NCS01788_2024Permit_Initial

2024
Permit and Registration
Posh Potty and Events
is hereby issued a Septage Management Firm Permit,
�szArr of
Permit Number NCS-01788
o and registered as a�EQ
-�= Septage Management Firm Department fE wrnmentallltp
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 not authorized to discharge septage. Permittee only to place luxury restroom trailer. Permittee to contact a permitted firm to pump out trailer.
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 PerryDigital
ly signed by Wrn
Perry Sugg
Sugg
Date: 2024.09.23
14:48:25-04'00'
Perry Sugg, Environmental Compliance Branch Head

New OpevatoiZ
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 exact as it is shown on your vehicle(s).
Posh Potty and Events
Street address of office:1008 Keith Rd
City. Wake Forest
Mailing address (if different):
NC Zip.27587
City: State: Zip:
Phone: Fax
E-Mail:
County:
(2.) Firm owner's
Septage Management Firm permit number: NCS #
Samuel & Natalie Norris
Mailing address (If different):
City:
State: Zip:
Phone: Fax:
(3.) Firm operator's name: Samuel & Natalie Norris Firm operator's title: Owners
Mailing address (if different):
City:
Phone:
State: Zip:
z
0
L
¢�
w
cn
�
J
0
W
(4.) Type(s) of septage pumped: Write in the number of gallons Pumped in 2015 (Example: Domestic: 50,000).
Domestic Portable Toilet Waste Grease Restaurant Treatment Plant IndusVial/Commercial
(5.) N.C. Counties of Operation: All
(List each county you do business in)
(6.) Total Number of Pumper Vehicles Operated:
Number used for: Domestic Septage:
Other:
Vehicle Information: (use additional paper ff needed)
Grease (restaurant):
Portable Toilet Waste:
License Tag #
Vehicle Identification #
Tank Capacity
1
DC66279
4B9BE1 912NE01 1206
350 gallons restroom trailer
2
3
4
5
APPLICATION CONTINUED ON PAGE 2
PAGE 1

APPLICATION FOR PERMIT TO OPERATE A SEPTAGE MANAGEMENT FIRM
(CONTINUED FROM PAGE 1)
(7.) Septage Disposal Method: (check one)
a) Approved wastewater treatment plant: C1yes no. If yes, submit Wastewater Treatment Authorization
for each plant, as indicated in Subparagrap .083 c 4) 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: _
(8.) Septage Management Firm Operator Training Completed:
Date: 09/12/2024 Location: Virtual New Operator Hours: 6
Training Sponsored or Provided by: NCDE
(9.) Septage Land Application Site Operator Training Completed:
Date: Location: _
Training Sponsored or Provided by:
(10.) Registration type requested: CHEC
Registered Portable Sanitation Flr`.N
Registered Septage Management Firm:
Registered Portable Sanitation and Septage Management Firm: M
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.
Signature (Signature of company official mquimd)
Na,iali'c S. ►Ucrris
Print Name
Date
Title
Other Comments:
This application is for a new operator for a portable restroom trailer.
Contracted with Lyons Septic Service 919-685-2770
S:/SoI WasteJCLAISEPTAGEIFORMS/2016 FMm AppkatbNFMmPe nRAppicatbn2D16
PAGE 2