Registered Portable Sanitation Firm:
Registered Septage Management Firm:
Registered Portable Sanitation and Septage Management Firm:
Certification Statement
1 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 staterent, representation, or certification.
Signature (Signature of companyoffrcialmquired)
'$ Iak' #-- B vs ts� l
Print Name
Other Comments:
Date
Title
PAGE 2
Rev. 04.26.2021

ROCKY MOUNT
WATER RESOURCES
THE CENTER OF IT ALL
SEPTAGE DISPOSAL PERMIT (SDP)
Boswell and Son Septic Tank Service, Inc,
6101 Nobles Mill Pond Road
Rocky Mount, NC 27801
CRM-00470
Permit Number
N/A
40 CFt Category
The City of Rocky Mount (City) agrees to allow the discharge of septage wastewaters collected
as described in Part I, D, into the Tar River Regional Wastewater Treatment Facility; herein
"WWTP", at the designated disposal site:
Tar River Regional WWTP
3031 Treatment Plant Rd
P.O. Box 1180
Rocky Mount, NC 27802-1180
Edgecombe County
NPDES Number: NCO030317
Effective date, this permit and the authorization to discharge shall become effective at midnight
on this date:
January 1, 2023
Expiration date, this permit and the authorization to discharge shall expire at midnight on this
date:
December 31, 2023
Aarn-esls-
Costello, Wastewater Superintendent
City of Rocky Mount
Subscribed and affirmed before me this
Date
day of b U 20 9
My Commission Expires:
(Notary Public)
Beverly Anne Harrelson Ricks
NOTARY. PUBLIC [OFFICIAL SEAL]
Nash County, NC

r
SDP, PART 1, OUTLINE
A. Basic Information:
B.
Receiving POTW name:
Tar River Rep
A.)
Basic Information
B.)
Terms of Permit
C.)
Modification History
D.)
Description of Discharges
ional WWTP
SDP Name:
Boswell and Son Septic Tank Service,
Inc
SDP Original Effective Date:
January 1, 2023
SDP Expiration Date:
December 31, 2023
Location of Accepted Waste(s):
Ed ecombe, Nash, and Wilson Counties
POTW NPDES #:
Permit Number:
NCO030317
CRM-00470
Pipe Numbers, list all regulated pipes:
_ Designation not aptilicable.
SDP 40 CFR # (if applicable), or NIA:
NIA
Terms of Permit
1. The customer must follow the City's Rules for Septage Haulers. These rules define
the requirements for discharging wastewater into the WWTP.
2. Only the wastewater described in Part I, D is allowed. A sample may be collected
from each load and submitted to the laboratory for analyses. Should discharge and/or
results indicate a problem, the septage hauler will be contacted immediately and not
allowed to discharge again until issue is resolved.
3. All wastewater shall meet the Sewer Use Ordinance restrictions for pH, flammability,
metals, toxic and hazardous wastes, or any other restrictions that may be included.
4. The monthly fee for disposal shall be identified in the Septage Hauler Rates
information. Each time wastewater is to be discharged, a City form shall be
completed by the driver of the vehicle PRIOR to discharge that identifies the type of
wastewater to be discharged, volume discharged, and the address and phone number
of the location that the wastewater was generated. The original form will remain at
the WWTP; the driver shall remove the carbon copy of the form for his records.
5. Discharge shall occur during the hours of 7:30 am to 5:00 pm, Monday through
Friday. Discharge may occur after hours and on holidays for an additional charge. In
an emergency, please contact City personnel for instructions. At the discharge site,
the driver of the vehicle is to ensure that the area is kept clean and free of debris. If
there is a problem during discharge, or a spill the driver shall halt discharge and
immediately contact facility personnel. Failure to do either of these may result in
revocation of dumping privileges.
Should the Terms of Permit be violated, penalties will be imposed which may include fines
and/or loss of dumping privileges.

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.)
441 Buck Newsome Rd. Fremont, NC 27830
do hereby authorize:
Boswell & Son Septic Tank Service
Daniel L Newsome
(Facility Operator)
(Operator Address)
Blake Boswell
(Owner of Septage Management Firm)
00470
NCS #
(Name of Septage Management Firm)
419 Flood Store Rd. Rocky Mount, NC 27803
(Address of Septage Management Firm)
(00953)
98-08
to utilize septage detention or treatment facility # for the treatment or storage of septage
in 2023._The facility will be operated in accordance with the Septage Management Rules **.
11-01-22
Date: _ _ _ Signed
it r)
* As defined in G.S.130A-290(a)(321
** As defined in 15A NCAC 13B .0800
Return the properly completed form to:
North Carolina Department of Environment and Natural Resources
Division of Waste Management
Solid Waste Section
1646 Mail Service Center
Raleigh, NC 27699-1646

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.)
I, TE21 C--'s 14-". (
(Site Operator)
do hereby authorize:
(Operator
4- -c- l39swe- �'t
(Owner of Septage Management Firm)
S-es viee-T-4 C
(Name of Sep age Management Firm )
(9 to l 13 abt FS A C t 1 �10.1 ci 2.cj 9 (%—
(Septage Ma
# 4-7 D
A,a+x--'47Z < Z
ent Firm Address)
to use septage disposal site # .?�D(o for the disposal of 3S' f` o gallons of septage* in 20 Z3
Date: 7- Z-
Signed''
(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.)
r (Facility Operator) ,r
f o n 4 g 3 rZ C_1� j l VLD l,A-A& ./,J C- Z IS-C f
(Operator Address)
LA, e-t�
do hereby authorize: fly :� i (< �'� , �.c } I tr1 % 9--e-r L
(Owner of Septage Management Firm)
t c . NCS # ``f `70
(Name of Septage Management Firm)
,,1, ( eo^d 4uQ.�c
(Address of Septagd Management Firm)
to utilize septage detention or treatment facility # "� for the treatment or storage of
septage *
in 20 The facility will be operated in accordance with the Septage Management Rules **.
Date: I 1 �/ 2 �` Signed
(Facility Operator)
* As defined in G.S.130A-290(a)(32)
** As defined in 15A NCAC 13B .0800
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

NC SEPTAGP MANAGEMENT FIRM
Recertification of Pumper Vehicle(s)
Septage Firm Permit #: NCS- 14170
Number of Pumper Vehicles:
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)
!�, kk 0- 13S�SwYz t
Print Name
Date
Title
S:%Solid_Wastelclalseptagelforms%Pumper Vehicles Cetification.doc