HomeMy WebLinkAboutOP-03-2016-070201.TIF CATAWBA COUNTY 0 Pe, o • 0 Case# OP-03-2016-070201
T \ Public Health Department Subdivision LUTHER COWANS SHERF
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< Environmental Health Division • . '3 Pim 462802563168
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/ PO Box 389, 100-A Southwest Blvd, Newton.NC 28658 v .} F LOTS 63
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NAME ON PERMIT: STEPHEN & JENNIFER FORD, 7914 SKYE LOCHS DR, WAXHAW NC 28173
Site Address: 2690 SOUTHERN BREEZE, SHERRILLS FORD NC 28673
Property Size: Square Feet: 19,166.40 Acres:0.44
Directions: Hwy 16 North to 150 exit, R onto 150, L onto Sherrills Ford Rd, R onto Island Point Rd, L onto Riviera Dr, R
onto Southern Breeze, lot is on left
Catawba County Health Department Operation Permit
System Type: IVA-ANY SYSTEM WITH LPP DISTRIBUTION
(In accordance with Table Va)
Description: 50% REDUCTION PPBPS
System Code: PPBPS System Code Description: PPBPS
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_X_ No
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.
Wendell Caldwell#1044 03/18/2016
SYSTEM INSTALLER INSTALLATION DATE
Robbie Phelps 03/18/2016
AUTHORIZED STATE AGENT DATE OF OPERATION PERMIT Form F
ISSUANCE
ehpermit 03/18/2016 10:34 Page 1 of 3
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