NCS00637_2023Permit_Initial

2023
Permit and Registration
Kearns Pumping Service
is hereby issued a Septage Management Firm Permit,
STATE,,
Permit Number NCS-00637
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. Town of Troy WWTP, Troy, 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 Perry Digitallysigned by
Wm Perry Sugg
Suqq Date: 2023.02.16
10:31:33-05'00'
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*
Kearns Pumping Service, Inc.
The "Firm name" must be exactly as it is shown on your vehicle(s).
Septage Management Firm permit number (NCS #)
NCS-00637
Enter the five digits following the NCS #
Street address of office*
Street Address
216 Shaw Rd.
Address Line 2
City
State / Province / Region
Troy
NC
Postal / Zip Code
Country
27371
United States
County*
Montgomery
Mailing address same as street address of office?*
Yes • No
Mailing Address*
Street Address
PO BOX 115
Address Line 2
City
State / Province / Region
TROY
NC
Postal / Zip Code
Country
27371
United States
Phone* Fax
9105760681
Email*
[e-mail]
Owner Info
Firm owner's name*
TODD KEARNS
Mailing address same as street address of office?*
Yes 0 No

Mailing Address*
Street Address
PO BOX 115
Address Line 2
City
TROY
Postal / Zip Code
27371
State / Province / Region
NC
Country
United States
Phone* Fax
9105760681
Operator Info
Firm operator's name*
Firm operator's title
TODD KEARNS
PRESIDENT
Mailing address same as street address of office?*
Yes • No
Mailing address*
Street Address
PO BOX 115
Address Line 2
City
State / Province / Region
TROY
NC
Postal / Zip Code
Country
27371
United States
Phone* Fax
9105760681
Type and amount of septage pumped in the last 12 months
Amount in gallons*
Domestic 272,000
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: *
MONTGOMERY RICHMOND STANLY ANSON RANDLOPH MOORE DAVIDSON
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
Date*
10/21/2022
Title*
PRESIDENT / OWNER
Choose how to add vehicle descriptions*
• Add vehicles individually Upload List
Pumper Vehicles
Usage* License Tag #* Vehicle Identification #* Tank Capacity*
Domestic Septage YA002762 2NPLHN7X78M758723 2,500
Domestic Septage YA46793 1FDXR82ASNVA31825 2,300
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*
TOWN OF TROY
Septage Land Application Sites (SLAS)
Yes • No
Septage Detention or Treatment Facility (SDTF)
Yes • No
Expiration Date* Authorization
12/31/2022
Other disposal method*
Yes 0 No
Septage Management Firm Operator Training Completed �,

Date* Hours*
10/19/2022 6
Location*
GREENSBORO
Training Sponsored or Provided by*
NC Septic Tank Association
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
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
TOM k' Wff
Date
10/20/2022
10:08:39 AM
Print Name* Title*
TODD KEARNS PRESIDENT

North Carolina Department of Environmental Quality
Division of Waste Management
NORTH CAROI.INA INVOICE
Fnv WOU.&V Solid Waste Section
Division of Waste Management -To: Todd Kearns
Solid Waste Section Kearns Pumping Service
1646 Mail Service Center 370 Shiloh Road
Raleigh, NC 27699-1646 Troy, NC 27371
Phone/Fax: [phone]
Email: [e-mail] I FI-M
�
CK. NO. �dS2� Date: 09/27/2022
DATE Invoice #: NCS-00637-2023
BCD, ego
Description Due
Septage - Annual:
Kearns Pumping Service (NCS-00637)
370 Shiloh Road $800.00
Troy, NC 27371
Number of Trucks: 2
Date Due: 1211512022
LATE FEES:' ;4—rdance with NC General Statutes GS 130A-291.1(e2), a late fee will be applied to any annual permit fees not submitted by January 1, 2023.
Payment Options:
E-check Available online at https:Hdeq.nc.aov/swpaay
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.00v/swpaay
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 available on the web:
North Carolina Department of Environmental Quality (DEQ) - https:Hdeg.nc.ciov
North Carolina Solid Waste Program - htts d n v bou tdivision waste -man emenLsolid-waste-section
North Carolina Septage Management Program - httasYldee.nc.gov/abouUdivisions/waste-manaaemenUsolid-waste-section/s ,ecial-wastes-and-alternative-
handling/septaae

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.)
do hereby authorize:
(Facility Operator)
In Y h1 e- 2 73 -71
(Operator Address)
Todd I\eOrr,S
(Owner of Septage Management Firm)
KEARNS PUMPING SERVICE, INC NCS # 00637
(Name of Septage Management Firm)
216 SHAW ROAD, TROY, NC 27371
(Address of Septage 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: 1,2-5- 2 -ZSigned
(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 Environrr
Division of Waste Management
Solid Waste Section
1646 Mail Service Center
Raleigh, NC 27699-1646
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NC SEPTAGE MANAGEMENT FIRM
Recertification of Pumper Vehicle(s)
Septage Firm Permit #:_ NCS- bp Qn Q3
Number of Pumper Vehicles: --a,
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)
61WDoA--1'-e)Ad Kaa- -A-s
Print Name
Date
S:lSolid WastelcialseptagelformslPumper Vehicles Cetification.doc

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