HomeMy WebLinkAboutOP-03-2016-069911.TIF aye' CATAWBA COUNTY 0 Case# OP-03-2016-069911 a.
�'i L Public Flealth Department .� Subdivision
'Cr" "" Environmental Health Division ryr• PIN# 266801286507
T^� PO Box 389, 100-A Southwest Blvd,Newton,NC 28658 i LOT#
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NAME ON PERMIT: CLYDE & KAREN BROWN, 1308 SW 39TH ST, HICKORY NC 28602
Site Address: 8940 JACOB FORK RIVER RD, VALE NC 28168
Property Size: Square Feet:865,101.60 Acres:19.86
Directions: Old Shelby Rd/approx 5 miles/right Jacob Fork River Rd
Catawba County Health Department Operation Permit
System Type: IIIG -OTHER NON-CONY 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:
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.
Brandon Martin #4716 03/08/2016
SYSTEM INSTALLER INSTALLATION DATE
Steven Price 03/09/2016
AUTHORIZED STATE AGENT DATE.OF OPERATION PERMIT
ISSUANCE Form F
ehpermit 03/17/2016 14:06 Page 1 of3
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