NCS00735_2023Permit_Initial

2023
Permit and Registration
PVI Enterprises
is hereby issued a Septage Management Firm Permit,
STATE,,
Permit Number NCS-00735
o and registered as a
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-�� Septage Management Firm�� �� w� ��nrai�utr
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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. Septage Land Application Site, SLAS-24-06
2. Septage Detention or Treatment Facility, SDTF-24-06
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: 2023.02.16
10:40:12-05'00'
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
0.) Firm name: (The "Firm name" must be exc as it is shown on your vehicle(s)).
�►n�'aYC11r f< Csa C
Street address of office: A`
city: � !
State. Zip:
Mailing address (if different):
City: State: Zip
Phone:_ Fax:
E-Mail: V 1 �Y1�Q Yak' i co aQi1 I,n ti. r.r, C�
(% County: ��1%S Septage Management Firm permit number: NCS #
(2.) Firm owner's name:
Mailing address (if different):
City: State: Zip
Phone: Fax:
(3.) Firm operator's name: SCvK\14& I A X Firm operator's title: Q-
Mailing address (if different):
City: State: Zip:
Phone: Fax:
(4.) Type(s) of septage pumped: JIMe in the number of gallons Aumned in last 92 months (Example: Domestic: 50,000).
Domestic I
Portable Toilet Waste Grease (Restaurant) 'Treatment Plant Industrial/Commercial
�5Z� Ito o_I
(5.) N.C. Counties of Operation: 19l �lJ
(List each county you are authorized to do business in)
(6.) Total Number of Pumper Vehicles Operated: _
Number used for: Domestic Septage: Grease (restaurant):
Other: Portable Toilet Waste: n
Vehicle Information: (use additional paper if needed)
License Tag # Vehicle Identification # Tank Capacity
I S;T� W ab-p(z to ut)
APPLICATION CONTINUED ON PAGE 2

APPLICATION FOR PERMIT TO OPERATE A SEPTAGE MANAGEMENT FIRM
(CONTINUED FROM PAGE 1)
(7.) Do you plan to operate pumper vehicles? (check one) (V) 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 13B .0836(a). I am aware that there are significant penalties for false certification including the
possibility of fine and imprisonment."
Do you attest to the statement above? (V) yes ( ) no Initial Date
(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) Permit Numbers: (use additional sheets if needed)
SLAS#: �q (Expiration Date:11%SLAB#: Expiration Date:
c) Septage Det ntion or Treatment Facility (SDTF) Permit Numbers: (use additional sheets if needed)
SDTF#: Expiration Date: 31-a3 SDTF# Expiration Date:
(9.) Septage Management Firm Operator Training Completed:
Date: — — �1 / - Location: _Sg Hours: b
Training Sponsored or Provided by:
(10.) Septage Land��l
pplication Site Operator Training Completed:
Date: _ a , `Location: p Hours: 3
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.
l _
ure (Signature of companyoificial required)
Print Name
Other Comments:
Date
PAGE 2
Rev.04-26-2021

NORTH CAROLINA
North Carolina Department of Environmental Quality
Division of Waste Management
Solid Waste Section
Division of Waste Management
Solid Waste Section
1646 Mail Service Center
Raleigh, NC 27699-1646
Phone/Fax: [phone]
Fmail:[e-mail]
INVOICE
To: James W Faulk
PVI Enterprises
PO Box 684
Tabor City, NC 28463
PA
•�Y ;.
CK. NO.`�`�
DATE
$Da. op
Date: 09/27/2022
Invoice #: NCS-00735-2023
Septage - Annual:
PVI Enterprises (NCS-00735)
PO Box 684
Tabor City, NC 28463 $800.00
Number of Trucks: 5
Date Due: 12/15/2022
LATE FEES: In accordance with NC General Statures GS 13OA-2911(1-2), a ('ate fee -will be applied to any annual peemit fees not submMea by January 1, 2023_
Payment Options:
E-check Available online at'a_
Requires bank acco, int 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
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.]
Ex I nati n of Invoice Amount is Based on Firm's Current Permit Status:
Pursuant to North Carolina General Statute 130A-29'1.1 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 uestions reciardiflLL
Billing
Regulations or Technical Assistance
Jared Wilson [phone]
Chester Cobb [phone]
Jeffrey Bullard [phone]
More information available on the web -
North Carolina Department of Environmental Quality (DEQ) -
North Carolina Solid Waste Program it •LL'% { c . { n. r r �i _ �t
North Carolina Septage Management Program