NCS00612_2023Permit_Initial

2023
Permit and Registration
Donahue Septic Tank Co.
is hereby issued a Septage Management Firm Permit,
ZNti STATE
Permit Number NCS-00612
o and registered as a
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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. TZ Osborne WRF, Greensboro, 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 by
Wm PerrywmPerrySugg
Sugg 1D0:294O23O.O2O.O16
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
(1.) Firm name: (The "Firm name" must be exactly as it is shown on your vehicle(s)).
Donahue Septic Tank Service
Street address of office: 5506 Fairwav Run Drive
City: McLeansville State: NC Zip: 27301
Mailing address (if different):
City: State: Zip
Phone: Fax:
E-Mail: [e-mail]
County: Guilford Septage Management Firm permit number: NCS ## 00612
(2.) Firm owner's name: Keith Donahue
Mailing address (if different):
City:
State: Zip
Phone: [phone] Fax:
(3.) Firm operator's name: Keith Donahue Firm operator's title: Owner
Mailing address (if different):
City: State: Zip:
Phone: [phone] Fax:
(4.) Type(s) of septage pumped: Write in the number of galions pumaed in last 12 oaths (Example: Domestic: 50,000),
Domestic Portable Toilet Waste Grease (Restaurant) Treatment Plant Industrial/Commercial
220,000
(5.) N.C. Counties of Operation: Guilford
(List each county you are authorized to do business in)
(6.) Total Number of Pumper Vehicles Operated:
Number used for: Domestic Septage: 1 Grease (restaurant):
Other: Portable Toilet Waste:
Vehicle Information: (use additional paper if needed)
License Tag #
Vehicle Identification #
Tank Capacity
1
YA36718
1 XPBD59X1 LN297456
2,000
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) ( Y) yes ( ) no.
If you checked yes above, you must attest to the following statement before a permit may be issued.
"1 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 1313.0836(a). I am aware that there are significant penalties for false certification including the
possibility of fine and imprisonment." len
Do you attest to the statement above? ( x) yes ( ) no Initial Date
11 /15/22
(8.) Septage Disposal Method: (check one)
a) Approved wastewater treatment plant: ( x ) 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#: Expiration Date: SLAS#: Expiration Date:
c) Septage Detention or Treatment Facility (SDTF) Permit Numbers: (use additional sheets if needed)
SDTF#. Expiration Date: SDTF#. Expiration Date:
(9.) Septage Management Firm Operator Training Co
ftered Septage 6
Date: 10/18/22
Location: Hours:
Training Sponsored or Provided by:
(10.) Septage Land Application Site Operator Training Completed:
Date: Location: Hours:
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
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.
Keith Donahue
Signature (Signature of companyofficiai requiretq
Keith Donahue
it Name
Other Comments:
11/15/22
Date
Owner
Title
Rev_04-26-2021

CITY OF GREENSBORO
WATER RESOURCES DEPARTMENT
INDUSTRIAL WASTE SECTION
HAULED WASTE DISCHARGE PERMIT
In compliance with the standards and regulations adopted
by the North Carolina Environmental Management Commission,
and the regulations and policies established by the City of Greensboro
Donahue Septic Tank Service
is hereby authorized to discharge hauled domestic septage at the
T. Z. OSBORNE WASTEWATER TREATMENT PLANT
NPDES PERMIT NCO047384
This permit is effective
JANUARY 1, 2023
This permit expires
DECEMBER 31, 2023
boro Industrial Waste Section Signature/Seal/Date
City of Greensboro CY2023 Hauled Waste Discharge Permit: Page 1 of 1

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.
Bradley Flynt (Grade IV 27171) ORC for T Z Osborne Water Reclamation Facility
(Plant operator in Responsible Charge (ORC), ORC License Number, Name of Plant)
2350 Huffine Mill Road, McLeansville NC 27301
336-433-7262
(Address)
Keith Donahue
do hereby authorize
(Phone Number) (Owner/Operator of Septage Management Firm)
of Donahue Septic Tank Service NCS 4 612
(5eptage Management Firm Name and NCS number)
to dispose of: domestic septage XXX portable toilet waste NO
grease septage (grease trap pumpings) NO commercial/industrial septage NOfrom
Guilford County NC
(County or other Geographic Area)
at the above named wastewater treatment facility. Septage shall be discharged at:
City of Greensboro T. Z. Osborne Water Reclamation Facility
(Location)
between the hours of 7:00 a,m. - 6:00 p.m. Monday through Saturday
Reintroducing partially treated liquid into a grease trap is acceptable Yes XX No
This authorization shall be valid until December 31, 2023
(usually December 31, Year)
Signed v(GC Date
(F cility Aerator)
Subscribed --aIrff'rrn�efore me this day of QC7C78��, 20
My Commission expires: _/"/�Y ZI 202—Y
(Notary Public)
✓/ am
2026
Note: Falsification of this document by the septage management firm shall lead to permit revocation.
S:/Solid_Waste/CLA/SEPTAGE/FORMS/2018 Firm Application/WWTP Authorization Form 2018

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