NCS01766_2024Permit_Initial

2024
Permit and Registration
Simple Septic
is hereby issued a Septage Management Firm Permit,
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: ",1s Permit Number NCS-01766
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o and registered as a e:le DE
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` a= Septage Management Firm Department ofEnvironmental Quality
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. Warren County WWTP, Warrenton, 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.
Digitally signed by
Jason M. Watkins
Date: 2024.07.18
13:48:01-04'00'
Jason M. Watkins, Chief
Solid Waste Section

�\AeQD ()PQSo�For
APPLICATION FOR PERK,,_ T 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 exac as it is shown on your vehicle(s)).
Street address of office: �, n �'p LO i nC1i nos d, kY' % \A_
City:t%'AN\?_\' I'__.N State: WU!_ , Zip: a_7%t
Mailing address (if different):
City:
State: Zip
Phoneat;4-?i'-101��1K Fax:
E-Mail: _6 6_yi-e _�q° Zsm,)V)_ 7� �C • 1y�}
County: l00L_v 4� e JA Septage Management Firm permit number: NCS #
(2.) Firm owners name: C-) C r -Q
Mailing address (if different):o�
City: State: Zip
Phone: Fax:
(3.) Firm operator's name. i A VCR _ Firm operator's title:
Mailing address (if different): S�crse
City: State: Zip:
Phone: Fax:
(4.) Type(s) of septage pumped: Write in, the number of gallons oumned in last 12 months (Example: Domestic: 50,000).
Domestic Portable Toilet Waste Grease (Restaurant) Treatment Plant IndustriaUCommercial
O 7
(5.) N.C. Counties of Operation: ,O(C CR1L1 rlQt i tt� .x i v>Sihamoknu
each county you are authorized to do business in)
(6.) Total Number of Pumper Vehicles Operated: ;
Number used for. Domestic Septage:_I Grease (restaurant):
Other: Portable Toilet Waste:
Vehicle Information: (use additional paper if needed)
Vehicle Identification # Tank Capacity
1F C',NVAA 5Y W_-, V6 7 (K I ;�Xfk),
APPLICATION CONTINUED ON PAGE 2
PAGE 1
hCod
'74 ./ a62JI

APPLICATION FOR PERMIT TO OPERATE A SEPTAGE MANAGEMENT FIRM
(CONTINUED FROM PAGE 1)
(7.) Do you plan to operate pumper vehicles? (check one) 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
requirements for safe and sanitary transportation of septage as required
as required by 15A NCAC .0835(b). Furthermore, I also certify that a loc
required by 15A NCAC 13B .0836(a). I am aware that there are significE
possibility of fine and imprisonment."
Do you attest to the statement above . (`� ) yes ( ) no Initial Datef,,\21�
in the submitted permit application meets the
by 15A NCAC 13B .0835(a) and vehicle lettering
is maintained of each septage pumping event as
it penalties for false certification including the
(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 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 Operator Training Completed:
Date: --I III�- Location: M : u n v.c. Hours:
Training Sponsored or Provided by: %C'
(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.
� rr
L
Signs ure (Sign ure of �ompanyoff d u� J
n
Print Name
Other Comments:
C" . VL&�A
Date
NO
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, William R. Perkinson ORC License Number 987831
(Plant Operator in Responsible Charge (ORC) and ORC License Number)
Warren County WWTP 738 US Hwy 401 S.. PO BOX 281, Warrenton. NC 27589
(Address)
252-257-1776 do hereby authorize David Kres e
(Phone Number) (Owner/Operator of Septage Management Firm)
of Simple Septic NCS #01766
(Septage Management Firm Name and NCS number)
to dispose of: domestic septage X , portable toilet waste X
grease septage (grease trap pumpings) commercial/industrial septage , from
Warren. Vance Granville and surrounding counties
(County or other Geographic Area)
at the above -named wastewater treatment facility. Septage shall be discharged at:
Influent works
(Location)
between the hours of 8:00 AM - 3:30 PM Monday - Friday —
Reintroducing partially treated liquid into a grease trap is acceptable Yes X No
This authorization shall be valid until December 31- 2024
`Q�(Usually December 31, Year)
Signed �1�� �Z�Q GtJ�'� Date
(Facility Operator)
Sworn to and subscribed before me this ! C
.. 0aj
day of t 20
4 -%- �5
(Notary Public) `` ��1NIEiRF/1�,i
A*-IAL SEAL)
���,y
atV0G
Note: Falsification of this document by the septage management firm shall lead to permit revocatioc 7 m
S:/Solid_Waste/CLA/SEPTAGE/FORMS/2013 Firm Application/WWTP Authorization Form 2013 0 to Zo�
11
My Commission expires:

ROY COOPER
Governor
ELIZABETH S. BISER
Secretary
MICHAEL SCOTT
Director
NORTH CAROLINA
Environmental Quality
July 2, 2024
Sent via Email
Denise & David Kresge
Simple Septic
156 Windward Dr.
Littleton, NC 27850
Re: New Firm — Assignment of Permit Number (NCS#)
Simple Septic NCS-01766
Dear Denise & David Kresge:
You have been assigned the Septage Management Firm Permit Number of NCS-01766 based
upon the receipt of an Application for a Permit to Operate a Septage Management Firm and a
permit fee payment in the amount of $800. However, a Permit to Operate a Septage
Management Firm will not be issued until:
1) Submission of the disposal authorizations to cover the type(s) of septage you plan to
pump and the area you plan to serve. Authorizations can also be scanned and
emailed to me at [e-mail].
2) Attend a New Operator Class for operating a Septage Management Firm. There is
no fee for the class. Currently, this Class is being taught virtually. The next
scheduled New Operator Class will be on Thursday, July 11th. Please contact Mr.
Jeffrey Bullard about attending this Class so that he can place you on the list of
attendees. Jeff can be contacted by phone at 919-707-8285 or email at
Jeffrey. [e-mail].
3) Inspection of the pumper vehicle(s) for compliance with the Septage Management
Rules and approved by the Division. 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-01766, must be visible and permanently attached on both sides of the pumper
vehicle. Each letter must be at least 3 inches in height. When ready to schedule an
inspection, please contact Mr. Chester Cobb, Environmental Program Consultant in
the Raleigh Office at [phone] or email at [e-mail] .
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 919-707-8292.
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
oeParonemmrnrironmemaiouai� � 919.707.8200

Sincerely,
Lee Sorrell, Environmental Specialist II,
Division of Waste Management, NCDEQ
copied: Chester Cobb, Environmental Program Consultant, Raleigh Office
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 _
DepammammEmimnmameiausil /`� 919.707.8200