NCS01141_2023Permit_Initial

2023
Permit and Registration
Tony's Ice Cream Company, Inc.
is hereby issued a Septage Management Firm Permit,
STATE,,
Permit Number NCS-01141
- o and registered as a
a= Septage Management Firm QepartmeTH n[ f E W� omeotalQulity
91AM
NORTH CAROLINA (RESTAURANT)
Frivironmental 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. Material removed from an interior point -of -use grease interceptor is treated to remove any free liquids, bagged, and placed into a dumpster. Solid Waste Management Rule
15A NCAC 13B .1626(9)(c)(i) defines "free liquids" as determined by Method 9095 (Paint Filter Liquids Test) S. W. 846.
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 PerrybyWmPerry
7 Sugg
Sugg Date: 2023.02.23
14:36:17-05'00'
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*
�7—ot1 '5 =Ge. �Gt O'Yl
The "FinA name" must be exactly as it is shown
11G
ur vehicle(s).
Septage Management Firm permit number (NCS #)
NCS-pI 1 4L--i
Enter the five digits following the NCS #
Street address of office
Street Address
C 4 East Fra*i L It, � B IYd
Address Line 2
City State / Province / Region
Postal / Zip Code
Country
County*
qa4un "
v
Mailing address same as street address of office?
Yes Q No
Mailing Address
l fe,r5 d
OIL
RECEIVED
FEB 21 2023
SOLID WASTE SECTION
https://edocs.deq.nc.gov/Forms/wm—restseptage
2/3123, 9:22 AM
Page 1 of 5

Street Address
r3ax,�)L,1621 Blvd
-U2—LA EL
Address Line 2
City
State / Province / Region
HEIROWNAAt Iffff-MV-
Postal / Zip Code
Phoney
-Iclq -196aoQ113
Country
Fax
Email
F - --
Owner Info
Firm owner's name* ^y
L d F�a+iMV
1MOL, 6-no
I P
" Mailing address same as street address of office?*
Q No
Mailing Address
`Street Address
l
Address Line 2
J
City State / Province / Region
Postal / Zip Code Country
7
Phone Fax
s y17
-
Operator Info ^
https://edocs.deq.nc.gov/Forms/wm_restseptage 213/23, 9:22 AM
Page 2 of 5

Firm operator's name*
Mailing address same as reet address of office?
Yes O No
Mailing address
Street Address
Firm vice— operator's title
Address Line 2
city State / Province / Region
Postal / Zip Code Country
Phone
Fax
Approximate amount of Grease Septage managed within the fast 12
months
Amount in gallons
Grease (Septage) 0 / �00
North Carolina counties of operation
List each county you plan to do business in:
Gos-ra�n
Vehicle Info
Do you plan to operate pumper vehicles?
-J
0
https://edocs.deq.nc.gov/Forms/wm_restseptage
213/23, 9:22 AM
Page 3 of 5

O .Yes y No
Procedure to Clean an Interior Paint -Of -Use Grease Interceptar
Please read the following procedure and and check the box acknowledging you have read the procedures.
Note: Interceptor must be cleaned when the sinks are not being used and no food preparation is taking place.
Do not VIOLATE any Health Department Regulations.
1. Obtain proper tools to open the interceptor.
2. Place plastic trash bags (or any disposable item) on floor to protect floor from contamination.
3. Remove lid from interceptor and place upside down on floor protection item.
4. Skim grease from top of interceptor and place in a container lined with two strong disposable bags.
5. Scrape walls of the interceptor with a wide putty knife or similar item to remove solids and grease that have
accumulated on the walls.
6. Remove solids from the bottom of the interceptor and place in the same container with the grease
skimmings.
7. Inspect the trap for any equipment deficiencies and make repairs.
8. Place lid on interceptor carefully. Make sure lid is sealed properly or odors will be released.
9. Place floor covering item in the trash dumpster.
10. Remove container with grease and solids from the food preparation area.
11. Solidify contents with an absorbent material such as kitty litter. Make sure all contents are solidified. This may
take several minutes for the material to absorb all of the liquid.
12. Tie bags together securely.
13. Inspect bag for leaks and re -bag if needed.
14. Place bag in trash dumpster.
15. Clean the area and sanitize all surfaces in the areas as prescribed by the Health Department.
Acknowledgement
I acknowledge I have read the procedure to clean an interior point -of -use grease
interceptor.
Septage Management Operator Training
Indicate which type of training you have completed. * fl0 � O-P P II CO-6ie,
O In -person training O Online training
Registration Type
Selec one
Registered Septage Management Firm
Comments and Notes
"J
https:/Iedoes.deq.nc.gov/Forms/wm_restseptage 213/23, 9:22 AM
Page 4 of 6

Conments 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. 1 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* Dci—j / �
Sign
Date
1 2/3/2023
09:22:41 AM CO
Print Name*
SubmitSave as Draft
Title
�1
https://edocs.deq.nc.gov/Forms/wm_restseptage
213123, 9:22 AM
Page 5 of 5