NCS01762_2024Permit_Initial

2024
Permit and Registration
Tate Farm by the Pond, LLC
is hereby issued a Septage Management Firm Permit,
STATE,,
Permit Number NCS-01762
o and registered as a
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NORTH
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-�� Septage Management Firm�� �� w� ��nffii�utr
E� M
NORTH CAROLINA (NON -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 only authorized to operate Septage Management Facilities listed below:
1. Septage Detention or Treatment Facility, SDTF-71-13
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. Also, this permit does not entitle the permit holder to operate a pumper vehicle for the transportation of Septage.
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, 2024.
Wm Perry
Sugg
Digitally signed by Wm
Perry Sugg
Date: 2024.06.21
12:51:51-04'00'
Perry Sugg, Environmental Compliance Branch Head

APPLICATION FOR A PERMIT TO OPERATE A.SEPTAGE MANAGEMENT FACILITY
(NON -PUMPER - $200 FEE PER FACILITY)
(1.) Facility name:
Street address of office
DIVISION OF WASTE MANAGEMENT - SOLID WASTE SECTION
1646 MAIL SERVICE CENTER, RALEIGH, NC 27699-1e4.6
P �trCV-\ \'I �_ 9ON-1 is� I � LC
Mailing address (if different)
/J C, or
A� IJ(",
County Q�P
(2.) Facility owner's namesy^-1
Mailing address
Phone: k C) ^ Email: �T
(3.) Facility operator's name _ T� T� acilit operator's title_ CSC\kN.
Mailing address_fQj CG S a �V� D, k 1
Phone
(4.) Tit, otel of septage managed (check all that apply) C
Domestic Portable Toilet Waste Grease (restaurant)
Treatment Plant Industrial/Commercial
(5) Facility Types: Check all that are applicable and provide the permit numbers.
a) Septage land application site
b) Boat pump -out storage
c) Septage storage tanks
d) Septage treatment
e) Grease treatment
"` ame is
(2)
(3)
Number of all
.r - _ e■
(Use additional sheets if necessary)
C T ' C S0lo4
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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 maybe 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
t ther, e Grim, enaltie*-ft-.knowln ly making a false statement, repr �entairn or certification.
i
signature* I Date j
Print NalIlne Titlet5
(�}•..�
*Signature of company official required.
S: Sol id_Waste/CLA/septage/fonns/2018 Firm Application/Non-Pumper-2018