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HomeMy WebLinkAboutOP-05-2016-072464.TIF y;�A ip CATA\VBA COUNTY 0 ;o' D Case# OP-05-2016-072464 _¢' 1'a:©� Public Health Department (7,: J Subdivision Austin Lee Keller & Brian W 0 ,.`t, Environmental health Division I' � + PIN# 266803121106 ' I- PO Box 389, 100-A Southwest Blvd,Newton, NC 28658 i �; r G LOT# /842 s. X ci • NAME ON PERMIT: BRIAN & STEPHANIE KELLER JR, 9309 COSTNER RD, HICKORY NC 28602 Site Address: 8996 COOKSVILLE RD, VALE NC 28168 Property Size: Square Feet: 217,800.00 Acres:5.0 Directions: Old Shelby Rd to Cooksville Rd/Property just past breezeway drive 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: 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. Dean Evans#1782 05/10/2016 SYSTEM INSTALLER INSTALLATION DATE Megen McBride 05/17/2016 AUTHORIZED STATE AGENT DATE OF OPERATION PERMIT Form F ISSUANCE elipemitl 05/17/2016 09:10 Page 1 of 3 OP (41P42-2x14- 10606 $996 CooksuiIle FA, Vale, 5j*?) ins1kllecl skim by r lea., Ew s. + SeP+cc Tnk: SMoUr - lo00, SIB- 7k6, )-73-ic. + 30) -1. o4 )5,0 fedvcftan X07(septic,Repair 9-' TwI 05' � ms, 3 Bedroom well Howe