NCS01194_2023Permit_Initial

2023
Permit and Registration
Mountain Septic Service
is hereby issued a Septage Management Firm Permit,
STATE,, _ Permit Number NCS-01194
oand 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:
Septage Detention or Treatment Facility, SDTF-57-03
Town of Franklin WWTP, Franklin, NC
Tuckaseigee Water and Sewer Authority, Sylva, 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
PerryWm Perry Sugg
Date: 2023.02.23
Sugg 14:46:35-05'00'
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*
Mountain Septic Service
The "Firm name" must be exactly as it is shown on your vehicle(s).
Septage Management Firm permit number (NCS #)
NCS-01194
Please enter the complete NCS #, including the 5 end digits (NCS-XXXXX)
Street address of office*
Street Address
252 Fox Ridge Circle
Address Line 2
city State / Province / Region
Franklin NC
Postal / Zip Code Country
28734 USA
County*
Macon
Mailing address same as street address of office?*
• Yes No
Phone* Fax
8283425700
Email*
[e-mail]
Owner Info
Firm owner's name*
Robert Greg Raby
Mailing address same as street address of office?*
• Yes No
Phone* Fax
8283425700
Operator Info
Firm operator's name* Firm operator's title
Greg Raby Owner
Mailing address same as street address of office?*
0 Yes No

Phone* Fax
8283425700
Type and amount of septage pumped in the last 12 months
Amount in gallons*
Domestic 400,000
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:
Macon Jackson Swain Clay
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*
12/18/2022
Title*
Owner
Choose how to add vehicle descriptions*
• Add vehicles individually Upload List
Pumper
Vehicles
Usage*
License Tag #*
Vehicle Identification #*
Tank Capacity*
Domestic
Septage
YA165619
2nplhz7xx6m630125
2,000
Domestic
Septage
Ya146634
2npnhd7x94m813069
2,300
Domestic
Septage
HP-1963
1hslrtvn5jh600077
1,300
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*
Town of Franklin WWTP
Expiration Date*
12/31/2023
Tuckaseigee Water and Sewer Authority 12/31/2023
Septage Land Application Sites (SLAS)*
Yes ! No
Septage Detention or Treatment Facility (SDTF) *
Authorization *
image.jpg 2.18MB
Image.3pg 2.23MB
• Yes No
Permit Verification
❑✓ I certify that I AM the permit holder for this SDTF.
If unchecked, please attach a signed detention/treatment authorization form for each site.
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 #*
SDTF-57-03
Expiration Date*
8/10/2023
Other disposal method*
Yes • No
Septage Management Firm Operator Training Completed
Date* Hours*
10/10/2022 6
Location*
Franklin
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
12/18/2022
07:41:28 PM
Print Name* Title*
Robert Greg Raby Owner

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AUTHORIZATION TO DISCHARGE SEPTAGE TO VVAqTF:IArnT�o
« 'nCHlIVft1V1 I�ACILITY
Nc�rth Carolina Department of Environmental Quality
Division of UVaste Managemenfi - Solid Waste Section
1546 Mai! Service Center, RaleighNC Z7699-1C4f,
Fee assessments and waste defierminations will be re uirtreatrnent facility. The facility has fihe ultimate rero�a�ied at the discretion of the wastewater
�nC°wing Wastewater stream.'� g Ve to deny discharges of any wastes to the
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(Pant C� erat �p or in Responsible Charge (ORC), ORC License Number, Name of Plant)
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do hereby
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authorize
{Owner/Operator of Sgpfage M g ment Firm}
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NCS # (31
� (Septage Management Fi-rm--N'a'me-a'nd NCS number)
to dispose of: domestic septage (/ ,portable toilet waste v
grease septage (grease trap pumpings) commercial/industrial septage .from
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at the above named wastewater treatment facility. Septage shall be discharged at:
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(Location) r /
between the hours of ?O� �� — �`Q� ZS!!:1yr/�/.7igg
Reintroducing partially treated liquid into a grease trapis acceptable
This authorization shall be valid until
Signe
Subscribed and affi
rmed before me this
Yes Lo*"'" N o
3rs� ao��
v December 31, Year)
Date
��day of
My Commission expires:
Note,* falsification of this document by the septage management firmshall lead
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AUTHORIZATION TO DISCHARGE SEPTAGE TOA 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 strum.
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(Plant Opgra'tor in Responsible Charge
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(Phone Number)
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of
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Septage M
to dispose of: domestic septage
1
ORC), OiW License Number., Name of Plant)
(Address)
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raze
(Owner/Operator of Septageh/anagemen(Firm)
PAO* rocs #
anagement Firm Name and NCS number)
,port
able toilet waste cw'or� t
grease septage (grease trap pumpings) commercial/industrial septage , from
(County or other
at the above named wastewater treatment facility.
between
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NEENNEENEXEMENWEEPMe
Geographic Area)
Septage shall be d
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I(Location)
the hours of I ►' - V ' � :
ischarged at:
N
Reintroducing partially treated liquid into a grease trap its acceptable Yes No -
This authorization shall be valid until
Signed
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acility Operator)
d and affirmed before me
V-
(N tary Public)
� Te � /�'lnore
this I �
(Usually lDcember 31, Year)
Datef.�1lL�1f'�
day of _
My Commission expires:
Note: Falsification of this document by the septage management firm shall I
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