NCS01186_2023Permit_Initial

2023
Permit and Registration
R&W Septic Tank Services
is hereby issued a Septage Management Firm Permit,
STATE,,
Permit Number NCS-01186
o and registered as a
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-�� Septage Management Firm�� �� w� ��nffii�utr
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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. Johnnie Mosley Regional WRF, Kinston, 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
Digitally signed
by Wm Perry
Perry
Sugg
Sugg
Date: 2023.02.23
14:44:27-05'00'
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*
R & W Septic Tank Services
The "Firm name" must be exactly as it is shown on your vehicle(s).
Septage Management Firm permit number (NCS #)
NCS-01186
Enter the five digits following the NCS #
Street address of office*
Street Address
126 Holly Springs Road
Address Line 2
City
State / Province / Region
Newport
North Carolina
Postal / Zip Code
Country
29570
United States
County*
Carteret
Mailing address same as street address of office?*
• Yes No
Phone*
Fax
252-726-7390
Email*
[e-mail]
Owner Info
Firm owner's name*
Richard Miller
Mailing address same as street address of office?*
• Yes No
Phone* Fax
252-241-1973
Operator Info {
Firm operator's name* Firm operator's title
Richard Miller Owner / Operator
Mailing address same as street address of office?*
0 Yes No

Phone* Fax
252-241-1973
Type and amount of septage pumped in the last 12 months
Amount in gallons*
Domestic 427,000
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:
Carteret County
Craven County
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*
12/8/2022
Title*
Owner
Choose how to add vehicle descriptions*
• Add vehicles individually Upload List
Pumper Vehicles
Usage*
License Tag #*
Vehicle Identification #*
Tank Capacity*
Domestic
Septage
YA155716
1FUJGEDR4DLFG3604
3,500
Domestic
Septage
YA171005
3AKBGDDVXESFLO466
4,000
Domestic
Septage
YAO19049
1XPCDB8X7TN402170
3,500
Septage Disposal Method

For each method, indicate whether you plan to use it by checking yes or no.
Approved wastewater treatment plant*
• 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* Expiration Date* Authorization
JOHNNIE MOSLEY REGIONAL WATER 12/31/2023 image.3pg 2.42MB
RECLAMATION FACILITY
Septage Land Application Sites (SLAS)*
Yes • No
Septage Detention or Treatment Facility (SDTF)
Yes • No
Other disposal method*
Yes • No
Septage Management Firm Operator Training Completed
Date* Hours*
4/11/2022 4
Location*
Carteret Community College Convention Center
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
�a��u�s9M�ec
Date
12/8/2022
07:12:21 AM
Print Name* Title*
Richard Miller

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