Restaurant Training Certification for Permitting Renewal

20 North Carolina Restaurant Septage Training Certification Statement
In accordance with North Carolina General Statue 130A-291.3 (a) requiring septage management firm
operators to attend a training course approved pursuant to subsection (d) of said section of no less than four
hours of instruction per year, I certify that, I have met my septage management firm permit annual training
requirements. I certify that
has/have completed the requisite four hours of training via the online NC Division of Waste Management Solid
Waste Section's presentations/training developed specifically for restaurants which have applied for or are
renewing a North Carolina Septage Management Firm Permit. You can find these presentations at
https://deg.nc.gov/restaurant-grease-management-training-modules. I understand 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 required) Date
NCS permit number
Name of Restaurant
Signature of Person completing the course:
Position:
Signature of Person #2 completing the course:
Position: