NCS01245_2023Permit_Initial

2023
Permit and Registration
Granville Septic Service
is hereby issued a Septage Management Firm Permit,
STATE,,
Permit Number NCS-01245
o and registered as a
e:,e D
NORTH
EQ
%L 12. 9*
-�� Septage Management Firm�� �� w� ��nffii�utr
E,%r Q'M
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. City of Oxford WWTP, Oxford, NC
2. Warren County WWTP, Warrenton, 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 14:55301-050'003
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*
Granville Septic Service
The "Firm name" must be exactly as it is shown on your vehicle(s).
Septage Management Firm permit number (NCS #)
NCS-01245
Enter the five digits following the NCS #
Street address of office*
Street Address
2320 Wilkins Farm Rd
Address Line 2
City
State / Province / Region
Oxford
NC
Postal / Zip Code
Country
27565
USA
County*
Granville
Mailing address same as street address of office?*
• Yes No
Phone*
Fax
9196912434
Email*
[e-mail]
Owner Info
Firm owner's name*
Holden Wilkins
Mailing address same as street address of office?*
• Yes No
Phone* Fax
9196912434
Operator Info
Firm operator's name* Firm operator's title
Holden Wilkins Owner Operator
Mailing address same as street address of office?*
0 Yes No

Phone* Fax
9196912434
Type and amount of septage pumped in the last 12 months
Amount in gallons*
Domestic 366,000
Portable Toilet Waste 4,000
Grease (Restaurant) 0
Treatment Plant 0
Industrial/Commercial 0
North Carolina counties of operation
List each county you plan to do business in: *
Granville, Vance, Person, Warren, Wake, Durham, Orange, Franklin
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*
12/1/2022
Title*
Owner Operator
Choose how to add vehicle descriptions*
• Add vehicles individually Upload List
Pumper Vehicles
Usage*
License Tag #* Vehicle Identification #* Tank Capacity*
Domestic Septage
YA149780 2NKHHM7X5LM398463 2,500
Domestic Septage
YA130493 1FV6HFAA5TL657963 2,500
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*
CITY OF OXFORD WWTP 12/31/2024
WARREN COUNTY WWTP 12/31/2023
Septage Land Application Sites (SLAS)
Yes • No
Septage Detention or Treatment Facility (SDTF)
Yes • No
Authorization
Warren County 450.7KB
WWTP 2023.pdf
Other disposal method*
Yes • No
Septage Management Firm Operator Training Completed
Date* Hours*
2/19/2022 4
Location*
RALEIGH
Training Sponsored or Provided by*
NC Pumper Group & NC Portable Toilet Group
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 U

Comments or notes
CITY OF OXFORD WWTP AUTHORIZATION IS ALREADY ON FILE FROM PREVIOUS
APPLICATION.
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
em w
Date
12/1/2022
02:00:22 AM
Print Name*
Holden Wilkins
Title*
Owner Operator

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.
of
(Plant operator in Responsible Charge (ORC), O
(Address)
ber, Name of Plant)
do hereby authorize ;
(Phone Number) (Owner/Operator of Septage Management Firm)
(Septage Management Firm Name and NCS number)
to dispose of: domestic septage v"� , portable toilet waste
grease septage (grease trap pumpings) commercial/industrial septage from
(County or other Geographic Area)
at the above named wastewater treatment facility. Septage shall be discharged at:
I
(Location)
between the hours of 60 AM
Reintroducing partially treated liquid into a grease trap is acceptable Yes -"'No
This authorization shall be valid until / Q1 it —2�0?
(Usually December 31, Year)
Signed Gate ? 2 C)
Facility Operator)
Subscribed a d 41lipe4before me this
day of 0- i�L20 i_6,1___�
My Commission expires; 14AV
t (Notary biic} •.•°Y ��,.+-�- • �A '"F.
a. P U 9 L
Note: Falsification of this document by the septage management firm shall lead td� � U ocitti �� .•y�
S:/Solir!_Waste/CiA/SEPTAGE/FORMS/2036 Firm Application/WWTP Authorization Form 2016 �'�i�, 0`v �••••
EI OI lS
'AS

AUTHORIZATION TO DISCHARGE SEPTAGE TO A WASTEWATER
TREATMENT FACILITY
North Carolina Department of Environment and Natural Resources
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.
1, William R. Perkinson ORC License Number 987831
(Plant Operator in Responsible Charge (ORC) and ORC License Number)
Warren Count WWTP 738 US Hw 401 S. PO BOX 281 Warrenton NC 27589
(Address)
252-257-1776 do hereby authorize Holden Wilkins
(Phone Number) (Owner/Operator of Septage Management Firm)
of Granville Se tic Service NCS #01245
(Septage Management Firm Name and NCS number)
to dispose of: domestic septage X , portable toilet waste X
grease septage (grease trap pumpings) commercial/industrial septage , from
Warren Vance Granville and surroundin counties
(County or other Geographic Area)
at the above -named wastewater treatment facility. Septage shall be discharged at:
Influent works
(Location)
between the hours of 8:00 AM - 3:30 PM Monday - Friday
Reintroducing partially treated liquid into a grease trap is acceptable yes X No
This authorization shall be valid until December 31 2023
(Usuaily December 31, Year)
r
Signed Date �, —z�z
((Facility Operat r}
Sworn to and subscribed this me before �
� � day of G�G I��1� . 20 �� �
AAWem t [A_�_ My Commission expires:
(Notary Public)
Note: Falsification of this document by the septage management firm shall lead to permit revocatii. � \'40 rA'Q 2—A
8:/5olid_Waste/CtA/SEPTAGE/FORMS/2413 Firm Application/WWTP Authorization Form 2013� p w Z
G