NCS01309_2023Permit_Initial

2023
Permit and Registration
Larry Carpenters Septic Tank Service
is hereby issued a Septage Management Firm Permit,
ZNti STATE
Permit Number NCS-01309
o and registered as a
e:,e D
E� M
-�� Septage Management Firm ��en� f� w� nmenta�llry
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:
GCWSA Three Creek WWTP, Emporia, VA
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.
Digitally signed
Wm Perry by Wm Perry
1 Sugg
Sugg Date: 2023.02.27
12:10:00-05'00'
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*
larry carpenters septic tank service
The "Firm name" must be exactly as it is shown on your vehicle(s).
Septage Management Firm permit number (NCS #)
NCS-01309
Enter the five digits following the NCS #
Street address of office*
Street Address
16767 Governor Harrison Pkwy
Address Line 2
City
State / Province / Region
Freeman
VA
Postal / Zip Code
Country
23856
United States
County*
Brunswick
Mailing address same as street address of office?*
• Yes No
Phone* Fax
14346373479 4348482520
Email*
[e-mail]
Owner Info}
Firm owner's name*
larry w carpenter
Mailing address same as street address of office?*
• Yes No
Phone* Fax
14346373479 4348482520
Operator Info
Firm operator's name* Firm operator's title
larry w carpenter owner
Mailing address same as street address of office?*
0 Yes No

Phone* Fax
14346373479 43484825208200
Type and amount of septage pumped in the last 12 months
Amount in gallons*
Domestic 82,000
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:
warren northampton hallfax
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
dt?,�'v rw,44*wz�t
Date*
12/15/2022
Title*
owner
Choose how to add vehicle descriptions*
• Add vehicles individually Upload List
Pumper Vehicles
Usage* License Tag #* Vehicle Identification #* Tank Capacity*
Domestic Septage tx35-350 ihtmmaa148h560138 2,000
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*
gwsa-three creek wwtp
Septage Land Application Sites (SLAS)
Yes • No
Septage Detention or Treatment Facility (SDTF)
Yes • No
Other disposal method*
Yes • No
Expiration Date* Authorization
12/31/2023 Scan_20180111 247.82...
(3).png
Scan_20170120 444.54...
(2).png
Septage Management Firm Operator Training Completed^
Date* Hours*
12/3/2022 4
Location*
n c state fair grounds governor martin building
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

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
12/15/2022
05:34:59 PM
Print Name* Title*
larry w carpenter owner

North Carolina Department of Environmental Quality
Division of Waste Management INVOICF
NORTH CAROLINA
Envtronmentat Qaattty Solid Waste Section
Division of Waste Management
To:
Larry W. Carpenter
Solid Waste Section
Larry Carpenters Septic Tank Service
1646 Mail Service Center
16767 Governor Harrison Parkway
Raleigh, NC 27699-1646
Freeman, VA 23856
Phone/Fax: [phone]
Email: [e-mail]
PAI
M NIX.
i'Z
DATA
1
Date: 09/27/2022
$'SO. 00
Invoice #: NCS-01309-2023
Septage - Annual:
Larry Carpenters Septic Tank Service (NCS-01309)
16767 Governor Harrison Parkway $550.00
Freeman, VA 23856
Number of Trucks:1
Date Due: 1211512022
LATE FEES: In accordance with NC General Statutes GS 130A-291.1(e2), a late fee will be applied to any annual permit fees not submitted by January 1, 2023
Payment Options:
E-check Available online at https://deq.nc.gov/swpaay
Requires bank account and routing information. You will need to use the zip code in the description box and the invoice number
shown on this invoice to access your account. If a zip code is not listed, use the code: 99999 along with the invoice number.
Credit Card Available online at htt s:,,/�iencgev swaav
Accepts MasterCard, Visa, and Discover cards. You will need to use the zip code in the description box and the invoice number shown
on this invoice to access your account. If a zip code is not listed, use the code: 99999 along with the invoice number.
[*Convenience Fee of 2.65% added to amount invoiced.]
Paper check Make checks payable to N.C. Division of Waste Management, Solid Waste Section, include Permit Number and invoice number on
check. If you are paying by electronic transfer, include the invoice number with your electronic transfer. Please return a copy of this
Invoice with your payment.
[G.S. 25-3-506: A $25.00 processing fee will be charged on all returned checks.]
Explanation of Invoice Amount is Based on Firm's Current Permit Status:
Pursuant to North Carolina General Statute 130A-291.1 you are required to pay fee(s) based on your solid waste management
activities. The fee(s) shall be used to support the septage management program.
For questions regarding,
Billing
Regulations or Technical Assistance
Jared Wilson [phone]
Chester Cobb [phone]
Jeffrey Bullard [phone]
More information available on the web:.
North Carolina Department of Environmental Quality (DEQ) - httos://deQ.nc.gov
North Carolina Solid Waste Program - httt s.L dec.nc.gov/about'divisions/waste-rnanaaement%solid-waste-section
North Carolina Septage Management Program - htts!s:'deq.ncaov,/aboutdivisions.'waste-rnanagement/solid-waste-sectionlspecial-waste_-and-alternative-
handlin se tagg

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, l���l,��f �.5.�'•-f _ /9"00 �r9. �Cw�'�1 `There Cteek W41TP
(Plant Operator in Responsible Charge (ORC), ORC License Number, Name of Plant)
"off ? i' lr_►o"I f, -' h "t' JQW . Z," /W ri r , VA
" (Address)
Z F2 ddo hereby authorize
(Phone Number) (Owner Ope/r or of Septage ManageVent Firm)
of I'a P-0aLJ%,0/ s 45 Lc t `tom ✓✓.�aL1VCS # d7/,�O
ge Management Firm rdame and NCS number)
to dispose of: domestic septage ___✓ portable toilet waste
grease septage (grease trap pumpings) commercial/industrial septage from
CCI) sil>*1116
(CSunty or other Geographic Area)
at the above named wastewater treatment facility. Septage shall be discharged at:
Try A)en v r
srekyl
(Location)
between the hours of 0?00 h rS " /46 00 hiS_
Reintroducing partially treated liquid into a grease trap is acceptable Yes _ZNo
This authorization shall be valid until Dec % �/ � �� 0C �
(Usually December 31, Year)
Signed Date
(Facility Operator)
r
Subscribed and affirmed before me this 1� day of 20 2.7—
My Commission expires:
(Notary Public)
TOM C.Pwd (OFFICIAL SEAL)
t"'4r
VA Camanwealih
Note: Falsification of this document by th( - gement firm Shall ea to permit revocation.
S:/Solid_Waste/CLA/SEPTAGE/FORMS/2014 Firm Application/WWTP Authorization Form 2014

NC SEPTAGE MANAGEMENT FIRM
Recertification of Pumper Vehicle(s)
Septage Firm Permit #: NCS- x,; / > 0
Number of Pumper Vehicles: f
CERTIFICATION:
" I certify, under penalty of law, that the pumper vehicle or vehicles listed in the
submitted permit application meet the requirements for safe and sanitary
transportation of septage as required by15A NCAC 13B .0844 (a) and vehicle
lettering as required by 15A NCAC 13B .0844 (b). I also certify that a log is
maintained of each septage pumping event as required by 15A NCAC 13B .0839
(a). I am aware that there are significant penalties for false certification including
the possibility of fine and imprisonment."
,4 -
CA���fv
Signature ( gnature of company o al required)
/A-
? P
Print Name
Date
Title
o j ✓
er-
SASolid_Waste%clalseptagelforms\Pumper Vehicles Cetification.doc