NCS01377_2023Permit_Initial

2023
Permit and Registration
Island Septic
is hereby issued a Septage Management Firm Permit,
STATE,,
Permit Number NCS-01377
o and registered as a
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-�� Septage Management Firm�� �� w� ��n>�i�utr
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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:
1. Septage Land Application Site, SLAS-27-23
2. Septage Detention or Treatment Facility, SDTF-27-23
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
0
Sugg 112:26 33-05 00'7
Perry Sugg, Environmental Compliance Branch Head

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' J North Carolina Department of Environmental Quality
Division of Waste Management INVOICE
NORTH CAROLINA
Envtro mentWQ.uaUry Solid Waste Section
Division of Waste Management
Solid Waste Section
1646 Mail Service Center
Raleigh, NC 27699-1646
Phone/Fax: [phone]
Email: [e-mail]
Septage - Annual:
Island Septic (NCS-01377)
5003 the woods rd .
To: Jonathan Younts
Island Septic
5003 the woods rd
Kitty Hawk, NC 27949
CK. No.
83
DATE
Kitty Hawk, NC 27949
Number of Trucks: 3
Date Due:
LATE FEES: 1(e2), a . : fee wi l be any annual
Date: 09/27/2022
Invoice #: NCS-01377-2023
$800.00
UA
Payment Options:
E-check Available online at https://deg.nc.gov/swpay
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 httos://deq.nc.aov/swpay
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]
E�Qlanation pf 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 re ag rding:
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) - https://deq.nc.ciov
North Carolina Solid Waste Program - htt s: de .nc.,:ov abou• divisions waste-mana1,emen•_ solid -waste -section
North Carolina Septage Management Program - htt -L - de •.nc.-ov about. division . waste-mana emen•_ solid -waste -section = rj ecial-wastes -and -alternative
handlina/septage

the recertification of pumper vehicles. Otherwise, see attached guidance document for
link to the recertification form.
For application issues or questions, please contact:
Jared Wilson at [phone] or email at jared.Wils0n`c(?nCdenr'gov
Chester Cobb at [phone] or email at chester.cob (tincdenr.gov
Jeffrey Bullard at [phone]or email at jeffrey.bullard`0'ncdenr.gov
Thank you for your prompt attention to this matter.
Sincerely,
Ethan Brown
Ethan Brown
Environmental Program Consultant, Waste Management
North Carolina Department of Environmental Quality
919.707.8295 (Office)
F�than,� B.�Ca n� cdenr.gov
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APPLICATION FOR PERMIT" TO OPERATE A SEPTAGE MANAGEMENT FIRM
DIVISION OF WASTE MANAGEMENT - SOUD WASTE SECTION -1646 MAIL SERVICE CENTER, RALEIGH, NC 27MI646
(1.) Firm name: (The "Firm name" must be txu& as it is shown on your vehide(s)).
Island Septic Inc
Street address of office: 934 W Kitty Hawk Rd
al . Kitty Hawk We. NC
Zp; 27949
Mailing address (if different): 5003 The Woods Rd
Cky: Kitty Hawk State: N U
zip 27949
Phone: [phone] Fax:
E-Mall: [e-mail]
County: Dare Septage Management Firm permit number: NCS # 01377
(2.) Firm owner's name: Jonathan Younts
Mailing address (i€ different): 5003 The Woods Rd
City. Kitty Hawk State: NC
Tzip 27949
phone: [phone] Fax:
_
(3.) Firm operator`s name: t Y Jonathan ouns
Firm operator's title: -- owner
--
Mailing address (if different): _
T
Phone:
3tatTiext Zip:
Fax:
(4.) Type(s) of septage pumped. Write in the number of gakns n_ uWd in fast 12 monrihs (Example: Domestic: 50,000).
Domestic Portable Toilet Waste J Grease (Restaurant) j Treatment Plant Inc
nne tM -1 ' 1 Cl M
(5.) N.C. Counties of Opere, Currituck Dare
— (fist each county you are authorized to do business in)
(6.) Total Number of Pumper Vehicles Operated: 3
Number used for. Domestic Septage: 3 Grease (restaurant): 3
Other, Portable Toilet Waste:
Vehicle Information: (use additional paper if needed)
License Tag #
Vehicle Identification # _
I Tank Capacity
t
A145
4400
2
YA137320
INPCXPEX4JD457
3
YA142613
2NP3 S
4
5
APPLICATION CONTINUED ON PAGE 2
PAGE 1

APPLICATION FOR PERMIT TO OPERATE A SEPTAGE MANAGEMENT FIRM
(CONTINUED FROM PAGE 1)
(7.) Do you plan to operate pumper vehicles? (check one) ( X) yes ( ) no.
If you checked yes above, you must attest to the following statement before a permit may be issued.
"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 are significant penalties for false certification including the
possibility of fine and imprisonment"
Do you attest to the statement above? (X) yes ( ) no Initial_ _ Date
(8.) Septage Disposal Method: (check one)
a) Approved wastewater treatment plant: ( ) yes ( X ) no. If yes, submit Wastewater Treatment Authorization for each
plant, as indicated in Subparagraph .0834(c)(14) of the Septage Management Rules.
b) Septage Land Application Site (SIRS) Pemtit Numbers: (use additional sheets if needed)
S". 27-23 Expiration Date:06-23-23 S" Expiration Date:
c) Septage Detention or Treatment Facil' T,31- permit Numbers: (use additional sheets if needed)
SDTr* 27-23 F_xpiration Dat 23'L3 SDTF# Expiration Date:
(9.) Septage Management Firm Operator Training Completed: Text
Datel0/19/2022 Location: Bur- Mil Club Rd Hours:.
s
Greensboro NC
Training Sponsored or Provided by:
NCSTA
(10.) Septage Land Application Site Operator Training Completed:
Date: 10/19/2022 Location: Bur -Mil Club Rd Hcere.
Training Sponsored or Provided by:
(11.) Registration type requested: CHECK ONE
NCSTA
Registered Portable Sanitation Firm:
Registered Septage Management Firm:
Registered Portable Sanitation and Septage Management firm: X
Certification 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.
Sig
paWre ( of companyoflffcfal regtriredJ
Text sdtuo,44,aJ L)®u"`)s
Print Name
Other Comments:
Date
Owner
Tide
Rev. 04.26-2021

NC SEPTAGE MANAGEMENT FILM
Recertification of Pumper Vehicle(s)
Septage Firm Permit #: NCS- 01377
Number of Pumper Vehicles: 3
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."
2 C 2-2—
%natUM44Mawre of company official repftM Date
Jonathan Younts
Print Name
Owner
Tide
S..XWIC __WastelclaweptapifomslPumper Vehicles Cetifiicatlon.doc