NCS01730_2024Permit_Initial

2024
Permit and Registration
Quality Septic Service
is hereby issued a Septage Management Firm Permit,
STATE� Permit Number NCS-01730
- o and registered as a
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NORTH CAROUNA
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-�� Septage Management Firm awnen� fEnvironmental �lty
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. Old Brookford Plant, Hickory 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 this registration expire on December 31, 2024.
Wm Perry Digitally signed by Wm
Perry Sugg
Date: 2024.01.26 12:33:38
S u g g-05'00'
Perry Sugg, Environmental Compliance Branch Head

APPLICATION FOR PERMIT TO OPERATE A SEPTAGE MANAGEMENT FIR"
DIVISION OF WASTE MANAGEMENT - SOLID WASTE SECTION -1646 MAIL SERVICE CENTER, RALEIGH, NC 27699-1646
(1.) Firm name: (The "Firm name" must be ex� as it is shown on your vehicle(s)).
Street address of office: ,� 0.,N Y
City: State:41C
Mailing address (if different):
City: State: Zip
Phone: 3319 Fax:
E-Mail: 91& &A /1 de P ii C
County: A Septage Management Firm permit number: NCS # `�✓
(2.) Firm owner's name: D h e 6er9eA
Mailing address (if different):
City: State: Zip
Phone: Fax:
(3.) Firm operator's name:M:A-C _rA( Y I Firm operator's title:AW�
Mailing address (if different): JP.2e G/9-/Le5 Ra IUD
City: ! G D ift H State:Al�Zip:
Phone: 3 1— O Fax: �A(
(4.) Type(s) of septage pumped: Write in the number of gallo_n_ssnc_mge in last 12 month- (Example: Domestic: 50,000).
(5.) N.C. Counties of Operation:E42e14
1.01
(List each county you are authorized to do business in)
(6.) Total Number of Pumper Vehicles Operated:
Number used for: Domestic Septage: ! Grease (restaurant):
Other: _ Portable Toilet Waste:
Vehicle Information: (use additional paper if needed)
License Tag # I Vehicle Identification # Tank
443 0 9 1 >ri a.r, o? r1 r.1 a is e f ,ft 12" .
APPLICATION CONTINUED ON PAGE 2

APPLICATION FOR PERMIT TO OPERATE A SEPTAGE MANAGEMENT FIRM
(CONTINUED FROM PAGE 1)
(7.) Do you plan to operate pumper vehicles? (check one) (✓ryes ( ) 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? yes ( ) no InitialJ' L Date _ �% ZU-
(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 theSeptage 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 Manageme,:t Fir.., Operator Training Comple d:
L/ Date: 6< f = Location: �f.� Hours:_
Training Sponsored or Provided by: �� 1LJ4E141 7
(10.) Septage Land Application Site Operator Training Completed:
Date: _ Location:
Training Sponsored or Provided by: _ _
(11.) Registration type requested: CHECK ONE
Registered Portable Sanitation Firm: k-"'
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 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.
4g'nat�ure(Sig�reofcompanyo ial regairedJ
R, Z
Print Name
Other Comments:
Title
PAGE 2
Rev. 04-26-2021

AUTHORIZATION TO DISCHARGE SEPTAGE TO A WASTEWATER
TREATMENT FACILITY
North Carolina Department of Environment and Natural Resources
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.
I, Shawn Pennell. City of Hickory
4014 River Rd Hicko. NC 28602 (Plant Operator and Name of Plant)
(Address)
828-323-7427 _do hereby authorize Jason R Lineberger
(Phone Number) (Owner/Operator of Septage Management Firm)
of Qualil Se tic Service
(Septage Management Firm Name and NCS number)
NCS #
to dispose of: domestic septage _ X , portable toilet waste ,
grease septage (grease trap pumpings) - commercial/industrial septage ---- — , from
Alexander Burke. Caldwell. Catawba. Iredell and Lincoln
(County or other Geographic Area)
at the above named wastewater treatment facility. Septage shall be discharged at:
Old Brookford Plant
between the hours of 7:00am and 7:00pm (Location)
Reintroducing partially treated liquid into a grease trap is acceptable Yes X No
This authorization shall be valid until December31, 2024
(Usually December 31, Year)
Signed Date_ Z 1-1
(Facility Operator)
Swom to and subscribed before me this day of.. r , IL 20 ��
A !.. � k _L M 1.` My Commission expires: f
(Notary Public)
(OFF„N
i
��, try ''�+��"•�� F� ��i
Note: Falsification of this document by the septage management firm shall lead to permit revocation. Y URr 2
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""ANIL (M%�P%
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ROY COOPER
Governor
ELIZABETH S. BISER
Secretary
MICHAEL SCOTT
Director
Sent via Email
Mr. Jason R. Lineberger
Quality Septic Service
259 Bob Friday Road
Dallas, NC 28034
NORTH CAROLINA
Environmental Quality
January 9, 2024
Re: New Firm — Assignment of Permit Number (NCS#)
Quality Septic Service NCS-01730
Dear Mr. Holden:
We have received an Application for a Permit to Operate a Septage Management Firm, a permit fee
payment in the amount of $800, and a disposal authorization for the Old Brookford WWTP in Hickory,
NC. Also, we have record of Mr. Mike Ingle's attendance at the November 16, 2023 New Operator Class.
However, your Application to Operate a Septage Management Firm will not be processed until the
vehicle has 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-01730.
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-01730, 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.WiIIiams(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,
Chester R. Cobb, Environmental Program Consultant
Division of Waste Management, NCDEQ
copied: Stephanie Williams, Environmental Specialist II, Asheville Regional Office
�� NOTth Carolina Department of Environmenta Quality I Division of Waste Management
,/-,�-D Et
217 West Jones Street 1 1646 Mail Service Center I Raleigh, North Carolina 27699 -16 46
919.707.8200