NCS00985_2023Permit_Initial

2023
Permit and Registration
Frank Hildreth Septic Tank
is hereby issued a Septage Management Firm Permit,
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Permit Number NCS-XXXX
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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. Anson County Regional WWTP, Wadesboro, 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.
W rn
Digitally signed
by Wm Perry
Perry
Sugg
Date: 2023.02.23
S u g g
13:50:21-05'00'
Perry Sugg, Environmental Compliance Branch Head

For questions regarding this form or the online application process, please contact Jeffrey Bullard (http://mailto:
[e-mail])(919-707-8285) or Chester Cobb (http://mail to:[e-mail])(919-707-8283).
Firm Info
Firm name*
Frank Hildreth Septic Tank
The "Firm name" must be exactly as it is shown on your vehicle(s).
Septage Management Firm permit number (NCS #)
NCS-0089$57
Enter the five digits following the NCS #
Street address of office*
Street Address
878 city pond road
HUU1Ubb LIIIC L
City State / Province / Region
wadesboro NC
Postal / Zip Code Country
28170 United States
County*
Anson
Mailing address same as street address of office?
* Yes O No
Phone Fax
704-695-1776 704-695-1664
Email
[e-mail]

Owner Info
Firm owner's name*
Frank Hildreth
Mailing address same as street address of office?*
® Yes O No
Phone* Fax
Operator Info
Firm operator's name Firm operator's title
Frank Hildreth Owner
Mailing address same as street address of office?*
Yes O No
Phone' Fax
Type and amount of septage pumped in the last 12 months
Amount in gallons*
Domestic 100,000
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:
Anson County Montgomery County Richmond County Stanley County Union County
Vehicle Info
Do you plan to operate pumper vehicles?*
CeJ Yes 0 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*
x
Date
Date will be captured on form submission
Title
Frank Hildreth Septic
Choose how to add vehicle descriptions*
O Add vehicles individually O Upload List
Septage Disposal Method
For each method, indicate whether you plan to use it by checking yes or no.
Approved wastewater treatment plant
Yes Q No
If yes, list the facilities below and upload or submit by mail a copy of Wastewater Treatment Authorization
(https://fiiles.nc.gov/ncdeq/DWM/SW/Composting%2520and%252OLand%252OApplication/WWTP%2OAuthorization.pdo 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 Expiration Date Authorization
01 Upload
+ Add another WWTP
Septage Land Application Sites (SLAS)
O Yes Q No
Septage Detention or Treatment Facility (SDTF)
Yes O No
If you are not the permit holder for the septage detention/treatment facility, you must have a signed detention/treatment authorization form
(https://fiiles.nc.gov/ncdeq/DWM/SW/Composting%2520and%252OLand%252OApplication/SDTF%2OAuthorization.pdf) for each site.
SDTF #* Expiration Date* Authorization
SDTF- J Upload
+ Add another SDTF
Other disposal method*
O Yes ® No
Septage Management Firm Operator Training Completed
Date
10/25/202
Location *
Monroe
Training Sponsored or Provided by*
NC Septic Tank Association
in
Hours*
6

Septage Land Application Site Operator Training Completed
Date
IE
Location
Training Sponsored or Provided by
v
Registration Type
Hours
0
Select one*
O Registered Portable Sanitation Firm
O Registered Septage Management Firm
* Registered Portable Sanitation and Septage Management Firm
Comments and Notes
Comments or notes
Certification Statement
1 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*
x
Date
12/8/2022
02:38:44 PM %,

Print Name*
Frank Hildreth
Save as Draft
Title
owner

FRANK 2022
Gallons
H I LDRETH
Discharged
January
30,000
February
15,000
March
2,500
April
7,500
May
10,000
June
5,000
July
5,000
August
September
12,500
Total Gallons
87,500
Billed

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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, GARY GARRISON 990415 ANSON COUNTY REGIONAL WASTEWATER TREATMENT PLANT
(Plant Operator in Responsible Charge (ORC), ORC License Number, Name of Plant)
POST OFFICE BOX 553 WADESBORO NC 28170
(Address)
704) 994-3281 do hereby authorize FRANK KENNETH HILDRETH
(Phone Number) (Owner/Operator of Septage Management Firm)
of FRANK HILDRETH SEPTIC TANK SERVICE NCS # NCS00985
(Septage Management Firm Name and NCS number)
to dispose of: domestic Septage 1XI , portable toilet waste 1XI
grease septage (grease trap pumpings) commercial/industrial Septage , from
ANSON COUNTY, MONTGOMERY COUNTY, RICHMOND COUNTY, STANLEY COUNTY & UNION COUNTY
(County or other Geographic Area)
at the above named wastewater treatment facility. Septage shall be discharged at:
THE MAIN LIFT — WWTP SITE —1360 HOLLYWOOD ROAD WADESBORO, NC
(Location)
between the hours of _ 7:30am & 4:30pm Monday— Saturday
Reintroducing partially treated liquid into a grease trap is acceptable Yes _[X]_No
This authorization shall be valid until DECEMBER 31, 2023
(Usually December 31, Year)
Signed / dew """kz) • Date 12/05/2022
(Facility Operator)
Subscribed and affirmed before me this 5th da of December, 2022
(Notary Public)
My Commission expires: May 12, 2024
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Note: Falsification of this document by the septage management firm shall lead to permit revocation.
S:/Solid_Waste/CLA/SEPTAGE/FORMS/2016 Firm Application/WWTP Authorization Form 2016

North Carolina Department of Environmental Quality
RO Division of Waste Management INVOICE
NORTH rm;�,. Solid Waste Section
Division of Waste Management
Solid Waste Section
1646 Mail Service Center
Raleigh, NC 27699-1646
Phone/Fax: [phone]
Email: [e-mail]
To: Frank Hildreth
Frank Hildreth Septic Tank
878 City Pond Rd
Wadesboro, NC 28170
P A I Sao
CK, NO. Mo 2.713,Sp/ b
DATE 11-13 -22
Date: 09/27/2022
Invoice #: NCS-00985-2023
Septage - Annual:
Frank Hildreth Septic Tank (NCS-00985)
878 City Pond Rd $550.00
Wadesboro, NC 28170
Number of Trucks:1
Date Due: 1211512022
LATE FEES: accordance with NC General Statutes GS 130A-291.1(e2), a late fee will be applied to o+iy annual permit fees not submitted by January I. 2023.
Payment Options:
E-check Available online at https://dea.nc.aov/swoav
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.
Credit Card Available online at https://deq.nc.gov/swIav
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.]
Explanation of Invoice Amoun 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.
For guesti9ns regarding -
Billing Jared Wilson [phone]
Regulations or Technical Assistance Chester Cobb [phone]
Jeffrey Bullard [phone]
More information available on the web:
North Carolina Department of Environmental Quality (DEQ) - https://deo.nc.gov
North Carolina Solid Waste Program - h • d .n ov■ b rdivi i ns w ste-m na emen lid -waste ion
North Carolina Septage Management Program - h s Id .nc. ov abou division waste mono emen slid -waste sectionrs ecial wastes and-alterna
handling septaoe