HomeMy WebLinkAboutOP-05-2016-072145.TIF gA CATAWBA COUNTY 0 'ID!. f Case# SHAMROCK PARK MAP 3
T Public Health Department Subdivision
Environmental Health Division i PIN# 375119624271
h42 PO Box 389, 100-A Southwest Blvd,Newton,NC 28658 AD G 1,1, 6 & 7 &ADJ•
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NAME ON PERMIT: PAUL GAITHER, 2637 TIFFANY ST, CONOVER NC 28613
Site Address: 2637 TIFFANY ST, CONOVER NC 28613
Property Size: Square Feet: 55,321.20 Acres:1.27
Directions: Keistler Dairy Road, into Shamrock Park, Left onto Tiffany St, Last lot on the Right
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: under driveway they used corrugated DOT culvert and added a cleanout to the supply
line.
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.
leatherman septic 1111 04/15/2016
SYSTEM INSTALLER INSTALLATION DATE
Steven Price 05/09/2016
AUTHORIZED STATE AGENT DATE OF OPERATION PERMIT
Form F
ISSUANCE
chpennit 05/10/2016 11:32 Page 1 of3
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