NCS00899_2023Permit_Initial

2023
Permit and Registration
Tripp's Outback
is hereby issued a Septage Management Firm Permit,
�szArr of
Permit Number NCS-00899
o and registered as a1 7 D
-�= Septage Management Firm Department fE w� rmentalQulity
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. Town of Murphy WWTP, Murphy, 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 09:45:41-05'0 00'
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*
Tripp's Outback
The "Firm name" must be exactly as it is shown on your vehicle(s).
Septage Management Firm permit number (NCS #)
NCS #0899
Please enter the complete NCS #, including the 5 end digits (NCS-XXXXX)
Street address of office*
Street Address
333 REGAL RD
Address Line 2
City
State / Province / Region
Murphy
North Carolina
Postal / Zip Code
Country
28906
us
County*
Cherokee
Mailing address same as street address of office?*
• Yes No
Phone*
Fax
8283613634
Email*
[e-mail]
Owner Info
Firm owner's name*
Willard Beaver III
Mailing address same as street address of office?*
• Yes No
Phone* Fax
8283613634
Operator Info
Firm operator's name* Firm operator's title
Willard Beaver III Owner
Mailing address same as street address of office?*
0 Yes No

Phone* Fax
8283613634
Type and amount of septage pumped in the last 12 months
Amount in gallons*
Domestic 42,250
Portable Toilet Waste 0
Grease (Restaurant) 0
Treatment Plant 0
Industrial/Commercial 0
North Carolina counties of operation}
List each county you plan to do business in:
Cherokee, Clay, Macon, Graham
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
ul Awa /V
Date*
12/29/2022
Title*
Owner
Choose how to add vehicle descriptions*
• Add vehicles individually Upload List
Pumper Vehicles
Usage* License Tag #* Vehicle Identification #* Tank Capacity*
Domestic Septage YA75186 1HTGGG3T5LH217836 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*
Town of Murphy WWTP
Septage Land Application Sites (SLAS)*
Yes • No
Septage Detention or Treatment Facility (SDTF)*
Yes • No
Other disposal method*
Yes • No
Expiration Date* Authorization *
12/31/2023 image_123927... 3.21MB
(1).JPG
Septage Management Firm Operator Training Completed^
Date* Hours*
10/14/2022 6
Location*
FRANKLIN NC
Training Sponsored or Provided by*
NC Septic Tank Association
Septage Land Application Site Operator Training Completed
Date Hours
0
Location
Training Sponsored or Provided by
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

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
Date
12/29/2022
11:24:44 AM
Print Name* Title*
Willard Beaver III Owner

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.
Wi�f
giant operator In Responsible Charge (ORC), ORC License Number, Name of Plant)
3 9 0 _ �g 6 S�-rec rvulr off u m c. 7.R cfr) to
g�$`SS-1-12101 do hereby authorize
(Phone Number) r i
(Owne
511
u+b
perator of Septage Management Firm)
NCS#00q Iq
(Septage Management Firm Name and NCS number)
to dispose of: domestic Septage ✓
grease septage (grease trap pumpings)
portable toilet waste
commercial/industrial septage , from
(County or other Geographic Area)
at the above named wastewater treatment facility. Septage shall be discharged at:
w WTP
(Location)
between the hours of pQUAM" 67)-Oi'M
�7
Reintroducing partially treated liquid into a grease trap is acceptable Yes No
This authorization shall be valid until "—��r (Usually December 31, Year)
Signed
Date / /8 A
(Facility Operator)
(Notary Public)
me this day of
NL ZeiOU
top
s
I —
JoFnCIAL SEAL) 1
C; Poe
Note: Falsification of this docu
ment by the septage management firm shall lead to permit revocation.-. -
S,/Solid_Waste/CLA/SEQTAGE/FORMS/2018 Firm AppcicationAv1 %JTP Authorizatjan form 2018
My Commission expires:

NC SEPTAGE MANAGEMENT FIRM
Recertification of Pumper Vehicte(s)
Septage Firm Permit #:
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."
f
Print Name
company official r+equire�
ti
Date
Title
5`tSdd Waste�faisep�agetformslPumper Vehicles Ceti6cation.doc