NCS01285_2023Permit_Initial

2023
Permit and Registration
Doby's Plumbing & Repair
is hereby issued a Septage Management Firm Permit,
STATE,,
Permit Number NCS-01285
o and registered as a
e:,e D
NORTH
EQ
A%L i2. ��
-�� 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. Town of Boone WWTP, Boone, 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 Perry Digitally signed by
Wm Perry Sugg
Sugg 115:2214-005'003
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*
Doby's Plumbing and Repair Inc.
The "Firm name" must be exactly as it is shown on your vehicle(s).
Septage Management Firm permit number (NCS #)
NCS-01285
Please enter the complete NCS #, including the 5 end digits (NCS-XXXXX)
Street address of office*
Street Address
712 South Jefferson Ave
Address Line 2
PO Box 868
city
West Jefferson
Postal / Zip Code
28694
County*
Ashe
Mailing address same as street address of office?*
Yes • No
Mailing Address*
Street Address
PO Box 868
Address Line 2
City
West Jefferson
Postal / Zip Code
28694
Phone*
336-846-3629
Email*
[e-mail]
State / Province / Region
NC
Country
United States
State / Province / Region
NC
Country
Ashe
Fax
Owner Info Q
Firm owner's name*
Steven Doby
Mailing address same as street address of office?*
Yes 0 No

Mailing Address*
Street Address
PO
Address Line 2
City
WEST JEFFERSON
Postal / Zip Code
28694
Phone*
3368463629
Operator Info
State / Province / Region
North Carolina
Country
United States
Fax
Firm operator's name*
Firm operator's title
Steve Doby
Owner
Mailing address same as street address of office?*
Yes • No
Mailing address*
Street Address
PO Box 868
Address Line 2
City
State / Province / Region
West Jefferson
NC
Postal / Zip Code
Country
28694
United States
Phone*
Fax
3368463629
Type and amount of septage pumped
in the last 12 months
Amount in gallons*
Domestic
452,100
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:
Ashe, Watauga, Avery, Wilkes
Vehicle Info
Do you plan to operate pumper vehicles?*
0 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*
1/10/2023
Title*
Owner
Choose how to add vehicle descriptions*
• Add vehicles individually Upload List
Pumper Vehicles
Usage*
License Tag #* Vehicle Identification #* Tank Capacity*
Domestic Septage
YA 144739 5KKHALCV14PM47361 3,600
Domestic Septage
YA 158178 1HTCSAANOSH699976 2,300
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* Expiration Date* Authorization *
Town of Boone WWTP 12/31/2022 Rudy.pdf 647.78...
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*
10/10/2022 6
Location*
Greensboro
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
kWA A#
Date
1/3/2023
03:26:02 AM
Print Name* Title*
Steven Doby Owner

AUTHO
RIZATION 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 any wastewater
tes the
treatment facility.he Tfdischarges acility has the ultimate prerogative to deny
incoming wastewater stream.
�rMnt
(Plant operator in Responsible Charge (ORC), ORC License Number, Name of Piantl
ze. r 00 �-ez w-
(Addressss)
"�t''�4''�� do hereby authorize S� eve �C)�
f (Owner/Operator of 5eptage M nagement Firm)
(Phone Number)
of Ncs # � I Zk�
(Septage-Management Firm Name and NCS number)
C 2i�Ge)I
to dispose of: domestic septage portable toilet waste
grease septage (grease trap pumpings) commercial/industrial septage from
at the above named wastewater treatment facility. Septage shall be discharged at:
�L�c tl �OCc�i,rJTrr
between the hours of
i11
Reintroas!cing paretally treated liquid into a grease trap is acceptable Yes
✓No
This authorization shall be valid until 3
(Usually December 31, Year)
Signed Date S
(Facility operator)A LLFk1
Subscribed and affirmed before me this �0.� J h day of a 20 —
h �
MY Commission expires:
(Notary Public) Crjrr{rny,���'''�
V9''
IAL
�Q
O Q
_ MY p(PIRES —_
= Comm$ 10
Note: Falsification of this document by the septage management firm shall lead to perN,%fs'vo��i }.1G �•�.�
&Vsnlid_wastOCLA/SEPTAGE/FORMS/201$ Firm Application/WWTP Authorization Form 2018 ''��i yE lit
'�����rrrrCrO U n
Scanned with CamScanner