NCS01683_2023Permit_Initial

2023
Permit and Registration
Coastal Waste Solutions LLC
is hereby issued a Septage Management Firm Permit,
�4 �Nti STATE
Permit Number NCS-01683
- o and registered as a
e:,e D
NORTH CAROUNA
EQ�J
ILL i2�ti�
-�� Septage Management Firm tiepartmento}Enulr nmentalllty
aunrt
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. Scientific Water & Sewer, Jacksonville NC
This pen -nit 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 operateas permitted mayresultin the Department suspending or revoking thispermit, 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
Sugg 116:0355-04005
Perry Sugg, Environmental Compliance Branch Head

N m bpe
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 "Firm name" must
be exactly as it is shown on your vehicle(s)).
y V
Street address of office: a _
City: State: NC. Zip:_ 7_'S' A�Q
Mailing address (if different):
City:
State:
Zip
�h
Phone: " 1
Fax:
E-Mail: C S
County: L1�_
Septage Management Firm permit number:
NCS # i/
(2.) Firm owner's name:_���(�
~ N
Mailing address (if different):
City:
State:
Zip
N
Phone:cJr
Fax:
(3.) Firm operators name:_ U h0 Gm-
Firm operator's title:
9U
Mailing address (if different):
4
City:
State:
Zip:
Phone: 0M) III - 005IS
Fax:
(4.) Type(s) of septage pumped: Write in the number
of gallons pumped
in last 12 month
(Example: Domestic: 50,000).
Domestic Portable Toilet Waste I
Grease (Restaurant)
I Treatment Plant
I Industrial/Commercial
(5.) N.C. Counties of Operation:
Yha\.1i((, 1 _br\ck\ .
county you are
(6.) Total Number of Pumper Vehicles Operated: A
Number used for: Domestic Sept ge: \ Grease (restaurant): n
Other: Portable Toilet Waster
Vehicle Information: (use additional paper if needed)
License Tag #
Vehicle Identification #
Tank Capacity
IbbaCNIA
2
3
4
5
APPLICATION CONTINUED ON PAGE 2
PAGE

APPLICATION FOR PERMIT TO OPERATE A SEPTAGE MANAGEMENT FIRM
(CONTINUED FROM PAGE 1)
(7.) Do you plan to operate pumper vehicles? (check one) ( ) 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? (✓ryes ( ) no Initial G Date
(8.) Septage Disposal Method: (check one)
a) Approved wastewater treatment plant: Oyes ( ) 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 (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 Management Firm Operator Training Completed:
Date: Location:
;[ •111R
Training Sponsored or Provided by:
(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 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.
uk�N&,
Signature (Signature of companyofficial required)
Print Name
Other Comments:
Date
'► ►.:,till
PAGE 2
Rev.04-26-2021

AUTHORIZATION 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 the wastewater
treatment facility. The facility has the ultimate prerogative to deny discharges of any wastes to the
incoming wastewater stream.
t3ygl _
Plant Operator in Responsible Charge (ORC), ORC License Number, Name of Plant)
3 Y8- -y Z Y ':s7a - //z- Aj C-ZefY-a
(Address)
/ i0 ;�w do hereby authorize
(Phone Number) (Owner/Operator of Septage Management Firm)
of �; :�_'...'��_ �:I''.� vr' NCS# bv�
(Septage Management Firm Name and NCS number)
to dispose of: domestic septage I portable toilet waste Y -r—
grease septage (grease trap pumpings) commercial/industrial septage �4 C4 from
0:..1, W ' cC:T
(County or other Geographic Area)
at the above named wastewater treatment facility. Septage shall be discharged at:
i ri.J � . '�'- C. L r0 Cr &10 ),/ 2 1,,Lj %-pd / ' C— a ® 0 Re Z 2
--y oc tion)
between the hours of _
I
Reintroducing partially treated liquid into a grease trap is acceptable Yes ZNO
This authorization shall be valid until '2--r��.. 2�A
(Usually December 31, Year)
Signed Date a ` ` Z.G L
(Facil Operator)
Subscribed n affirme before me this day of 20 Z6
My Commission expired
xpir
(Notary Public 1
k.
MICHELLE & C®RP (OF IAL SEAL)
NOTARY PUBLIC
ONL=LOW COUNT►►
STATE OF NORTH CAROLINA
Note: Falsification of this document by the septage management firm-sfiaT
S:/Solid_Waste/CLA/SEPTAGE/FORMS/2018 Firm Application/WWTP Authorization Form 2018

ROY COOPER
Governor
ELIZABETH S. BISER
Secretary
MICHAEL SCOTT
Director
Sent via Email
Mr. Caleb Gill
Coastal Waste Solutions LLC
121 Garnet Lane
Jacksonville, NC 28546
NORTH CAROLINA
En vironmen (a I Quality
April 26, 2023
Re: New Firm — Assignment of Permit Number (NCS#)
Coastal Waste Solutions LLC NCS-01683
Dear Mr. Gill:
We have received an Application for Permit to Operate a Septage Management Firm and payment of the
permit fee of $550. However, your Application for Permit to Operate a Septage Management Firm
will not be processed until the operator has attended the New Operator Class, at least one
disposal authorization has been received, and the vehicle(s) have been inspected for compliance
with the rules and approved by the Division. When the Permit to Operate a Septage Management
Firm is issued, the Firm Permit Number will be NCS-01683. Please note that this letter is not a permit.
Requirements for the pumper vehicle(s) can be found within 15A NCAC 13B .0835 of the Septage
Management Rules. As noted within Rule .0835 (b), the firm name, town name, phone number, and
permit number, NCS-01683, must be visible and permanently attached on both sides of the pumper
vehicle. Each letter must be at least 3 inches in height. When the required lettering has been completed,
please contact Mr. John Farnell at 910-796-7397 or email at John. Farnell(a)ncdenr.gov to request a truck
inspection.
This letter shall not be considered as a permit to operate a Septage Management Firm. Please
note that you may not legally operate a septage management firm in North Carolina without a
permit. General Statutes, GS 130A-291.1 (c) states in part "A septage management firm that
commences operation without first having obtained a permit shall cease to operate until the firm obtains a
permit under this section." You are hereby advised that, pursuant to N.C.G.S. 130A-22, an administrative
penalty of up to $15,000 per day may be assessed for each violation of the Solid Waste Statute or
Regulations. If you have any questions, feel free to contact me at 919-707-8283.
Sincerely,
Digitally signed by Chester Cobb
DN: cn=Chester Cobb, o=NC DEQ, ou=Division of
Wasteto Management,
�;gemail=[e-mail], c=US
19—�e Date: 2023.04.26 11:40:52-04'00'
Chester R. Cobb, Environmental Program Consultant
Division of Waste Management, NCDEQ
copied: John Farnell, Environmental Specialist II, Wilmington Regional Office
owr
�� North Carolina Department of Envirunmentai Quality I Division of Waste Management
z.,-DEf
217 West Jones Street 1 1646 Mai Service Center I Raleigh, North Carolina 27699.1646
919.707.8200