HomeMy WebLinkAboutOP-03-2016-069894.TIF �9 CATAN'BA COUNTY 0 �., 1 0 Case# OP-03-2016-069894
L.t ll'% Public Health Department ' -Vimr Subdivision
Q , a. Environmental Health Division .. e } PIN# 373511773047
'-'0- PO Box 389, 100-A Southwest Blvd,Newton, NC 28658 a _"11: I. " LOT// TR 1
1g42 :w •: -*t ti A
NAME ON PERMIT: TONY BUTLER, 230 CHAUCER LN, MATTHEWS NC 28104
Site Address: 4161 54TH AV NE, HICKORY NC 28601
Property Size: Square Feet:44,866.80 Acres:1.03
Directions: North on Sulphur springs Rd ? Left onto 37 th st NE First right onto 54th Ave NE, Lot with Burned out house
on left
Catawba County Health Department Operation Permit
System Type: IIIG - OTHER NON-CONV TRENCH SYSTEMS
(In accordance with Table Va)
Description: 25% REDUCTION
System Code: IQ4PS System Code Description: Infiltrator Quick 4 Plus Standard
Types V and VI systems expire in 5 years.
Owner must contact health department 6 months prior to expiration for permit renewal.
System Installation Comments: *An infiltrator plastic 1000 gallon tank was placed in series with the existing 1000 gallon
precast tank.
PERMIT CONDITIONS:
1. All maintenance, monitoring, and performance requirements shall be in accordance with
15A NCAC 18.1900, Rule .1961
2. Operation & Maintenance Specifics:
Subsurface system operator required? Yes No_X_
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
This system has been installed in compliance with applicable North Carolina General Statutes, Rules for Sewage
Treatment and Disposal, and All conditions of the Improvement Permit and Construction Authorization.
Jon Watts - 1879 03/01/2016
SYSTEM INSTALLER INSTALLATION DATE
Robbie Phelps 03/09/2016
AUTHORIZED STATE AGENT DATE OF OPERATION PERMIT Form F
ISSUANCE
ehpermit 03/09/2016 09:56 Page 1 of
i
1.w,- N;.kory f 6 q
•
_ w w Op- 5`ZOI0- D01 �1 �
H O
m n v., 14. o Tony 8vf1cr
b4 a$ �$$ �. p$ 416 Pith Ay wE
. 2. 01; Z p viol vl l:
1
k
t !
I ast
• 4n-
'Qrcii hot m r
„
,ti_
10. ry 6t-i It CE
. S-15,- 4-1'41 of
0 PapYSL Q it N I ll CQ
��ig� " —
„
1
• grscA • i a .7.-_— i
1S°r° - E
toMP• • �� 14.P. et Nn'
64Th
r"-- nI __....,f-1