HomeMy WebLinkAboutOP-03-2016-070490.TIF sli' CATAWBA COUNTY 0 M—o-r b 0 CaSe# OP-03-2016-070490
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Public Health Department �' " . • r Subdivision
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Environmental Health Division r NNW 470002657298
4® PO Box 389. 100-A Southwest Blvd.Newton-NC 28658 _ Lon 1
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NAME ON PERMIT: JASON MCCOY, 5805 CEDAR RUN RD, DENVER NC 28037
Site Address: 7715 MONBO RD, CATAWBA NC 28609
Property Size: Square Feet: 134,600.40 Acrcs:3.09
Directions: East on Hwy 10, right onto 8th St SE/ right Brown Chapel Rd/ left on Monbo Rd
Catawba County Health Department Operation Permit
System Type: IIIG - OTHER NON-CONV TRENCH SYSTEMS
(In accordance with Table Va)
Description: 25% REDUCTION
System Code: 104W System Code Description: Infiltrator Quick 4 Standard W
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.
Kenny Dellinger#1062 03/23/2016
SYSTEM INSTALLER INSTALLATION DATE
Jason Boyd 03/28/2016
AUTHORIZED STATE AGENT DATE OF OPERATION PERMIT
ISSUANCE Form F
ehpermit 03/28/2016 09:28 Page 1 of3
4y13A Permit # RBPR-9-15-22288
G CATAWI3A COUNTY Name Jason McCoy
:IT Ii Public Health Department
a Address 7715 Monbo Rd Catawba NC
d 4 oQ R Environmental Health Division PIN# 470002657298
,Q� PO Box 389, 100A Southwest Blvd. Newton NC 28658
1842 xu (828)465-8270 Fax (828)465-8276 TDD(828)465-8200
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