NCS01263_2023Permit_Initial

2023
Permit and Registration
R & D Septic Tank Pumping
is hereby issued a Septage Management Firm Permit,
ZNti STATE
Permit Number NCS-01263
o and registered as a
e:,e D
NORTH
EQ
A%L i2. ��
-�� Septage Management Firm�� �� w� ��nffi�iity
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. Johnnie Mosley Regional WRF, Kinston, NC
2. Septage Land Application Site, SLAS-25-12
3. Septage Detention or Treatment Facility, SDTF-25-08
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.
W m
Digitally signed
by Wm Perry
Perry
Sugg
Sugg
Date: 2023.02.23
15:15:46-05'00'
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&D Septic Tank Pumping
The "Firm name" must be exactly as it is shown on your vehicle(s).
Septage Management Firm permit number (NCS #)
NCS-01263
Enter the five digits following the NCS #
Street address of office*
Street Address
117 Davis Rd.
Address Line 2
City
State / Province / Region
Cove City
NC
Postal / Zip Code
Country
28523
us
County*
Craven
Mailing address same as street address of office?*
• Yes No
Phone*
Fax
252670-4031
Email*
[e-mail]
Owner Info
Firm owner's name*
Randy Register
Mailing address same as street address of office?*
• Yes No
Phone*
Fax
252 670-4031
Operator Info
Firm operator's name*
Firm operator's title
Randy Register
Owner
Mailing address same as street address of office?*
0 Yes No

Phone* Fax
252 670-4031
Type and amount of septage pumped in the last 12 months
Amount in gallons*
Domestic 368,000
Portable Toilet Waste 0
Grease (Restaurant) 91 000
Treatment Plant 0
Industrial/Commercial 0
North Carolina counties of operation
List each county you plan to do business in: *
Craven,Jones,Lenior,Pamlico,Carteret
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*
12/14/2022
Title*
Owner
Choose how to add vehicle descriptions*
• Add vehicles individually Upload List
Pumper Vehicles
Usage* License Tag #* Vehicle Identification #* Tank Capacity*
Domestic Septage YA113641 1GDM7J1C83F513098 2,500
Septage Disposal Method
For each method, indicate whether you plan to use it by checking yes or no.
Approved wastewater treatment plant*
0 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 12/31/2022 image.jpg 3.34MB
Reclamation Facility
Septage Land Application Sites (SLAS)
• Yes No
If you are not the permit holder for the septage land application site, you must have a signed land application authorization form for each site.
SLAS #* Expiration Date* Authorization
SLAS-2512 5/4/2025 image.3pg 2.33MB
Septage Detention or Treatment Facility (SDTF)
• Yes No
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-00912
Other disposal method*
Yes • No
Expiration Date*
12/31/2022
Authorization
Septage Management Firm Operator Training Completed
Date* Hours*
6/25/2022 4
Location*
New Bern Convention Center
Training Sponsored or Provided by*
NC Pumper Group & NC Portable Toilet Group
Septage Land Application Site Operator Training Completed
Date Hours
6/25/2022 3
Location
New Bern Convention Center
Training Sponsored or Provided by
NC Pumper Group & NC Portable Toilet Group

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
raii j "00
Date
12/10/2022
09:33:43 PM
Print Name* Title*
Randy Register Owner

OF
to Operaite a Septag-e Land ApilcationPBite
� QUality�,of
.�, ---- Ot W�eefu gem E�11• Wd Waste �iElCi�Oi1
r a, penod ot
vn ih� mstrictcms an land u
v. znta
may be land applied until the
DIVS10n of Waste Management has ass
site. The above desrdbed property is owned so
Signature of landowner
Sianature of- landowner
NC 17699-
1646
�•�{t18t11@ ot!it@ owerl hem
Lan
bY fly that I am the owner of
1 q QP �,.� � and
Lon
r-lot
(sloe Opamtor name)
(length ot time)
e Management Rules',
se aftr septage hand application ends
ued a permit for a septagg land application
to use seta lend tor
beglnning O 2() —(g�e
and I understand and agree to
lely by me or jointly with
**. I further understand that nO septage
(names of aU co -owners, or state none).
� v Date
jo Date
SWOM to and subscribed before me this. day of
(Notary Public)
MV Commission expires:
* 15A N.C. Adman. Code 13B Section .0800
U Rule
.0843
Date
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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.
I, Kenneth R. Stevens, Jr.- Wastewater License #21198 Johnnie Mo I v Regional Water Reclamation Facili
(Plant Operator in Responsible Charge (ORC), ORC License Number, Name of Plant)
P. 0 Drawer 339, Kqr
inston NC 28502
(Address)
252-939-3375 do h
(Phone Number)
by authorize
Randy-G. Register
(Owner/Operator of Septage Management Firm)
of R & D Septic Tank Pumping
(Septage Management Firm Name and NCS number)
to dispose of: domestic septage x , portable toilet waste x ,
NCS # 01263
grease septage (grease trap pumpings).- 1 commercial/industrial septage , from
at the above named wastewater treatme
between the hours of
Johnnie Mosley
Brie
Lenoir and surrounding counties
(County or other Geographic Area)
nt facility. Septage shall be discharged at:
Regional Water Reclamation Fac
Run Lift Station- Hi-qhwav 55 Ea
8:00 a.m. to 4:00
(Location)
).m. (Monda
ility- 2101 Becton Farm Road
St
th.ru Frida
Reintroducing partially treated liquid into a grease trap is acceptable Yes
This authorization shall be valid un
Signed
X No
til December 31 2023
'� Date (Facility Operator)
/6
Sworn to and subscribed before me this
Note: Falsificatio
day of
Oj
20 "?z
1!
_Z1 I My Commission expires: �� ��
AF
(Notdry Public} `rat ,,,".-_`-. F-IF I .•,,•.
A? Tgj pip
n of this document by the septage management firm shad lead to permit revocation
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