HomeMy WebLinkAboutOP-05-2016-072119.TIF ,A CATAWBA COUNTY 0 . � 'i.. 0 Case# OP-05-2016-072119
C � Public Health Department Subdivision ROXBURY FIELDS
4 et; k Environmental Health Division • . . yr PIN# 375501351758
mod- PO Box 389, 100-A Southwest Blvd,Newton,NC 28658 O O O LOT# 2
/8.2 s. ' . IL+ 7
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NAME ON PERMIT: LAVINE SCROGER, 383 N THOMAS LN, STONY POINT NC 28678
Site Address: 6245 ROCKY RD, CLAREMONT NC 28610
Property Size: Square Feet: 21,780.00 Acres:0.5
Directions: Hwy 16 toward Taylorsville, Right onto Riverbend Rd, Left onto Rocky Rd, Property is on the Left.
Catawba County Health Department Operation Permit
System Type: IIIE - PPBPS GRAVITY DOSED SYSTEM
(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 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.
al backhoe 1071 04/15/2016
SYSTEM INSTALLER INSTALLATION DATE
Steven Price 05/09/2016
AUTHORIZED STATE AGENT DATE OF OPERATION PERMIT Form F
ISSUANCE
ehpermit 05/10/2016 10:47 Page 1 of
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