NCS01413_2023Permit_Initial

2023
Permit and Registration
A+ Portable Toilets
is hereby issued a Septage Management Firm Permit,
STATE
Permit Number NCS-01413
oand registered as a e:,e D
NORTH CAROUNA
EQ�J
-�� Septage Management Firm awnen� f� wrnmenta�lty
4sr
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. Cherokee WWTP, Cherokee, 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
Perryby Wm Perry Sugg
Sugg 112:36:203— 05'�200'7
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*
A+ portbale Toilets, Inc
The "Firm name" must be exactly as it is shown on your vehicle(s).
Septage Management Firm permit number (NCS #)
NCS-01413
Enter the five digits following the NCS #
Street address of office*
Street Address
101 Ashe Lane
Address Line 2
PO Box 816
City
State / Province / Region
Bryson City
NC
Postal / Zip Code
Country
28713
US
County*
Swain
Mailing address same as street address of office?*
Yes • No
Mailing Address*
Street Address
PO Box 816
Address Line 2
City
State / Province / Region
Bryson City
NC
Postal / Zip Code
Country
28713
us
Phone*
Fax
8287360695
Email*
[e-mail]
Owner Info
Firm owner's name*
Matthew Bradley Adams
Mailing address same as street address of office?*
Yes 0 No

Mailing Address*
Street Address
PO Box 816
Address Line 2
City
State / Province / Region
Bryson City
NC
Postal / Zip Code
Country
28713
us
Phone* Fax
8287360695
Operator Info
Firm operator's name*
Firm operator's title
Matthew Bradley Adams
Owner/Operator
Mailing address same as street address of office?*
Yes • No
Mailing address*
Street Address
PO Box 816
Address Line 2
City
State / Province / Region
Bryson City
NC
Postal / Zip Code
Country
28713
us
Phone* Fax
8287360695
Type and amount of septage pumped in the last 12 months
Amount in gallons*
Domestic 0
Portable Toilet Waste 10,000
Grease (Restaurant) 0
Treatment Plant 0
Industrial/Commercial 0
North Carolina counties of operation
List each county you plan to do business in: *
Swain, Graham, Jackson, Cherokee Indian Reservation
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
eW, � WawQ
Date*
11/28/2022
Title*
Owner/Operator
Choose how to add vehicle descriptions*
• Add vehicles individually Upload List
Pumper Vehicles
Usage*
License Tag #*
Vehicle Identification #*
Tank Capacity*
Portable Toilet Waste
KT-6224
1FDRF3HTOMED16881
400
Portable Toilet Waste
J-P--&449--
1 FDWF37Y16EA13000
250 JRB 1/10/2023
RH7737
Portable Toilet Waste
KD-4503
1GBJC34141F181817
400
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
Cherokee Wastewater treatment plant 12/31/2023 image.3pg 3.58MB
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*
10/14/2022 4
Location*
Franklin, NC
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
r�2�8ct'r �i�aa�fd
Date
11/28/2022
09:27:02 AM
Print Name* Title*
M. Bradley Adams Owner/Operator

i
f
1 A -dal IIIIIJIDWI.&Pd1l RUN
UTHORIZATION 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 27699mr1646
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.
���•�L1��_��c-a�a,.��-.t
(Plant Operator in Responsible Charge (ORS), ORC License Number, Name of Plant)
rN k�n Aft Jft% sck
(Address)
- lfl`Y1 � do hereby author4F
ize t3f6ALS
(Phone Number) (Owner/Operator of eptage Management Firm)
,-00A
of ► -3- - �-�,61.� T.� � NCS a
(Septage Manage At Firm Name and NCS number)
to dispose of.: domestic septage Ilk." �- portable toilet waste %,W k,��
grease septa,e (grease trap pumpings) R!s.C. commercial/industrial septage c�0 ,from
Ilk
IF
(County or other Geographic Area)
at the al ove named wastewater treatment facility. Sep age shall be discharged at:
C.- r 1. A,^ Lo \C\
Location—
between the hours of IF•yS 1%k%WAr,��.. � --- �-.�►.���
Reintroducing partially treated liquid into a grease trap is acceptable Yes ✓,.,No
This authorization shall be valid until c.A��Pr
(Usually December 31, Year)
Signed � Date
(Facility Operator)
tl t
u n e and affirmed before met i s � �-Q.i� day o 20 Z. Z
My Commission ex
iresIll Q�
(Notary Public%still
ICIAL SEAL)
Z
do
OP 11
do
Note:.* Falsification all this document by the septagm e all lead to evocationl
S.:/Solid.Waste/cLA/S p /2016 Firm Appfication/WWTP Authorization�rj� •�1