NCS01707_2023Permit_Initial

2023
Permit and Registration
Capital Waste
is hereby issued a Septage Management Firm Permit,
STATE,,
Permit Number NCS-01707
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. City of Mount Airy WWTP
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 Digitallysigned byWrn
Perry Sugg
Date: 203.10.1
Sugg 09:59:20- 04'00?
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 "Firm name" must be exactly as it is shown on your vehicle(s)).
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Street address of office: ? L-1 ca)05 Sd S
City: )6'r ytilcw!) idr n _ State: C Zip: -' 70 q
Mailing address (if different):
City:AA. State: .,Zip �I ,
Phone: S5- 3029 Fax: 1�liF ,Q
E-Mail: OFP'fce O ;-12� f vQcr.5iegT251 . Can
County: SUrfj Septage Management Firm permit number: NCS #
(2.) Firm owner's name! -JO(CI04 KOtA fed"
Mailing address (if different):
City: /j /,4 -State:
!h Zip /V1
Phone: ly"7S---932©i Fax: /+�
(3.) Firm operator's name: {AciA )dot k6- Firm operator's title: 0L3 r,,t I -
Mailing address (if different):
0
City: All State: Zip: AIM -
Phone: 3,A, - 7SS-q32G Fax: / WA
(4.) Type(s) of septage pumped: Write in the number of gallons oumoed in Jost 12 months (Example: Domestic: 50,000).
_Domestic I Portable Toilet Waste Grease (Restaurant) Treatment Plant Industrial/Commercial
- -J .- Q - L
(5.) N.C. Counties of Operation: _1; vrl , re�/� 1
(List each county you are authorized to do business in)
(6.) Total Number of Pumper Vehicles Operated: I
Number used for: Domestic Septage: R- Grease (restaurant): p
Other: 4i> _ Portable Toilet Waste: _ r
Vehicle Information: (use additional paper if needed)
License Tag # Vehicle Identification #
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) (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 S� Zoe
(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 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 Firyn Operator Training Completed:
Date: Al . Location: /1/ Hours
Training Sponsored or Provided by:
(10.) Septage Land Application Site Operator Training Completed:
Date: VIA Location: A11,4
Training Sponsored or Provided by:
(11.) Registration type requested: CHECK ONE
Registered Portable Sanitation Firm: X
Registered Septage Management Firm:
Registered Portable Sanitation and Septage Management Firm:
Certification Statement
Hours:
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 pergiit may be suspended or revoked upon a finding that its issuance was
based upon incorrect or i dequate informatio that materially affected the decision to issue the permit and that there are
criminal penalties for k 1y-malking•a f i statement, representation, or certification.
Sig (Signature of cafriparry6AIcial required) Date
Print
Other Comments:
le4 e e-;dl
W4115
A
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Title
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7
Rev. 04-26-2021
PAGE 2

CITY OF MOUNT AIRY WWTP
P.O. Box70
Mount Airy, NC 27030
September 18, 2023
Mr. Jordan Koehler
Capital Waste LLC.
1668 Park Drive
Mount Airy, NC 2703 0
Subject: Approval for wastewater discharge into Treatment Plant
Dear Mr. Koehler,
This letter is in reference to a request made by your company to discharge wastewater
into the City of Mount Airy Wastewater Treatment Facility. As stated in the request, the
wastewater will be generated by a Port a John business. The City hereby grants
permission for your company to discharge port a John waste into the headworks of the
treatment facility. The discharge will be accepted Monday — Friday from 8:00 am to 5:00
pm. No discharge will be allowed on weekends or holidays. The City will issue a monthly
fee for the discharge.
Should you have any questions or concerns, feel free to contact me at [phone].
Sincerely,
J/Y�� sd
Chris Marion
WWTP Superintendent
City of Mount Airy

8116/23, 8:37 AM User Task
t a
State of North Carolina Application for Permit to operate a
Environmental Quality
Waste Management Septage Management Firm
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*
Capital Waste LLC
The "Firm name" must be exactly as it is shown on your vehicle(s).
Septage Management Firm permit number (NCS #)
N/A
Please enter the complete NCS #, including the 5 end digits (NCS-XXXXX)
Street address of office*
Street Address
2227 Old US 52 S
Address Line 2
city
Pilot Mountain
Postal / Zip Code
27041
County
Surry
Mailing address same as street address of office?*
Jk Yes o No
Phone
336-755-9329
Email*
[e-mail]
State / Province / Region
North Carolina
Country
United States
Fax
https://edocs.deq.nc.gov/Forms/form/approval/e795f760-74f4-4fbl-9b51-294f96f5d750/ 1/6

8/16/23, 8:37 AM
User Task
Owner Info
Firm owner's name*
Jordan Koehler
Mailing address same as street address of office?
0 Yes O No
Phone*
336-755-9329
Operator Info
Fax
Firm operator's name* Firm operator's title
Jordan Koehler Owner
Mailing address same as street address of office?*
Yes O No
Phone' Fax
336-755-9329
Type and amount of septage pumped in the last 12 months
Amount in gallons*
Domestic 0
Portable Toilet Waste 0
Grease (Restaurant) 0
Treatment Plant 0
Industrial/Commercial 0
https://edocs.deq.nc.gov/Forms/form/approval/e795f760-74f4-4fb1-9b51-294f96f5d750/ 2/6

8/16/23, 8:37 AM
User Task
North Carolina counties of operation
List each county you plan to do business in:*
Surry and Iredell County
Vehicle Info
Do you plan to operate pumper vehicles?*
0 Yes 0 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*
8/15/2023
Title*
Owner
Choose how to add vehicle descriptions*
Q Add vehicles individually O Upload List
Pumper Vehicles
Usage *
License Tag #* Vehicle Identification # *
Portable Toilet Wast(y N/A
+ Add more vehicles
N/A
Tank Capacity*
•;►
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8/16123, 8:37 AM
User Task
Septage Disposal Method
For each method, indicate whether you plan to use it by checking yes or no.
Approved wastewater treatment plant*
0 Yes O 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*
Mt Airy Waste Water Plant
+ Add another WWTP
Septage Land Application Sites (SLAS)
O Yes Q No
Septage Detention or Treatment Facility (SDTF)
0 Yes o No
Other disposal method*
O Yes Q No
Expiration Date* Authorization *
8/15/2023M Upload
CAPITAL ... 25.45KB X
Septage Management Firm Operator Training Completed
Date*
8/15/200
Location
N/A
Training Sponsored or Provided by*
NC DEQ - New Operator Training
V
Hours*
0
https://edocs.deq.nc.gov/Forms/fon,n/approval/e795f760-74f4-4fbl-9b51-294f96f5d750/ 4/6

8/16/23, 8:37 AM
User Task
Septage Land Application Site Operator Training Completed
Date Hours
Cl 0
Location
Training Sponsored or Provided by
v
Registration Type
Select one*
Registered Portable Sanitation Firm
O Registered Septage Management Firm
O Registered Portable Sanitation and Septage Management Firm
Comments and Notes
Comments or notes
Please call me when possible I have a few questions and need some help
with this form thanks!
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.
Signature
,[� flf7fG �fff
Date
8/15/2023 n
08:16:25 AM
hftps://edocs.deq.nc.gov/Forms/form/approval/e795f760-74f4-4fbl-9b51-294f96f5d750/ 5/6

8/16/23, 8:37 AM
User Task
Print Name*
Jordan Koehler
Comments
Title
Owner
Mark Complete
2000 characters left
https://edocs.deq.nc.gov/Forms/form/approval/e795f760-74f4-4fbl-9b51-294f96f5d750/ 6/6

ROY COOPER
Governor
ELIZABETH S. BISER
Secretary
MICHAEL SCOTT
Director
Sent via Email
Mr. Jordan Kochler
Capital Waste
2227 Old US 52 S
Pilot Mountain, NC 27041
NORTH CAROLINA
Environmental Quality
August 31, 2023
Re: New Firm — Assignment of Permit Number (NCS#)
Capital Waste NCS-01707
Dear Mr. Kochler:
We have received an Application for Permit to Operate a Septage Management Firm and payment of
$550 for the permit fee. 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-01707. 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-01707, 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 Ms. Stephanie Williams, Environmental Specialist II in the Asheville Regional Office at
[phone] or email at Stephan ie.WiIliams(a)deg.nc.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,
ax-�? 40
Digitally signed by Chester Cobb
DN: —Chester Cobb, o=NC DEQ, —Division of Waste
Management, email=[e-mail], c=US
Date: 2023.08.31 14:59:40-04'00'
Chester R. Cobb, Environmental Program Consultant
Division of Waste Management, NCDEQ
copied: Stephanie Williams, Environmental Specialist II, Asheville Regional Office
owr
�� North Carolina Department of Environmentai Quality I Division of Waste Management
z.,-DEf
217 West Janes Street 1 1646 Mai Service Center I Raleigh, North Carolina 27699.1646
919-707-8200