NCS01410_2023Permit_Initial

2023
Permit and Registration
Piedmont Portable Services
is hereby issued a Septage Management Firm Permit,
ZNti STATE
Permit Number NCS-01410
o and registered as a
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-�� Septage Management Firm�� �� w� ��nffii�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. McAlpine Creek WWTP, Charlotte, 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
PerryWm Perry Sugg
Sugg 112:35 24—7 0 '00'
Perry Sugg, Environmental Compliance Branch Head

APPLICATION FOR PERMIT TO OPERATE A SEPTAGE MANAGEMENT FIRM
DIVISION OF WASTE MANAGEMENT - SOLID WASTE SECTION -1646 MAIL SERVICE CENTER, RALEIGH, NC 27699-1646
(1.) Firm name: (The "Finn name" must be L as it is shown on your vehicle(s)).
-1'"�[ieclo7oni PGr k/e Seiv,'ce
Ni
Street address of office: 6 3 e- // )3 d
City: 0) o 0.0 4 )4 State: Al C. Zip:
Mailing address (if different): 41v
City: State: Zip
Phone: 0 q- 10 S �/ a s o�3 Fax:
E-Mait: ; ecim o,7 t o,- i -Lk/e- Sep vy'r-es Q Cl m4., e, ec -.,
County: C- 4 5 f a n _ Septage Management Firm permit number. NCS #
(2.) Firm owner's name: �fj` .5 e. L•'ne44c A6err7t/hy 9LS1eyc•t )4,/o 4Ae,4,v*bp,
Mailing address (if different): S4 m e—
cftT.- -
State: Zip
(3.) Firm operator's name: X esi•'e- �- .ire ;eo eftFirm operator's tale:y w c
Mailing address (if different): - "Yet m e-
City: -State: _ Zip:
Phone: Fax:
(4.) Type(s) of septage pumped: Wife in the number of gallons AujUnd i, n last12 months (Example: Domestic. 50,000).
Domestic Portable Toilet Waste Grease (Restaurant) Treatment Plant Industrial/Commercial
ly, o Do
(5.) N.C. Counties of Operation: G' G S � eZ I -4i n e o 1 n M aGJ 1,'K � C /eve- A" c(
(List each county you are authorized to do business in
(6.) Total Number of Pumper Vehicles Operated:
Number used for: Domestic Septage:_ Grease (restaurant):
Other Portable Toilet Waste: ,
Vehicle Information: (use additional paper if needed)
License Tag #
Vehicle Identification #
Tank Capacity
tYX63
I? X y E2 X AE S 5*117.3
V SD 4,L I/6•7
2
H 2 SIA/1X
FAG F9Y EEalsr,
3
4
APPLICATION CONTINUED ON PAGE 2
PAGE 1
RECEIVED
DEC 13 2022
SOLID WASTE SECTION

APPLICATION FOR PERMIT TO OPERATE A SEPTAGE MANAGEMENT FIRM
(CONTINUED FROM PAGE 1)
(7.) Do you plan to operate pumper vehicles? (check one) (�es ( ) no.
If you checked yes above, you must attest to the following statement before a permit may be issued.
RI 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? (4 ( ) no Initial X Date dya
(8.) Septage Disposal Method: (check one)
a) Approved wastewater treatment plant: ( ✓) yes ( } no. If yes, submit Wastewater Treatment Authorization for each
plant as indicated in Subparagraph .0834(c)(14) of theSeptage Management Rules.
b) Septage Land Application Site (SLAS) Permit Numbers: (use additional sheets if needed)
SLAS#: Expiration Date: SLAS#: Expiration Date:
c) Septage Detention or Treatment Facility (SDTF) Permit Numbers: (use additional sheets if needed)
SDTF#: Expiration Date: SDTF#: Expiration Date:
(9.) Septage Managet R Operator Training Completed:
Date: 1 2 v 2 Location: M v r 4 n it JVG - Hours
me:Y—
Training Sponsored or Provided by: /I/ C 1=a /+ p-e'r GraU,P--
(10.) Septage Land Application Site Operator Training Completed:
Date: Location: Hours:
Training Sponsored or Provided by:
(11.) Registration type requested: CHECK ONE
Registered Portable Sanitation Firm:
Registered Septage Management Firm:
Registered Portable Sanitation and Septage Management Firm:
Certification Statement
I certify tie 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.
ignature (Signature of companyofflclaf
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Print Name
Other Comments:
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Date
i0 Cy n e
Title
PAGE 2
Rev. 04-26-2021

NC SE PrTAGE MANAGEMENT FIRM
Recertification of Pumper Vehicle(s)
Septage Firm Permit #: NCS-
Number of Pumper Vehicles:
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."
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ignature (Signaftire of company official rrequir
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Print Name
Date
Title
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CHARLOTTE
W'I 7ER
AUTHORIZATION TO DISCHARGE SEPTAGE TO A WASTEWATER TREATMENT
FACILITY
I, Bill Gintert / Environmental Compliance Manager
Charlotte Water - S4 stem Protection CLTWater - SPj.
4222 Westmont Drive Charlotte. NC 28217 704-336-4407
Do hereby authorize Kelly Abernathy
(Authorized Representative)
Of _Piedmont Portable Service. LLC
(Septage Management Firm Name)
To dispose of Septage. X Portable Toilet Waste X
Note: 1) Grease trap waste is not allowed at the disposal sites.
2) Re - introducing partially treated liquid into a grease trap is not allowed in the
Charlotte Water system.
From: Mecklenburg County and Surrounds Areas;
(County or other Geographic Area)
At the below named Wastewater Treatment Facility; Septage shall be discharged;
McAlpine Creek Wastewater Treatment Plant IMCWWTPI Septage Receiving Station
Between the hours of 7:30 a.m. until 11:00 a.m. and 12:00 .m. until 3:45 -.m. Mon. -Fri.
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.
This authorization will be effective: < January 15! 2023
This authorization shall be valid until: December 31St 2023
F
Signed: Date:
(Environmental Compliance Manager)
I
16 -27— 262—z
Note: Falsification of this document by the Septage management firm shall lead to permit revocation.