NCS00868_2023Permit_Initial

2023
Permit and Registration
Dennis Willis Septic Service
is hereby issued a Septage Management Firm Permit,
STATE,,
Permit Number NCS-00868
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. Septage Land Application Site, SLAS-36-10
2. Septage Detention or Treatment Facility, SDTF-36-10
3. McAlpine Creek WWTP, Charlotte, NC
4. Cherryville WWTP, Cherryville, 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
Perryby Wm Perry Sugg
Sugg Date: 2023.02.20
09:39:07-05'00'
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
(1.) Firm name: (The "Firm name" must bete/xagg as it is shown on your vehicle(s)).
t? Y1 vv 1
Street address of office: ;� 1 a l Fez i r wav t .
City: h C {` State: �
Zip: �!
_..
Mailing address (if different):
City: h. State: L Zip a s as l
Phone: 70y - Fax: 7 D (09 —ga oj7
E-Mail: NS�
County:_. (a ck5}V (1 Septage Management Firm permit number: NCS # DO 9 3
(2.) Firm owner's name: 1 Wl 1 1i S
Mailing address (if different): As A UL
City:
Phone:
State: Zip
Fax:
(3.) Firm operator's name: 9 PDen k Wil I I S Firm operator's title: w
Mailing address (if different): 1 Above —
City: State: Zip:
Phone: Fax:
(4.) Type(s) of septage pumped: Write in the number of aallons pumped in last 12 months (Example: Domestic: 50,000).
Domestic Portable Toilet Wassiej Grease (Restaurant) Treatment Plant Industrial/Commercial
4 9 700 I0 q Q
(5.) N.C. Counties of Operation: Gw ton Oe
(List each county you are authorized to do business in)
(6.) Total Number of Pumper Vehicles Operated:
Number used for. Domestic Septage: _ Grease (restaurant): 3
Other: Portable Toilet Waste:
Vehicle Information: (use additional paper if needed)
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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) (✓) 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? ( 4es ( ) no Initial � IN Date I - IY a a
(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#: &' ? _ Expiration Date: - -a d SLAS#: Expiration Date:
4 Re wod mold IeA 7-
c) Septage Detention or Treatment Facility (SDTF) Permit Numbers: (use additional sheets if needed)
SDTF#: (o l0 Expiration Date: is- -� SDTF#: Expiration Date:
y �{�newal rxai�poi Il-ly-�a.
(9.) Septage Management Firm Operator Training Completed:
Date: ) -a 7 " as Location: o^ Hours:
Training Sponsored or Provided by: k J rA -
(10.) Septage Land Application Site Operator Training Completed:
Date: " a ? L Location: n Hours:
I-t Training Sponsored or Provided by: s_
(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.
Signatu[.6h, �_IA'
(ig re of companyotiicial required)
Print Name
Other Comments:
Date
d vines
Title
Rev. 04-26-2021
PAGE 2

CHARLOTTE
WJ)TER
AUTHORIZATION TO DISCHARGE SEPTAGE TO A WASTEWATER TREATMENT
FACILITY
I, Bill Gintert / Environmental Com Dliance Manager
Charlotte Water - System Protection CLTWater - SP
4222 Westmont Drive Charlotte, NC 28217 704-336-4407
Do hereby authorize Bryson Willis
(Authorized Representative)
Of
Dennis Willis Septic Service
(Septage Management Firm Name)
To dispose of Septage X Portable Toilet Waste X
Note: 1) Grease trap waste is not allowed at the disposal sites.
2) Re - introducing partially treated liquid into a grease trap is not allowed in the
Charlotte Water system.
From: _Mecklenburg County and Surrounding Areas;
(County or other Geographic Area)
At the below named Wastewater Treatment Facility; Septage shall be discharged;
McAlpine Creek Wastewater Treatment Plant IMCWWTP) Septage Receivinn Station
Between the hours of 7:30 a.m. until 11:00 a.m. and 12:00 p.m. until 3:45 p.m. Mon. -Fri.
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.
This authorization will be effective: January 1st 2023
This authorization shall be valid until: December 31st 2023
Signed: L ), Date: 7-7 -- W Zz--
(Environmental Compliance Manager)
Note: Falsification of this document by the Septage management firm shall lead to permit revocation.

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.
Larril WrlflkC. q-V 0
In Responsible Charge (ORE), ORC License Number, Name of Plant)
(Address)
do hereby authorize U-50A I W1,
(Phone Number) tC (Owner/O erator of Septage Management Firm)
of pleylyi1S WI 11115 �edf!L JuVIL�' NCS#
(SeptagJ Management Firm Name and NCS number)
to dispose of: domestic septage , portable toilet waste AtIA
grease septage (grease trap pumpings) /Y commercial/industrial septage J from
Che
t (County or other Geograbhic Area)
at the above named wastewater treatment facility. Septage shall be discharged at:
(Location) AA
between the hours of • 00 ,_.DIY Mon. — F' ( .
Reintroducing partially treated liquid into a grease trap is acceptable Yes /'No
This authorization shall be valid until I of _ 51 r
(Usually December 31, Year)
Date 1 t —15 - 22—
(FacilityAerator)
Subscribed and affirmed before me this Is day of N ov__ 20 2-2-
My Commission expires: QL 2.�
(Notary Public)
\X��� pp.1�1 RIIV�'�i�,G
ICIAL SE,
Notary Public
Cleveland -A
County
My Comm. Exp.
Note: Falsification of this document by the septage management firm shall lead to Arr$it rm*M897 �r
5:/Solid_Waste/CLA/SEPTAGE/FORMS/2018 Firm Application/Morn) Authorization Form 2018 0
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. l - NorthCarolina Department of Environmental Quality
Division of Waste Management INVOICE
EnvRonAROLlMA Solid Waste Section
rtWromwtentd Quarr:
Division of Waste Management
Solid Waste Section
1646 Mail Service Center
Raleigh, NC 27699-1646
Phone/Fax: [phone]
Email: [e-mail]
Septage - Annual:
Dennis Willis Septic Service (NCS-00868)
PO Box 86
Cherryville, NC 28021
Number of Trucks: 3
To: Dennis Willis
Dennis Willis Septic Service
PO Box 86
Cherryville, NC 28021
FEDV
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DATE,
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1 Roo, oz.)
Date Due: I
Date: 09/27/2022
Invoice #: NCS-00868-2023
LATE FEES: in accordance 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
Credit Card
Paper check
Available online at https://deo.nc. ov/swoay
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.
Available online at https//deo.nc.gov/swoay
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 2.6S% added to amount invoiced.]
Make checks payable to N.C. Division of Waste Management;, Solid Waste Section, include Permit Number and invoice number on
check. � you are paying by electronic transfer, include the invoice number with your electronic transfer. Please return a copy of this
invoice iv, j payment
[G.S. 25-3-506: A,$25.00 processing fee will be charged on all returned checks.j
f-Y,pjanation 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.
Forquestions reoarding:
Billing
Regulations or Technical Assistance
Jared Wilson [phone]
Chester Cobb [phone]
Jeffrey Bullard [phone]
M:_ re inf.-)rmation :vailable on the web:
North Carolina Department of Environmental Quality (DEQ) - httns://dea.nccLov
North Carolina Solid Waste Program - https://dea.nc.aov,/about/divisions/waste-management/solid-waste-section
North Carolina Septage Management Program - httuyideci_rc.yovi,�,bQuudMsiuns,waste-manWement/solid-waste-sectiorVsr,,ieial-wastes-and-alternative
handling/septage