NCS01174_2024Permit_Initial

2024
Permit and Registration
Upstate Septics
is hereby issued a Septage Management Firm Permit,
ZNti STATE
Permit Number NCS-01774
o and registered as a
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-�� Septage Management Firm�� �� w� ��nffii�utr
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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. Forest City WWTP, Forest City 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 Wm Perry
Wm Perry S u g g Date: 2024.07.2913:07:27
-04'00'
Perry Sugg, Environmental Compliance Branch Head

APPLICATION FOR PERMIT 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 exactly as it is shown on your vehicle(s)).
Street address of office: �f Z--, 4 C'd L6d - _
City: % In , Yl P( _ State: _Zip: �,Z3 �- r
Mailing address (if different): (`
City: State: Zip
Phone: � q -6,1?_-2-7-5 L Fax:
Management Firm permit number. NCS #
(2.) Firm owner's name: 7 � V :c jn-
Mailing address (if different):
City: State: Zip
Phone: Fax:
(3.) Firm operator's name: ru ct xr. rz�' t:jg 2 -- Firm operator's title: 8d Aq!�&
Mailing address (if different): _�C2s--
City: V\ e c State:.'�;C' Zip: 7 9 :S 2-71�
Phone: l (I- el, l Z z-2 3I' Fax:
(4.) Type(s) of septage pumped: Write in the number of aallons 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: 12-
(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 #
Vehicle Identification #
Tank Capacity
1
2
3
4
5
APPLICATION CONTINUED ON PAGE 2

APPLICATION FOR PERMIT TO OPERATE A SEPTAGE MANAGEMENT FIRM
(CONTINUED FROM PAGE 11
(7.) Do you plan to operate pumper vehicles? (check one) (✓jyes ( ) 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 .0844(a) and vehicle lettering
as required by 15A NCAC .0844(b). Furthermore, I also certify that a log is maintained of each septage pumping event as
required by 15A NCAC 13B .0839(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 Date 7- Z Zq
(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 .0833(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)
SDTFA Expiration Date: SDTF#. Expiration Date:
(9.) Septage Management Firm Operator Training Completed:
Date: 7-11-Zq Location: Hours:
Training Sponsored or Provided by: ' �\,-zfj
(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.
nature(ftnatu vompanyofficialrequired)
Print Name
Other Comments:
-7-1Z-7,q
Date
M6t'V\'al.G P
Title
Rev.10-27-2020
PAGE 2

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 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, Jacob Hodge (ORC), License Number WW1002183, Town of Forest City WWfP
(Plant Operator in Responsible Charge (ORC), ORC Ucense Number, Name of Plant)
P.O.Box 728 Forest City NC, 28043 Phsicai Adderess 397 Riverside Dr Forest City NC, 28043
(Address)
828-248-5217 do hereby authorize Jonathan Bryant
(Phone Number) (Owner/Operator of Septage Management Firm)
of Upstate Septics NCS fi 01174
(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
Rutherford County North Carolina
(County or other Geographic Area)
at the above named wastewater treatment facility, Septage shall be discharged at:
397 Riverside Dr Forest City NC, 28013
(Location)
between the hours of 7:00 AM and 3:30 PM
Reintroducing partially treated liquid into a grease trap is acceptable _Yea X No
This authorization shall be valid until December 312024
(Usually December 31, Year)
Signed �� ✓ 122
Q' (Facility 0 rator)
A%— day ofJl�20
n '7
My Commission expires: (a a I
Subscribed and affirmed before me this
(Notary Public)
Date 7/29/2024
(OFFICIAL
r«
fin=
Note: Falsification of this document by the septage management firm shall lead to permit revocation,.:
S:/Solld Waste/CLA/SEPTAGEJFORMS/2016 Fhm Applkatbn/WWW Autlroriutim Form 2016 iCOOP,
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ROY COOPER
Governor
ELIZABETH S. BISER
Secretary
MICHAEL SCOTT
Director
Sent via Email
Jonathan Bryant
420 Sandclay Rd
Chesnee, SC 29323
NORTH CAROLINA
Environmental Quality
July 24, 2024
Re: New Firm — Assignment of Permit Number (NCS#)
Upstate Septics NCS-01774
Dear Jonathan Bryant:
You have been assigned the Septage Management Firm Permit Number of NCS-01774 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
lee. sorrell(a.deg.nc.gov.
2) 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-01774, 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.Williams(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 919-707-8292.
Sincerely,
Lee Sorrell, Environmental Specialist II
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