NCS00794_2023Permit_Initial

2023
Permit and Registration
Marshall Cummings Septic Tank Service
is hereby issued a Septage Management Firm Permit,
STATE,,
Permit Number NCS-00794
o and registered as a
e:,e D E
-�� Septage Management Firm ��en� f� w� nmenta�llty
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-78-18
2. Septage Detention or Treatment Facility, SDTF-78-18
3. City of Lumberton WWTP, Lumberton, 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 Perr Digitally signed by
Y Wm Perry Sugg
Sugg 14:15 09— 05 00'7
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*
Marshall Cummings Septic Tank Service
The "Firm name" must be exactly as it is shown on your vehicle(s).
Septage Management Firm permit number (NCS #)
NCS-00794
Enter the five digits following the NCS #
Street address of office*
Street Address
1234 W. McDuffie Crossing Road
Address Line 2
City
State / Province / Region
St. Paul's
NC
Postal / Zip Code
Country
28384
United States
County*
Robeson
Mailing address same as street address of office?*
• Yes No
Phone*
Fax
9107376310
Email*
[e-mail]
Owner Info
Firm owner's name*
Marshall Cummings
Mailing address same as street address of office?*
• Yes No
Phone* Fax
9107376310
Operator Info
Firm operator's name* Firm operator's title
Marshall Cummings Owner
Mailing address same as street address of office?*
0 Yes No

Phone* Fax
9107376310
Type and amount of septage pumped in the last 12 months
Amount in gallons*
Domestic 156,180
Portable Toilet Waste 0
Grease (Restaurant) 48,860
Treatment Plant 0
Industrial/Commercial 0
North Carolina counties of operation
List each county you plan to do business in: *
Robeson, Cumberland, Bladen, Hoke
Vehicle Info
Do you plan to operate pumper vehicles?*
• 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
d ed.4�,7-//
Date*
12/14/2022
Title*
Owner
Choose how to add vehicle descriptions*
• Add vehicles individually Upload List
Pumper Vehicles
Usage* License Tag #* Vehicle Identification #* Tank Capacity*
Domestic Septage YA1142401 1HTWNAZT99JO91150 3,500
Septage Disposal Method
For each method, indicate whether you plan to use it by checking yes or no.
Approved wastewater treatment plant*
0 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*
City of Lumberton
Expiration Date* Authorization
12/31/2023
Septage Land Application Sites (SLAS)
• Yes No
If you are not the permit holder for the septage land application site, you must have a signed land application authorization form for each site.
SLAS #*
SLAS-78-18
Expiration Date*
8/15/2023
Authorization
Septage Detention or Treatment Facility (SDTF)
• Yes No
If you are not the permit holder for the septage detention/treatment facility, you must have a signed detention/treatment authorization form for
each site.
SDTF #*
SDTF-78-18
Expiration Date*
5/29/2024
Authorization
Other disposal method*
Yes • No
Septage Management Firm Operator Training Completed
Date* Hours*
4/12/2022 4
Location*
Shallotte
Training Sponsored or Provided by*
NC Septic Tank Association
Septage Land Application Site Operator Training Completed^
Date Hours
4/12/2022 3
Location
Shallotte
Training Sponsored or Provided by
NC Septic Tank Association

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
SLAS-78-18 currently on file (not uploaded)
SDTF-78-18 currently on file (not uploaded)
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
d iaf����c:�ytd
Date
12/14/2022
02:05:05 AM
Print Name* Title*
Marshall Cummings Owner

AUTHORIZATION TO DISCHARGE SEPTAGE TO A WASTEWATER TREATMENT FACILITY
North Carolina Department of Environment and Natural Resources
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, HenryHarper; ORC # 1008147 City c,r Lumberton Waste Treatment Plant
(Plant Operator in Responsible Charge (ORC), ORC License Number, Name of Plant)
700 Lafayet` imberton NC 28358 Tammy Smith o1n_�71_zu�
(Address) (Contact / Phone Number)
do hereby authorize Marshall Cummings 910 737-6310
(Owner/Operator of Septage Management Firm)
of Marshall Cummings Septic Tank Service 1 1za %ni nnrr fie Cr. Rd St. Pauls NC 28384 NCS # 00794
(Septage Management Firm Name and NCS number)
to dispose of: domestic septage
grease septage (grease trap pumpings) _
portable toilet waste _ _ 'es
commercial/industrial septage , from
Robeson and Surrounding Counties
(County or other Geographic Area)
at the above named wastewater treatment facility. Septage shall be discharged at:
The Influent Basin at 700 Lafayette Street Lumberton NC
(Location)
between the hours of ' -im to 4 pm Monday — Friday. No weekends or Holidays
Reintroducing partially treated liquid into a grease trap is acceptable Yes X No
This authorization shall be valid until _
(Usually December 31, Year) , I
Signed Date
acility Operator)
Subscribed and affirmed before me this day of 110 vl , 20
My Commission expires:
(Nota blic)
RECEIVED DBLAD7ENCOUNTY,
MITH
^l'^� (OFFICIAL SEAL)BLIC
JAN 0 3 c; 231 NCes 10-19-2025Note: Falsification of this document by the septage management firm shall lead to permit revocation.�
S:/Solid_Waste/CLA/SEPTAGE/FORNS()1 VVAMSEA37MMuthorization Form 2014