HomeMy WebLinkAboutOP-06-2016-073179.TIF \3• CATAWBA COUNTY 0 r4 0 Case# OP-06-2016-073179
F 4 Public Health Department 7S'}' ` SF Subdivision ea_
4 -- Environmental Health Division • •- PIN# 371312858761
1�" '#PO Box 389, 100-A Southwest Blvd,Newton.NC 28658 t ' LOT# 6-11 PT 5
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NAME ON PERMIT: VANG PENG, 1511 21ST ST NE, HICKORY NC 28601
Site Address: 1511 21ST ST NE, HICKORY NC 28601
Property Size: Square Feet: 39,639.60 Acres:0.91
Directions: 140 Exit 146, McDonald Parkway, Follow to Springs Road & take a Left, About 1/2 mile down on Right 15th
Ave NE, 2nd Road on the Right, 2nd house on the Left.
Catawba County Health Department Operation Permit
System Type: **** no system class assigned **** ()
(In accordance with Table Va)
Description: REPLACEMENT OF SEPTIC TANK ONLY
System Code: System Code Description:
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.
Loose Ends Repair- Brandon Martin #4716 05/26/2016
SYSTEM INSTALLER INSTALLATION DATE
Megen McBride 06/07/2016
AUTHORIZED STATE AGENT DATE OF OPERATION PERMIT Form F
ISSUANCE
ehpemiit 06/07/2016 11:13 Page 1 of3
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1511 CIS! St NE, Hickory
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