NCS01715_2023Permit_Initial

2023
Permit and Registration
K & W Site Service LLC
is hereby issued a Septage Management Firm Permit,
�szArr of
Permit Number NCS-01715
and registered as a e D
o
-�= Septage Management Firm �� ;� fE�l� nmentalQulity
�
E#f QIIAM �
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, Tide 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. Cub Creek WWTP, Wilkesboro NC
2. City of Jefferson 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.
Digitally signed by
Wm Perry
9g
023.10.25 15:16:03
S u g g 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 gjaa v as it is shown on your vehicle(s)).
GO SZrE Seavxr-fs LLC•
Street address of office: 198 KimmirbY Rxmc LN
City: S FPAK-14 State: NC- Zip: 26 -75-
Mailing address (if different):
City: State: Zip
Phone �) is �7 27 % Fax:
E-Mail: rOber4o scc,9-d _ Gam
County: ALL-EGHAK V Septage Management Firm permit number. NCS #
(2.) Firm owner's name: '90BEt'T WEMA►EPY CRATG �JS(-t-LAn+S
Mailing address (if different):
City: State: Zip
Phone: (336)G 57- 2757 Fax:
(3.) Firm operators name: 10860,- I&AyxD!' CPA;rG firm operators title: r6
Mailing address (if different):
City: State: Zip:
Phone: Fax:
(4.) Type(s) of septage pumped: Write in the number of Uglions pumped in last 12 months (Example: Domestic: 50,000).
Domestic , Portable Toilet Waste Grease (Restaurant) Treatment Plant IndustriallCommercial �L
o C> o v
(5.) N.C. Counties of Operation: _ALLi &4Ar Y, &NF, SUQA _ I��yLKESr 1��+TQt1GA
YAP Kyiu
(List each county you are authorized to do business in)
(6.) Total Number of Pumper Vehicles Operated. I
Number used for: Domestic Septage: D Grease (restaurant): O
Other.y Portable Toilet Waste: 1
Vehicle Information: (use additional paper if needed)
License Tag #
Vehicle Identification #
Tank Capacity
1
G o 1
yo Ga..
2
3
4
5
APPLICATION CONTINUED ON PAGE 2
PAGE 1

APPLICATION FOR PERMIT TO OPERATE A SEPTAGE MANAGEMENT FIRM
(CONTINUED FROM PAGE 1)
(7.) Do you plan to operate pumper vehicles? (check one) ( v 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 .0844(a) and vehicle lettering
as required by 15A NCAC _0844(b). Furthermore. 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." f
Do you attest to the statement above? (-yes ( ) no Initial / G<� Date z®L3
(8.) Septage Disposal Method: (check one)
a) Approved wastewater treatment plant ( v-1 yes ( ) no. If yes, submit Wastewater Treatment Authorization for each
plant, as indicated in Subparagraph .0833(c)(14) of the Septage Management Rules.
b) Septage Land Application Site (SLAS) Permit Numbers: (use additional sheets if needed)
SLA-S# 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: `(-14- to Z 3 _ Location: DoE-zo a
Hours:
Training Sponsored or Provided by: 140 Q2 ' .l fFFRC Y' j zLw ZD -k- Fa' E«
(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:
Codification 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.
9-N-200
Signature (SlgnaOre of company facial requireO Date
o-)4'!!' - C t� G� su z_ar"s Ow:.sEz
Print Name Tide
Other Comments:
PAGE
Rev,10.27.2020

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rental The hadjantathad named Wheyetem he deny discharges of any aral by the
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AUTHORIZATION TO DISCHARGE SEPTAGE TO A WASTEWATER TREATM1ENT FACILITY
Mrlh Carolina Iaepartrrrent Gf Ere it-onmental Quality
DWisiorr of Waste Wiflagemevrt - Solid Wasbe Sect.pn
1646 Mail Service Center, R,oIeigk K 27699-1646
L,[^e immsmentsarldwaste deter rainationswlll be required at the discretion of the wastewater
t(eartment facility. The facility has the ultimate 1prero,gakiye tDderryrdiSchargt'iOf jYrPYWOsm 14) Me
M40171-ling wastewater strum_
[Flint Operator In Redponslble{nage gDRCJ440KC11.1cense Number: rUmavfiIPNntj
f (Address)
do hereby authorize o EE R T yF CNN I5
Wilma Numberl jownerjopamtw 4A 5ept30 Manaperhml Flrrn)
(Septage Man@Eernemt Firm Ngrrdaand NCS number)
to dlspme of: domesHe septage portable toilet waste
genw$WtW (grow trap pumVding) cornmerclaVindust rial sepbage . From
NO" WCjF� N-�IpSI0 0 RC3 E-71 hA
4C6unLy 6e 8tPie r Ge0. rf6P hif. AMO
atth6 Dboy* no MO wo6lewolertreartment facility. Septage shall he disdareed at:
between tie hour of , �rl`ti pop, —
Relrktrvdwir4 P"ORY Veated liquid Into a grease trap is aocQpUbls Yes No
Thisautharizattrl shall ;be valid until UL jr 31.2tq
lusuallyr Oicernber 31, YeN[
Signed UAS oato
(Facility Owrawr)
SUbS I affirmed hell'ore m ft's day: * ,,,)3
My CmmiSSion e!q*es•
I tary Rtl licl ,�o}Itr
rtr � M G(UN (U CIAL SW
c „y E.y
F- -
Npte; FAMCatkq Qf jhIsdxumerrt bKthe- UVLMLLrurkegemer►tfirm shall lead byparmltrcvmwlh3n.
$-jWd Wkv*[L1V5EFrAGE"1VSj1a78GvrnW1<j1kvfl'ti p.Aulhrrir.3Lwruimwm

ROY COOPER
Governor
ELIZABETH S. BISER
Secretary
MICHAEL SCOTT
Director
Sent via Email
NORTH CAROLINA
Environmental Quality
September 27, 2023
Mr. Robert Kennedy and Mr. Craig Williams
K & W Site Services LLC
168 Kennedy Ridge Lane
Sparta, NC 28675
Re: New Firm — Assignment of Permit Number (NCS#)
K & W Site Services LLC NCS-01715
Dear Sirs:
We have received an Application for Permit to Operate a Septage Management Firm and payment of
$550 for the permit fee. Also, we have record of your attendance at the New Operator Class on
September 14, 2023. However, your Application for Permit to Operate a Septage Management Firm
will not be processed until we have received at least one disposal authorization 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-01715. 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-01715, 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.Williams(@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,
Chester R. Cobb, Environmental Program Consultant
Division of Waste Management, NCDEQ
D E Q�� North Carolina Department of Environmental Quality I Division of Waste Management
-
217 West Jones Street 1 1646 Mail Service Center I Raleigh, North Carolina 27699-1646
NORTH CAROLINA
N.
oeParonemmrnrironmemaiouai� � 919.707.8200