WQ0045299_Application_20240415

I. PRESUBMITTAL INFORMATION:
1. Contacted representative from regional office (Pre -submittal)?: ® Yes ❑ No
2. Contact name (For Regional Office): Morelia Kind
It. APPLICANT INFORMATION:
1. Applicant's name (Municipality, Individual, Corporation, etc): Acme Station LLC
2. Applicant type: ❑ Municipal ❑ State ❑ Privately -Owned Public Utility
❑ County ❑ Other:
3. Origin of Wastewater:
❑ Residential Subdivision ❑ Retail (Stores, Shopping Centers) Domestic: /�� %
❑ Apartments/Condominiums ❑ Institution Commercial: %
❑ Mobile Home Park ❑ Hospital Industrial: %
® School ❑Church
Other: %
❑ Restaurant ❑ Nursing Home
❑ Office ❑ Other (specify)
4. Signature authority's name: John P. Grice per 15A NCAC 02T .0106 b
Title: Owner
5. Applicant's mailing address: 2629 Neils Edd Road
City: Riegelwood State: NC Zip: 28456
6. Applicant's contact information:
Phone number: [phone] Email:' ricel82 &mail.com
m. CONTACT/CONSULTANT INFORMATION:
1. Contact name: Wesley Wooten Lewis Farms & Liguid'Naste, Inc.
Title/Affiliation: owner/operator
2. Contact's information:
Phone number: [phone] Email: [e-mail]
Iv. RECEIVING FACILITY INFORMATION:
If more than 1 facility has agreed to accept the wastewater, please list all the owners, facility names, and permit
numbers as a separate attachment)
1. Owner: Town of Lake Waccamaw
2. Facility name: Lake Waccamaw Waste Water Treatment Plant
3. Facility permit number: NCO021881
4. WWTF permit number: NC 0021881
5. WWTF contact name: Talon Jacobs
Title/Affiliation: Wastewater Treatment Plant Supervisor
6. WWTF contact information:
Phone number: [phone] Email: tjacobs a�lakewaccamawnc. oovv
APPLICATION PRH 01-16 Page 3 of

V. PROJECT INFORMATION:
1. location of Project (physical address): 59 Pineland Road Rie elwood NC 28436
Approximate Coordinates (Decimal Degrees): Latitude: 34.310 Longitude:-78.200
2. Duration of Pump and Haul Request (Six Months Typical): six months
3. Has a prior permit been issued? ® New ❑ Prior Pump & Haul Permit
Permit No.:
4. Permanent Method of Wastewater Disposal: public utilitysewer
5. Date Permanent Disposal will be available: Summer, 2024
6. Have permits / approvals for permanent disposal been obtained?
® Yes ❑ No Permit Number: '�V� Q Q l q ?.2 0
7. Is there a Pretreatment Program in effect? ❑ Yes ® No
8. Describe any pretreatment prior to pumping and hauling:
9. Volume of Wastewater Generated: 300-500 Gallons per Day
10. Explain how the wastewater flow was determined: ❑ 15A NCAC 02T .0114 or ® Representative Data
If representative data, describe: Columbus County I lealth Department Director
11. Describe Tank / Container wastewater will be pumped from (attach description if necessary):
1500 gallon concrete septic tank
12. Is Tank / Container in place or will it be installed (attach description if necessary):
existing
13. What type of high water alarm does the container have (and/or):
® Audible and Visual ❑ Telemetry (Auto Dialer / SCADA)
VI. CERTIFICATION:
1. Applicant's Certification: (Signature of Signing Official and Project Name)
I, John P Grice , attest that this application for County Line Preschool
has been reviewed by me and is accurate and complete to the best of my knowledge. I understand that if all required parts of
this application are not completed and that if all required supporting documentation and attachments are not included, this
application package is subject to being returned as incomplete. I understand that issuance of a permit will require pump and
haul facilities or activities to be inspected at least daily by me or a designated representative. Note: In accordance with North
Carolina General Statutes 143 215.6A and 143.215 bB, any person who knowingly makes any false statement, representation,
or certification in any application shall be guilty of a Class 2 misdemeanor, which may include a fine not to exceed $10,000 as
well as civil penalties up to $25,000 per violation.
3
Signs g Official Signature Date
ENGINEERING DOCUMENTS MUST BE COMPLETED PRIOR TO SUBMITTAL.
ACTIVITIES SHALL BE INSPECTED AT LEAST DAILY BY THE PERMITTEE OR IT'S REPRESENTATIVE PER 15A NCAC 02T .02M d�.
APPLICATION P&H 01-16 Page 4 of 5

THE ENGINEER'S CERTFICATION IS REQUIRED FOR ACTIVITIES THAT RESULT IN THE PRACTICE OF ENGINEERING PER G.S. 89C-3.
ENGINEERING DOCUMENTS MUST BE COMPLETED PRIOR TO SUBMITTAL. IF CERTIFICATION BY AND ENGINEER IS REQUIRED,
THIS PAGE IS NOT NECESSARY.
2. Professional Engineer's Certification: (Signature of Design Engineer and Project Name)
,attest that this application for has been reviewed by me and is
accurate, complete and consistent with the information in the engineering plans, calculations, and all other supporting
documentation to the best of my knowledge. I further attest that to the best of my knowledge the proposed design has been
prepared in accordance with all the applicable regulations. Although other professionals may have developed certain portions
of this submittal package, inclusion of these materials under my signature and seal signifies that I have reviewed this material
and have judged it to be consistent with the proposed design. Note: In accordance with NC General Statutes 143 2IS. 6A and
143-215.6B, any person who knowingly makes any false statement, representation, or certification in any application shall be
guilty of a Class 2 misdemeanor which may include a fine not to exceed $10,000 as well as civil penalties up to $25,000 per
violation.
2a.
Professional Engineer Name
2b.
Engineering Firm
2c.
Mailing Address
2d.
City
2e. 2f.
2g. 2h. 2i.
Telephone
State Zip
Facsimile E-mail NC PE Seal, Signature & Date
APPLICATION P&H 01-16 page ; of i

�LEWIS FARMS
-I & L!Q[IID WASTE, INC.
February 26, 2024
Attn: John Grice
Acme Station LLC
2629 Neils Eddy Rd
Riegelwood, NC 28456
RE, Pump and Haul for County Line Preschool at 59 Pincland Road, Delco, NC 28436
Mr. Grice,
Lewis Farms can begin pump and haul for the above referenced property, effective immediately.
Pump and haul can be daily or weekly, as needed. Weekends and after hours would he
considered emergency rates.
If you need any additional information, please feel free to contact me.
Sincerely,
Wesley Wooten
910-604-0049
8155 Mulpam Corner Road Currie, NC 28435
910.283.9823rl-- we.+leyfalewiifarnrcnc,cumrnan!
www.lewisfarinsmrdliquidwci,cle.com hrh„rr

JO—oam olYalce, )Vacc .t (v
ON THE SHORES OF NORTH CAROLINA'S LARGEST NATURAL LAKE
P.O. Box 145
Lake Waccamew, North Carolina 28450
[phone]
[phone] Fax
March 18, 2024
Attn: John Grice
Acme Station, LLC
2629 Neils Eddy Rd.
Riegelwood, NC 28456
Member N.C. League of Municipalities
RE: Pump and haul for County Line Preschool at 59 Pineland Road, Delco, NC 28436
To whom it may content:
The Town of Lake Waccamaw, North Carolina will receive sewage/waste under pump and haul criteria
for the above referenced property, effective immediately. See facility information below.
RECEIVING FACILITY INFORMATION:
1. Owner: TOWN OF LAKE WACCAMAW
2. Facility name: LAKE WACCAMA W WASTEWATER TREATMENT PLANT
3. Facility permit number: NCO021881
4. WWTP permit number: NCO021881
5. WWTF contact name: TALON JACOBS
Title/Affiliation: WASTEWATER TREATMENT PLANT SUPERVISOR
6. WWTF contact information:
Phone number: [phone]
Email [e-mail]
t truly,
Damon Kempski
Town Managcr

April 12, 2024
To whom it may concern,
County Line Preschool, located in Delco, NC, seeks a pump and haul permit from the DEQ as a
short term waste -water solution while waiting on Columbus County Public Utility sewer system,
with construction to begin in late spring/early summer of 2024. The engineering for public sewer
has been completed, and this project is currently permitted, with funding that has been secured
through Columbus County. Once construction begins, it is expected to take approximately 3-4
weeks to complete.
Once the sewer system is active, County Line Preschool will connect to the public sewer system
as soon as possible. Reasons for delay of county public sewer are related to funding
appropriations, contractor procurement, engineering modifications, and county capacity studies.
County Line Preschool is excited to serve the eastern region of Columbus County and the
surrounding areas. Thank you for your consideration in this matter.
Best regards,
John Grice
910.612.7059
[e-mail]

i7kA
LEWIS
&LIQUID
April 12, 2024
Attn: John Grice
Acme Station LLC
2629 Neils Eddy Rd
Riegelwood, NC 28456
FARMS
WASTE, INC.
RE: Pump and Haul for County Line Preschool at 59 Pineland Road, Delco, NC 28436
Mr. Grice,
Lewis Farms can begin pump and haul for the above referenced property, effective immediately.
The vacuum trucks utilized for pump and haul have a capacity of either 3,000 or 3,500 gallons.
Pump and haul can be daily or weekly, as needed. Weekends and after hours would be
considered emergency rates.
If you need any additional information, please feel free to contact me.
Wesley Wooten
910-604-0049
8155 Malpass Corner Road Currie, NC 28435
910.283.9823 phone [e-mail] email
www.lewisfarmsandliquidwaste.com webslte

ON THE SHORES OF NORTH CAROLINA'S LARGEST NATURAL LAKE
P.O. Box 145
Lake Waccamaw, North Carolina 28450
[phone]
[phone] Fax
Member N.C. League of Municipalities
March 18, 2024
Attn: John Grice
Acme Station, LLC
2629 Neils Eddy Rd.
Riegelwood, NC 28456
RE: Pump and haul for County Line Preschool at 59 Pineland Road, Delco, NC 28436
To whom it may concern:
The Town of Lake Waccamaw, North Carolina will receive sewage/waste under pump and haul criteria
for the above referenced property, effective immediately, receiving 500 gpd of domestic waste
as listed on application. See facility information below.
RECEIVING FACILITY INFORMATION:
1. Owner: TOWN OF LAKE WACCAMAW
2. Facility name: LAKE WACCAMAW WASTEWATER TREATMENT PLANT
3. Facility permit number: NCO021881
4. WWTP permit number: NCO021881
5. WWTF contact name: TALON JACOBS
Title/Affiliation: WASTEWATER TREATMENT PLANT SUPERVISOR
6. WWTF contact information:
Phone number: [phone]
Email: [e-mail]
Qely,
--, X;q.
Damon Kempski
Town Manager