NCS00787_2023Permit_Initial

2023
Permit and Registration
Cherokee Septic
is hereby issued a Septage Management Firm Permit,
STATE,,
Permit Number NCS-00787
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. Town of Murphy WWTP, Murphy, 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 Perry
Sugg
Digitally signed by
Wm Perry Sugg
Date: 2023.10.12
09:58:16-04'00'
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*
Cherokee Septic
The "Firm name" must be exactly as it is shown on your vehicle(s).
Septage Management Firm permit number (NCS #)
Ncs-00787
Please enter the complete NCS #, including the 5 end digits (NCS-XXXXX)
Street address of office*
Street Address
817 shady grove road
Address Line 2
City
State / Province / Region
Murphy
NC
Postal / Zip Code
Country
28906
USA
County*
Cherokee
Mailing address same as street address of office?*
Yes • No
Mailing Address*
Street Address
641 shady grove road
Address Line 2
City
State / Province / Region
Murphy
NC
Postal / Zip Code
Country
28996
USA
Phone* Fax
8283613390
Email*
[e-mail]
Owner Info
Firm owner's name*
shannon helton
Mailing address same as street address of office?*
• Yes No
Phone* Fax
8283613390

Operator Info
^J
Firm operator's name* Firm operator's title
shannon helton Owner
Mailing address same as street address of office?*
Yes • No
Mailing address*
Street Address
641 shady grove road
Address Line 2
City State / Province / Region
Murphy NC
Postal / Zip Code Country
28906 USA
Phone* Fax
8283613390
Type and amount of septage pumped in the last 12 months
Amount in gallons*
Domestic 520,000
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:
Cherokee graham clay Macon
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
-
Date *
12/23/2022

Title*
Owner/ operator
Choose how to add vehicle descriptions*
• Add vehicles individually Upload List
Pumper Vehicles
Usage* License Tag #* Vehicle Identification #* Tank Capacity*
Domestic Septage NE-5131 2fzhazcv67av53524 3,000
Domestic Septage NH-1513 2fzaatdc15au82192 1,500
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*
Murphy wwtp 12/22/2022 image.3pg 3.08MB
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 l�j
Date* Hours*
11/9/2021 6
Location*
Franklin
Training Sponsored or Provided by*
NC Septic Tank Association
Septage Land Application Site Operator Training Completed
Date Hours

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
Sending check
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
12/23/2022
09:07:59 AM
Print Name*
shannon helton
Title*
Owner/operator

AUTHORIZATION TO DISCHARGE 5E€'TAGI_ TO A WASTEWATER TREATMENT FACILITY
North Carolina Department of Env! ronme ntal Quakily
tNvision of waste M�rlagement - Solid Waste section I
1646 Mail Service Cr:nter, Raleigh, NC 27 699,264 6
Feea55eSSmern5ard wasrtr deti�rrrlinations will berequired atthe dbuctionofthewasuewater
treatment faCiirty_ The Ncilltybas the ult[mate preroigotiveto deny discharge&o(any wastes to the
intaming wastewater stream.
5_ W 011lr a
l � Ali
IPlant Operator in Re5P0nsi1b1@ { W90 (ORQr CK Li[2n5R Number, Name of plant)
', d ress}
-v- -7- ato-I do horebyauthorize 6AF10146A rl
(Phvriemuml►erj {Ownerppraalnr rifSept ge Manapement Flrfn)
of —aerral lC ._ #c, -NCS 400
15eptage ManagerDenL Firm lame and NCS number)
to dispose of: domestic seiltage portabtetoilet waste,
gfease septage (grease trap pu rnoings) —,- co lnmt%reWli nd u itrlal septom from
RCountY cr other 6eogrq�iCAr28j
at the shove named wastewater treatmerK facility. Sept -age shall be discharged at=
I n t}4 YYl ut 114+'ar[ Q _ _ A
(Focatlon)
twtween the a7aurs of $cfD �+'`_ � $(*k i('i`IL4m—
Reintroducing partially Created liquid into a grease: trlap is acceptable Yes - No
?his autboriration shall be valid until 74 U �.
(Usuallw December 31, Fear)
Signed Date 22
Vadlity Operator)
Subscribed and a4frmed before me this tdoy of 20
My Comrnission cores:
(Notary Frolic)
(CIFFICLAL SEAL)
Nat*. FoLHIRmdan of this dacumcnt by the -5splaigu ManAP'+ne11t bFM sho11 IV;L0 to J3ermit ravpCatlprE.
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