NCS00721_2023Permit_Initial

2023
Permit and Registration
Howlett's Septic Tank Cleaning Service
is hereby issued a Septage Management Firm Permit,
STATE,,
Permit Number NCS-00721
o and registered as aD E
-�� Septage Management Firm ��en� f� w� nmental Ouallty
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. Septage Detention or Treatment Facility, SDTF-25-08
2. Town of Creswell WWTP, Creswell, NC
3. Town of Columbia WWTP, Columbia, 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 Perry Wm Perry Sugg
Sugg Date: 2023.02.16
10:38:36-05'00'
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 27699-16U
(1.) Firm name: (The "Firm name" must be exactiv as if is shown on your vehisle(s)).
Street address of office: ij.1 5 N e. r vee.1G 1R _ _ -
City: _ e, v( t. State: u L Zip:_ 7 9 A s
Mailing address (if different):
City: State: Zip:
Phone:.) 706-03Q-0 Fax: "oZ —744-0S"77
E-Mail: .»sTAw c tLL It JEL 47Ai I - yam - --- —
County: T'r1 i' >v Septage Management Firm permit number: NCS # 100%dti
(2.) Firm ownees name:_ --
Mailing address (if different): L -NA a 5 R dAmf S !4 t 6 S R ,,,t r va 1G IQ�
City: � ° Q (v Zip: a- 7 y 2-
Phone: Fax: _ �Y
(3,) Firm operator's name: !':no f SV W 14080 W- - /, d, do"*tm operator's title: O ln% Il%Gr g
Mailing address (if different):
City:
State: Zip.
Phone: Fax: --
(4.) Type(s) of septage pumped: We in the number of gallons aumW in fast 92 Uonths (Example: Domestic:
50,000).
Domestic j Portable Toilet Waste
(5.) N.C. Counties of Operation:
Treatment Plant
each county you ire authorized to do business in)
Industrial/Commercial
(6.) Total Number of Pumper Vehicles Operated: _ 14 i/
Number used for: Domestic Septage: i/ Grease (restaurant): _ ag
Other: Portable Toilet Waste: a-
-"--Vehicle Information: (use additional paper if needed)
License Tag #
�1' l
71
3: -12
4 � T t rx
5
Vehicle Identification #
Tank Capac
a. sso
oa
ann..
==t1W.n
APPLICATION CONTINUED ON PAGE 2

PAGE 1
APPLICATION FOR PERN11T 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 Subparagraph .0833(c)(14) of the Septage Management Ruies.
b) Septage Land Application Site (SEAS) Permit Numbers: (use additions! sheets if needed)
SLAS# Expiration Dated' ,23 SLAS#: 0072.1 Expiration Date: 12 -3 D-3
aS'0
c) Septage Detention or Treatment Facility (SDTF) Permit Numbers: (use additional sheets if needed)
SDTF#: Expiration Date: SDTF#: Expiration Date:
(8.) Septage Management Firm Operator Training Completed: K1,44y aglir Nr.,
Date: _Sew- .7-..�� LocatiowTia q, s Vp�,r a Hours: �J
Training Sponsored or Provided by: V-a fit, r- .1 4&t
(9.) Septage Land Application Site Operator Training Completed:
Date: Location: Hours;
Training Sponsored or Provided by: w
(10.) Registration type requested: CHECK ONE
Registered Portable Sanitation Firm, -
Registered Septage Management Firm:
Registered Portabte 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.
Signature {Si nature of company official required}
Print Name
Dat��.-1N'��_L�_
tj a e.lr
Title --
oJu
I
Other Comments: _T 61,A/ j t+ A C eiti F i Cq` e- ra r -L 4 wA A W'ct1+o+v
To-- .Lratvev Ab 6erv�ce5. Xw IA f7e- atdJj46 gruotx-er^
rry c k fo 1" Y F If -el- Oej+- yew s tie- rr,ade A a#o—tme-
Ta gF f :4 ;wIp-ee4e4 r+ ;s j* 47 rF $oe) - 3AcojAl +.qw?.
5,80,i _','ias?erC AaEPTAGtr-OR? S�2016 Rtw-kppLca*oi r rnpe,,m Aoca.caton2o18
PAGE 2

��o

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.
3 W
(Plant Operator in Responsible Charge (ORC), ORC License Number, Name of Plant)
(Address)
do hereby authorize
(owner/O rator of Septage Management Firm)
(Phone Number)
.:
'`. NCS #
of
(Septage Management Firm Na and NCS number)
to dispose of: domestic septage _ `/ portable toilet waste
grease septage (grease trap pumpings)
commercial/industrial septage from
(County or other Geographic Area)
at the above named wastewater treatment facility. Septage shall be discharged at:
Location)
between the hours of
Reintroducing partially treated liquid into a grease trap is acceptable -Yes
�No
This authorization shall be valid until (Usually December 31, Year)
Signed 41
41�Y Date, 441_0
(Facility Operator)
-tin day of ML,6K, 20
Subscribed and affirmed before me this
_ 2�
My Commission expires: S
(NotaTy Public) `��`\\GNAPM'9yZ�'.
(0FFIC���,SEAL}2
FI
Note: Falsification of this document by the septage management firm shall lead to�l{leti e/vocati)1fGioorl.G�����
S:/Sotid /�
Waste/CLA/SEPTAGE/FORMS/2018 Firm Application/WWTP Authorization Farm 2018 �1,hhl++,; '`CC,��0\

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,
(Plant operator in Responsible Charge (ORC), ORC License Number, Name Plant)
(Address)
`776 -27V do hereby authorize
(Phone Number) (Ownerlbperator of Septage Management Firm) r
of 41 i. ` NCS
(Septage Management Firm N e and NCS number)
to dispose of: domestic septage L0,11, portable toilet waste
grease septage (grease trap pumpings) commercial/industrial septage _ from
(Co my or other Geographic Area) m
at the above named wastewater treatment facility. Septage shall be discharged at:
� . s f� �•r�..��,�-;tee ZrTZr
(Location)
between the hours of At 00 14 Yn t d ` V©
Reintroducing partially treated liquid into a grease trap is acceptable Yeso
This authorization shall be valid until Z*Ck'r62�
(Usua ly December 31, Year)
Signed ' Date 74� G rZ
(Facility Operator) �n
4ZUS!
this �/ dayMy Commission expires
NOTARY PUBUC
TYRRELL COUNTY
STATE OF NORTH CARC
Note: Falsification of this document by the septage management firm
S:/Solid,Waste/CLA/SEPTAGE/FORMS/2018 Firm Application/WWTP Authorization Form

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.)
(Facility Operator)
(Operator Address)
do hereby authorize: / is W °
(Owner of leptage Management Firm)
1 -NCS #
(Name of Septage Management Firm)
� � mob, � ti� �79�
(Address of Septage Management Firm)
to utilize septage detention or treatment facility # for the treatment or storage of
septage
in 20 2, The facility will be operated in accordance with the Septage Management Rules **.
Date: i �- 7" aY _ Signed
(Facility Operator)
* As defined in G.S.130A-290(a)(32)
** As defined in 15A NCAC 138.0800
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

S
eptage Firm Permit M. FMCS- -
Number of Pumpe.r Vehicles:
CERTIFICATION:
"I certify+, tA n d e r pen a I ty of La w. th at the p umper ve Mile or veh i cle s 11-SKed I n the
subrnitie J permit application meet the req+jifements to safe and sanitary
transportat+on of soptage as required by15A NCAC 13B .0844 (a) and ueh4che
lettering as required by 15A NCAC 13B .0 84 4 (b). 1 al-,o certify thm a hc-9 Gs
maintained of each septage pumping agent as required by 1 bA NCAC 139 -0839
(a), i am aware fhat there are si9nifiCant penalties. for false ceTUFication incMudLn-q
the p()Si bti i ty of fine and impr1roonment."
SIgnature . nja r@ of campany caal raquked)
W
Print 14 FMO
Date
Title
Ifef I nstiPum per V0 Mel 0 3 C glfl-cation , do-c