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HomeMy WebLinkAboutNCS01000_2023Permit_Initial2023 Permit and Registration Braxton Septic Tank Service is hereby issued a Septage Management Firm Permit, ZNti STATE Permit Number NCS-01000 o and registered as a e:,e D NORTH EQ 4%L 12. 9* -�� Septage Management Firm�� �� w� ��nffii�utr E� M 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-25-10 2. Septage Detention or Treatment Facility, SDTF-25-10 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 M Digitally signed by Wm Perry Perry Sugg Sugg Date: 2023.02.23 13:51:57-05'00' 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* Braxton Septic Tank Service The "Firm name" must be exactly as it is shown on your vehicle(s). Septage Management Firm permit number (NCS #) NCS-01000 Enter the five digits following the NCS # Street address of office* Street Address 9900 US HWY 17 N Address Line 2 City State / Province / Region Vanceboro NC Postal / Zip Code Country 28586 US County* Craven Mailing address same as street address of office?* • Yes No Phone* Fax 2522440713 Email* braxton.brandon@gmail.com Owner Info Firm owner's name* Michael Braxton Mailing address same as street address of office?* • Yes No Phone* Fax 252-244-0713 Operator Info Firm operator's name* Firm operator's title Brandon Braxton co-owner Mailing address same as street address of office?* 0 Yes No Phone* Fax 252-229-0483 Type and amount of septage pumped in the last 12 months Amount in gallons* Domestic 283,025 Portable Toilet Waste 0 Grease (Restaurant) 18,550 Treatment Plant 0 Industrial/Commercial 0 North Carolina counties of operation List each county you plan to do business in: * Craven, Beaufort, Pamlico, Carteret, Onslow, Pitt, Jones 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 Date* 12/14/2022 Title* Co-owner Choose how to add vehicle descriptions* • Add vehicles individually Upload List Pumper Vehicles Usage* License Tag #* Vehicle Identification #* Tank Capacity* Domestic Septage YA14985O 1FVHCYBSO9HAM6697 3,550 Septage Disposal Method For each method, indicate whether you plan to use it by checking yes or no. Approved wastewater treatment plant* Yes 0 No 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 #* Expiration Date* Authorization SLAS-2510 2/2/2027 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 #* Expiration Date* Authorization SDTF-2510 2/7/2027 Other disposal method* Yes • No Septage Management Firm Operator Training Completed Date* Hours* 10/19/2022 4 Location* Greensboro Bur -mil Club Training Sponsored or Provided by* NC Septic Tank Association Septage Land Application Site Operator Training Completed^ Date Hours 10/19/2022 3 Location Greensboro Bur -Mil club 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 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 t I � 1.,E Date 12/14/2022 08:38:29 AM Print Name* Title* Brandon Braxton Co-owner