NCS01115_2023Permit_Initial

2023
Permit and Registration
Long's Septic Pumping
is hereby issued a Septage Management Firm Permit,
ZNti STATE
Permit Number NCS-01115
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. West Brunswick Regional WWTP, Supply, 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 Date: 2023.02.23
14:33:59-05'00'
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*
Long's Septic Service
The "Firm name" must be exactly as it is shown on your vehicle(s).
Septage Management Firm permit number (NCS #)
NCS-01115
Please enter the complete NCS #, including the 5 end digits (NCS-XXXXX)
Street address of office*
Street Address
1935 Oyster Harbour Prkwy SW
Address Line 2
City
State / Province / Region
supply
NC
Postal / Zip Code
Country
28462
United States
County*
Brunswick
Mailing address same as street address of office?*
• Yes No
Phone* Fax
9105403139
Email*
[e-mail]
Owner Info
Firm owner's name*
Daniel and Tina Long
Mailing address same as street address of office?*
• Yes No
Phone* Fax
9107210308
Operator Info
Firm operator's name* Firm operator's title
Daniel Long co-owner
Mailing address same as street address of office?*
0 Yes No

Phone* Fax
9108804403
Type and amount of septage pumped in the last 12 months
Amount in gallons*
Domestic 990,000,000
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:
Brunswick
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*
2/2/2023
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 YA151268 1HSHXAHR6AH250697 4,000
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*
West Brunswick regional waste water
treatment facility
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 longs 117.3KB
septic.pdf
Septage Management Firm Operator Training Completed^
Date* Hours*
10/18/2022 6
Location*
Greensboro, 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
2/2/2023
10:01:13 AM
Print Name* Title*
Daniel Long CO -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.
I, Matthew Henry, #998880, West Brunswick Regional Wastewater Treatment Facility
(Plant Operator in Responsible Charge (ORC), ORC License Number, Name of Plant)
of
235 Grey Water Road, Supply, NC 28462
(Address)
(910) do hereby authorize
(Phone Number) (Owner/Operator of Septage Management Firm)
( C►E/
Management Firm Name and NCS number)
to dispose of: domestic septage X portable toilet waste
grease septage (grease trap pumpings) commercial/industrial septage from
Brunswick County,
(County or other Geographic Area)
at the above named wastewater treatment facility. Septage shall be discharged at:
West Brunswick Regional Wastewater Treatment Facility, 235 Grey Water Road, Supply, NC
(Location)
between the hours of Monday -Friday 8 a.m. - 6 p.m.; Weekends & Holidays 9 a.m. - 5 p.m.
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 �a -E1 Date 1- l7• z'3
(Facility Operator)
Matthew Henry personally known to me
Subscribed and affirmed before me this 7 day of 20 0_5
My Commission expires: '
(Notary Pu ic) 14
�P (RFFICIAL SEALVr
_ otary Public
Brunswick =
— County
Note: Falsification of this document by the septage management firm shall lead to �ref0 evocatl Q\�``��
S:/Solid Waste/CLA/SEPTAGE/FORMS/2p18 Fcrm Application/WWTP Author zat on Form 2018 %CAR
/ I',``���

2023 SEPTAGE DISPOSAL PERMIT APPLICATION
BRUNSWICK COUNTY PUBLIC UTILITIES
NAME OF SEPTAGE DISPOSAL FIRM:$ Seryl CC,
CONTACT PERSON:�1rN or ��na Lan!
ADDRESS:
r boy , 10K4
PHONE NUMBER: 5 - 3 13 "
TRUCK INFORMATION
LI{-e
PLEASE PROVIDE THE FOLLOWING INFORMATION ABOUT THE TRUCKS THAT
MAY BRING SEPTAGE WASTE TO THE COUNTY FOR DISPOSAL. ONLY TRUCKS
SHOWN BELOW WILL BE ALLOWED TO DISCHARGE WASTE AT THE COUNTY
FACILITY.
MAKE
(Ford, GMC, etc)
2.pto
1. 1n�r�nca-h�n�ii
2.
r 3.
4.
LICENSE
NUMBER
Q1528
TANK CAPACITY
(gallons)
THERE IS AN ANNUAL FEE OF S100 PER TRUCK THAT WILL BE CHARGED FOR
DISPOSAL AT THE COUNTY FACILITY. CHECK/MONEY ORDER PAYABLE TO BCPU
(BRUNSWICK COUNTY PUBLIC UTILITIES).
NUMBER OF TRUCKS: I X $100 = ! ``
THE ANNUAL REGISTRATION FEE MUST ACCOMPANY THIS APPLICATION.
AGREEMENT
• 1, the undersigned applicant, acknowledge that I have received a copy of the County's
Septage Receiving Operating Plan and agree to comply with the requirements outlined in
the plan. I understand that violation of the provisions in the Septage Receiving Operating
Plan will result in the termination 7y ability to discharge waste at the County -owned
facility. 1
AUTHORIZED REPRESENTATIVE:
DATE:
(Signature)
� �3
COUNTY USE ,,"X//_
PPROVED 0 DENIED by /1��