NCS01737_2024Permit_Initial

2024
Permit and Registration
Harris Septic LLC
is hereby issued a Septage Management Firm Permit,
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", Permit Number NCS-01737
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and registered as a
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Septage Management Firm �►tm ;� fEnvironmental lity
QUAMNU�
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 Roxboro 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 this registration expire on December 31, 2024.
Wm Perry DI91tz lY sl9ned by —Ferry 5u99
Dale: 2024.02.2013 49.09-05'00'
Sugg
Perry Sugg, Environmental Compliance Branch Head

APPLICATION FOR PERMIT TO OPERATE A SEPTAGE MANAGEMENT FIRM
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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)).
7-/ G L C
Street ad ress of office: 7r'r`!5 1"r!
City: O r 0 State:ZYZ7,�Zip:_� �S _
Mailing address (if different):
City:
State: Zip
Phone: .33 6 —S-o Fax:
E-Mail:. JI h rT r'rj 3 % r� r; m _, -, / _ _ ,
County: Sept ge Management Firm permit number: NCS # '737
(2.) Firm owners name: .S L V 41
Mailing address (if different):
City:
State: Zip
Phone: Fax:
(3.) Firm operator's name-2-0S 8n h � y yy ��Pr%� Firm operator's title:
Mailing address (if different):
City:
State: Zip:
Fax:
(4.) Type(s) of septage pumped: Write in the number of gallons pumped in last 12 months (Example: Domestic: 50,000).
Domestic Portable Toilet Waste Grease (Restaurant) Treatment Plant Industrial/Commercial
� (5.) N.C. Counties of Operation: �P o �rrv�� J,I/I
,e-
(List each county you are authorized to do business in)
(6.) Total Number of Pumper Vehicles Operate : /
Number used for: Domestic Septage: Grease (restaurant):
Other: Portable Toilet Waste:
Vehicle Information: (use additional paper if needed)
a �G�
License Tag # Vehicle Identification # Tank Capacity
3
4
APPLICATION CONTINUED ON PAGE 2

/Ve mi r / /_// Y
APPLICATION FOR PERMIT TO OPERATE A SEPTAGE MANAGEMENT FIRM
(CONTINUED FROM PAGE 1)
(7.) Do you plan to operate pumper vehicles? (check one) (✓Syes ( ) 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 Initial ..1 Date_1" c J 9-- 0?
(8.) Septage Disposal Method: (check one) �
a) Approved wastewater treatment plant: ( V/) 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 Firm Operato Training CopeI td:
Date: ^' — `6- �, Location: r 7u a 1 ��[1%1i Hours: t h p� r, L
Training Sponsored or Provided by: C �. 1 F-r-
F
(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:
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.
S' atu (Signature o ompanyoffrcial required) Dat
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Print Na Title
Other Comments:
PAGE 2
Rev. 04-26-2021

AUTHORIZATION TO DISCHARGE SEPTAGE TO A WASTEWATER TREATMENT FACILITY
North Carolina Department of Environmental Quality
Division of Waste Management - Solid Waste Section
1646 Mail Service Center, Raleigh, NC 27699-1646
Fee assessments and waste determinations will be reouired 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.
Derek Clayton, ORC #9264 for City of Roxboro VMTP
(Plant Operator in Responsible Charge (ORC), ORC License Number, Name of Plant)
902 Cavel-Chub Lake Rd. Roxboro NC 27574 (NC0021024)
(Address)
3365998232 do hereby authorize Joe Harris
(Phone Number) (Owner/Operator of Septage Management Firm)
of NCS # NCS01737
(Septage Management Firm Name and NCS number)
to dispose of: domestic septage YES portable toilet waste NO
grease septage (grease trap pumpings) NO commercial/industrial septage NO from
Person County NC (only!) Domestic Septage (only!)
(County or other Geographic Area)
at the above named wastewater treatment facility. Septage shall be discharged at:
Septic Dump station at the head of the Roxboro WWTP located at 902 Cave] -Chub Lake Rd. Roxboro NC
(Location)
between the hours of 6:30am-11:30am & 12:30pm -6pm (later by permission only)
Reintroducing partially treated liquid into a grease trap is acceptable Yes X No
This authorization shall be valid until December 31, 2024
(Usually December 31, Year)
Signed L% t'-' Date
(Facility Ope ator)
Subscr' ed and affirmed before me this i 6 day of 74
_ter' My Commission expires: .
(Notary Public)�� �/of� Q. �OTA/QL'
MF6ICIAA EAL) G
to 6B 0U -
N COUN
Note: Falsification of this document by the septage management firm shall lead to permit revocation,
S:/Solid_Waste/CLA/SEPTAGE/FORMS/2018 Firm Application/WWTP Authorization Form 2018

ROY COOPER
Governor
ELIZABETH S. BISER
Secretary
MICHAEL SCOTT
Director
Sent via Email
Mr. Joseph Lynn Harris
Harris Septic LLC
127 Harris -Morris Road
Roxboro, NC 27574
NORTH CAROLINA
Environmental Quality
February 12, 2024
Re: New Firm — Assignment of Permit Number (NCS#)
Harris Septic LLC NCS-01737
Dear Mr. Harris:
We have received an Application for a Permit to Operate a Septage Management Firm and a permit fee
payment in the amount of $800. Also, we have record of your attendance at the November 16, 2023,
New Operator Class. However, your Application to Operate a Septage Management Firm will not
be processed until you have submitted the disposal authorizations and 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-01737. 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-01737, 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 me at [phone] or email at Chester.Cobb(D_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