SDTF7606_APPLICATION_RENEWAL_2023

APPLICATION FOR A PERMIT TO OPERATE A SEPTAGE DETENTION OR
TREATMENT FACILITY
Operator and
1. Applicant
Address
Phone
North Carolina Department of Environmental Quality
Division of Waste Management — Solid Waste Section
1646 Mail Service Center, Raleigh, NC 27699-1646
3LP- LA 3 - 100-,)
2. Contact peison for site operation (if dffferetrt from applicant):
Title or position Phone b3ko
Address ne
3. Landowner CWyV r
Address SQrn
4. Site Location: Count
y � Qndo l State Road Number 'C ed'
Directions to site: % QW D f Y . t acocxcqe-
5. Is the location on a permitted Septage Land Application Site? No
If yes, give the site permit number here: ^ _
6. Indicate whether project is: new renewal V modification
For a permit renewal or modification, indicate the existing permit number 5 T)l F - —1 to and the
permit expiration date _ W 14 l Z 3 _
7. Attach written, notarized landowner authorization to operate a septage storage or treatment facilitty
form signed by the landowner (if the permit applicant does not solely own the property), if a
corporation owns the land use a corporate landowner authorfzadon form. if Limited Liability
Company owns the land, use a limited liability company landowner authorization form.
8. Aerialphotograph scale 1 Inch = 400 feet with site property lines accurately located on the photograph
must be enclosed (if 1 inch = 400 feet is not available,1 inch = 660 feet may be substituted).
9. Vicinity map (county road map showing site location).
10. Land application site or wastewater treatment plant to be used after treatment or storage:
Eashide INastvwo�le Plta;n� h� i�'�yerda �d
(over) d ckvnzS�W n, NC a-lo1$at

Facility Information: the following information shall be included with the application lam.
1. Facility to be used for: Storage ✓ Treatment
2. Types of septage to be stored or treated:
Domestic Septage ✓ Grease Trap Pumpkrgs
Portable Toilet Waste Commer iaUlndustrial Septage
3. Types of treatment to be provided: pH Adjustment (lime stabilization) ✓
Sing Other' i (attach explanation if other)
4. A description of the proposed detention or treatment facitily Includirig the size, type, and number of
structures to be used and how those structures will be constructed or iniial(use additional
paper to explain, if necessary): K
5. An explanation of how septage A be discharged into and removed from the facility (use
additiomal paper to explain, If rosary): T1'1C0l1►
6. An explanation of how any leaks or spills at the facility will be deaned and tow odors will be
controlled (use additional paper to explain, if necessary): i . i 4j r L
I hereby certify that:
1. The information provided on this application is We, complete, and correct to the best of my
knowledge, and
2. 1 have read and understand the N.C. Septage Management Rules.
3. 1 am aware of the potential consequences, including penalties and permit revocation, for
failing to follow all applicable rules and the conditions of a Septage Detention or Treatment
Facility permit.
Signature or yv&WMq ' Date
('. O C1mos 0
Print name --- V T Title
Note: TMs application wm not be aceepted for review until all parts of the application are complete.
S-.Wid Waste' cWWeOage d'(w= 3DTF,AP0"U- 6 AUffMI atbn%WTF PMk AWkaUorWan 2016Aom
Rev 01-07-16

Wylie, Connie S
From: Charles Driggers <[e-mail]>
Sent: Friday, September 22, 2023 9:28 AM
To: Wylie, Connie S
Subject: [External] Re: SDTF-76-06
CAUTION: External email. Do not click links or open attachments unless verified
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I will get this filled out correctly and emailed back to you.
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On Tuesday, September 19, 2023, Wylie, Connie S <[e-mail]> wrote:
Hello Charles & Brenda Driggers
This is Connie Wylie — I am temporarily out of retirement to assist with permitting in the Septage Branch. I have been
reviewing the renewal application that Chester received earlier this year and need your help to correct some items.
One of the attachments to this email is that recent application and several questions were not answered completely.
have also attached a copy of the last application in 2017 for comparison. Each application for a new permit must be
completed in full to ensure that the information is accurate at this time. I have attached a blank application — can you
please complete the form & resend by email to me. Also, I need signatures on the application form from both of you
(as we did with the 2017 application) so that a landowners authorization form is not needed.
If you have any questions, please reach out to me by email (as my voice mail system is not yet set up plus I am only part
time).
Thanks
Connie Wylie
Connie S. Wylie
Environmental Specialist 11
Division of Waste Management
North Carolina Department of Environmental Quality
Office: [phone]
[e-mail]

Q V.-
�e..a4i re. �yo'E
Email correspondence to and from this address may be subject to the North Carolina Public Records Law and may be disclosed to third parties by an authorized
state official.
Driggers Septic Tank
7096 Beane Rd.
Archdale, NC 27263
[phone]
www.DriggersSept!cTank.com