NCS00880_2023Permit_Initial

2023
Permit and Registration
Travel Resorts of North Carolina, LLC
is hereby issued a Septage Management Firm Permit,
STATE,,
Permit Number NCS-00880
o and registered as a
e:,e D E
-�� 12 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. Moore County Water Pollution Control Plant, Aberdeen, 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
Wm Perry by Wm Perry
Perry
Sugg
Sugg Date: 2023.02.20
09:41:48-05'00'
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
V.) Firm name: (The "Firm name" mast be exactly as it is shown on your vehicle(s)).
P-,Jf- L- o r N C L A C
Street address of office: L4:1 11,c
City:] tiJ S State: Zip: z--)Z 8 1
Mailing address (if different): e i�"
City:
State: Zip
Phone: - D Fax:
E-Mail C_C D
County:yc- I v t a 00 5eptage Management Firm permit number: NCS # QQ 850
(2.) Firm owner's name:
Mailing address (if different).
city. -
Phone,
State: Zip
Fax:
(3.) Firm operator's name: - i —p►y_`i r2G)2 =: Firm operator's title u)L,6-'1
Mailing address (if different):
City:
Phone:
State: Zip:
Fax;
(4.) Type(s) of septage pumped: (Example: Domestic; 50,000).
Domestic Portable Toilet Waste Grease (Restaurant) Treatment Plant IndustriadCommercial
(5.) N.C. Counties of Operation, Gr-f
(List each county you are authorized to do business in)
K) Total Number of Pumper Vehicles Operated
Number used for: Domestic Septage:
Other:
Vehicle Information: {use additional paper if needed)
Grease (restaurant):
Portable Toilet Waste:
APPLICATION CONTINUED ON PAGE 2
PAGE 1

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? ( VJ yes ( ) no Initial pate 7- - [p �3
(8.) Septage Disposal Method: (check one)
a) Approved wastewater treatment plant: ( --'ryes { } no. If yes, submit Wastewater Treatment Authorization for each
plant, as indicated in Subparagraph .0834(c)(14) of the Septage Management Rules.
b) Septage Land Application Site (SLAS) Permit Numbers: (use additional sheets if needed)
SLAS#: Expiration Date: SLAS#' Expiration Date:
c) Septage Detention or Treatment Facility (SDTF) Permit Numbers: (use additional sheets if needed)
SDTF#: Expiration Date: SDTF#: Expiration pate: _
(9.) Septage Management Firm Operator Training Compteted
Date: tZ ' 13 ' Z 2 _ Location. o Fpi J_ Hours:
aca,�1,6
Training Sponsored or Provided by: �{ �a��FtEf— ���,�
00.) Septage Land Application Site Operator Training Completed:
Date: Location:
Training Sponsored or Provided by:
(11.) Registration type requested: CHECK ONE
Registered Portable Sanitation Firm:
Registered Septage Management 1=i:
Registered Portable Sanitation and Septage Management Firm:
Certification Statement
Hours:
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.
Signatur (Sig ature o ompanyofFicial required) Date
"`�o D
Print Name
Other Comments;
--i� E -Z- L s 4/1
Title
PAGE 2
Rev. 04-26-2021

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, Stephen G Morgan, ORC, Biological WW Operator 4 #997509, Moore County Water Pollution Control Plant
(Plant Operator in Responsible Charge (ORC), ORC License Number, Name of Plant)
910-947-4345
(Phone Number)
of
1094 Addor Road Aberdeen, North Carolina 28315
(Address)
do hereby authorize 6A6 4 Ce,
(Owner/Operator of Septage Manage nt Firm)
ems Or A JC L'o,
(Septa�e Mi�regement Firm Name and NCS number)
to dispose of: domestic septage Yes , portable toilet waste Yes
grease septage (grease trap pumpings) No commercial/industrial septage 11—thoft=tion4ulmd . from
Within the boundaries of Moore County, North Carolina OR a contracted service area of the WPCP
(County or other Geographic Area)
at the above named wastewater treatment facility. Septage shall be discharged at:
Septic Receiving Station located at the Moore County WPCP (unless otherwise specified by the ORC)
(Location)
between the hours of 7:00am to 5:00pm, Monday thru Friday (excluding observed holidays)
Reintroducing partially treated liquid into a grease trap is acceptable Yes No No
This authorization shall be valid until
Signed
(Facility Operator)
Subscribed and affirmed before me this
f
/I/
December 31, 2023
(Usually December 31, Year)
10-///-o2- ;7
day of 19ef4111114,e- 20 ZZ
IGI - r i� s: June 28, 2027
(Notary Public) Sa muel A Ring
Samuel A Ring
' NOTARY PUBLIC (OFFICIAL SEAL
�CEIVED
Aw� Moore County, NC RECEIVED
— - I NOV 17 2022
Note: Falsification of this document by the septage management firm shall lead to permit revocation.
S:/Solid_Waste/CLA/SEPTAGE/FORMS/2018 Firm Application/WWTP Authorization Form 2018
SOLID Wv.°r: vECTION

NC SEPTAGE MANAGEMENT FIRM
Recertification of Pumper Vehicle(s)
Septage Firm Permit #: NCS- 50
Number of Pumper Vehicles:
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."
Sig to&Sig of company official required)
--R Qo �s Gt--�
Print Name
Date
Tite
I -2-ZZ
S:%Solid WastelclalseptagelformslPumper Vehicles Cetification.doc