NCS01161_2023Permit_Initial

2023
Permit and Registration
D.C. Carter Septic Tank Services
is hereby issued a Septage Management Firm Permit,
STATE,,
Permit Number NCS-01161
- o and registered as a
--�� Septage Management FirmCAROL] � �nffi��NOR Ity
12 ��
LULAH
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, Tide 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. Cross Creek WRF/Rockfish Creek WRF, Fayetteville, 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.
Digitally signed
Wm PerrybyWm Perry
Perry
Sugg
Sugg Date: 2023.02.23
14:39:21-05'00'
Perry Sugg, Environmental Compliance Branch Head

APPLICATION FOR PERMIT TO OPERATE A SEPTAGE MANAGEMENT FIRM
DIVISION OF WASTE MANAGEMENT - SOLID WASTE SECTION - 16d6 MAIL SERVICE CENTER, RALEIGH. NC 27699.1646
W Frm name: (The "Firm name" must be ter as it is shorn on your vehicle{s)).
D C Carter Septic Tank Service
Street address of office: 708 Mayflower Court
Ci)r Fayetteville State: NC
Mailing address (if different):
State: Zip:
Phone: [phone]RR Fax:
E-Mail: [e-mail]
County: Cumberland Septage Management Firm permit number: NGS # 01161
(2.) Firm owners name: Darryl Carter
Mailing address (tf different):
Cty: State: Zip:
Phone: Fax:
{3.] Firm operators name: Darryl Carter Firm operators title:
City:
Mailing address (ff different):
Phone. [phone] Fax:
Zip:
Owner
City:
(4.) Type(S) of Septage pumped: write in the 0UM&r o! gaygMs puM&Kd in ARSt 12 MonthS (Example: Domestic: 50,000).
Domestic I Portable Toilet waste
r'oC7E,, 000
(5.) Wife
of Operation:
WW e , R(-I}�_e_ 50,
Grease Restaurant Treatment Plant IndustdallCommered
Hoke, Bladen, Scotland., Harnett, Lee, Johnston
}-.1QC1
(Usi each wunry you are authorized to do business in)
(6.) Tntal Number of Pumper Vehicles Operated: 1 0
Number used for: Domestic Septage: Grease (restaurant):
Other: Portable Toilet Waste:
Vehicle Information: (use additional paper if needed)
License Tag #
Vehicle Identification #
Tank Capacity
`-1
v l��W D C Li 5 (-IV a- 3 0
'G o 0
3
Fes- +S5 T qs
i VN 3 HH H [.0 Z,0ED
Zn00
4
5
APPLICATION CONTINUED ON PAGE 2
PAGE 1

APPLICATION FOR PERMIT TO OPERATE A SEPTAGE MANAGEMENT FIRM
(CONTINUED FROM PAGE 1)
(7.) Septage Disposal Method: (check one)
(81)
a) Approved wastewater treatment plant: ( X) yes ( ) no, If yes, submil Wastewater Treatment Authorization
for each plant, as indicated in Subparagraph .00(c)(14) of the Septage Management Rules,
b) Septage Land Application Site (SLAS) Permit Numbers: (use additional sheets if needed)
SLAS#: Expiration Date: St": Expiration Date:
c) Septage Detention or Treatment Facility (SDTF) Permit Numbers: (use additional sheets if needed)
SDTF#: Expiration Date: SDTF#; Expiration Date:
Septage Management Firm Operator Training Completed:
Date: Location:
Training Sponsored or Provided bv:
(9,) Septage Land Application Site Operator Training Completed:
Date: Location:
Training Sponsored or Provided by:
(10,) Registration type requested: CHECK ONE
Registered Portable Sanitation Firm:
Registered Septage Management Firm: X
Registered Portable Sanitation and Septage Management Firm:
Cerification Statement
Hours:
Hours:
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 thefe are criminal penalties for knowingly making a false statement, representation, or certification.
Signature (Signature of company omc a! required)
Darryl Carter
Print Name
Other Comments:
Slsand_Wasle1CLA1SEPTAGEIFoRMsi2ol8 Firm Ap04raWVRPrPermMppuDm20j8
12-15-22
Date
Owner
Tide
PAGE 2

NC SEPTAGE MANAGEMENT FIRM
Recertification of Pumper Vehicle(s)
Septage Firm Permit #: NCS-
01161
Number of Pumper Vehicles: 3
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."
signature (Signature ofcompany otllcialrequinxV
Darryl Carter
Print Name
12-15-2022
Date
Owner
Title
SASolld_wastslclatseptagelformslPumper Vehlcles Cetlflcation.doc

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, N.C, 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, Scott McCoV #24382 Cross Creek WRF / Rockfish Creek WRF
(Plant Operator in Responsible Charge (ORC), ORC License Number, Name or Plant)
P.O. Box 1089 Fayetteville, NC 28302.1089
(Address)
[phone] do hereby authorize Darryl Carter
(Phone Number) (Owner/Operator of Septage Management Firm)
of D.C. Carter Septic Tank Service NCS# 01161
(Septage Management Firm Name and NCS number)
to dispose of: domestic septage X portable toilet waste
grease septage (grease trap pumpings) commercia[find ustrial septage , from
Cumberland & surroundin counties
(County or other Geographic Area)
at the above named wastewater treatment facility. Septage shall be discharged at:
Facility Influent Pump Station
(Location)
between the hours of Sunrise to Sunset
Reintroducing partially treated liquid into a grease trap is acceptable Yes X No
This authorization shall be valid until December 31. 2023 _
Signed �peralor� Date I I Il zZ
(Facility
Subscribed and affirmed before me this �� day of 20 , 0
My Commission expires:
(Notary Public)
����1111/lrl�
N01m ~�
Mote: Falsification or this document by the septage management firm shall lead to permit revocation. i . 4P-40
:Z=
S,/Solid_Waste/CLA/SEPTAGFJFORMS12023 Firm ApplicationMWTP Authorization Form 2023 PUgt1�'

P
�J 0.cC ti�
First Name
U�Ao'- I Y
%e
Last Name
Received Credit Hours
of Continuing Education
e
This Certificate of Attendance Presented By:
rd. � siTA
NORTH CE#ROLINA SEPTIC TANK ASSOCIATION
li
Hours Accredited by:
NCOWCICB Installer/Inspector/Evaluator
NC Division of Waste Mgmt
Septage Firm Mgmt 4 Hours
Land Application SLAS
REHS Board
WPCSOCC CE02212201(Subsurface Operator
❑ Other:
Important: Keep this in a safe place.
� tV
Date: l + 2022
Signed:
Jerry O. Pearce, NCSTA President
Duplicates are not available.