HomeMy WebLinkAboutOP-06-2016-073633.TIF s$ CATAIVBA COUNTY 0 ml r: 0 Case# OP-06-2016-073633
Public Health Department �r Subdivision
K%\:::: Environmental Health Division �� f r } PIN# 364807579865
°� PO dos 389, 100-A Southwest Blvd,Newton,NC 28658 { LOT# 1
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NAME ON PERMIT: JACOB KILLIAN, 1513 PRISON CAMP RD, NEWTON NC 28658
Site Address: 1513 PRISON CAMP RD, NEWTON NC 28658
Property Size: Square Feet: 104,108.40 Acres:2.39
Directions: Hwy 321 - Prison Camp Rd g past the 4th house on the right- paved road by a cow pasture
Catawba County Health Department Operation Permit
System Type: IIIG -OTHER NON-CONV TRENCH SYSTEMS
(In accordance with Table Va)
Description: 25% REDUCTION
System Code: IQ4W 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.
Dennis Galliher#1071 06/16/2016
SYSTEM INSTALLER INSTALLATION DATE
Jason Boyd 06/17/2016
AUTHORIZED STATE AGENT DATE OF OPERATION PERMIT Form F
ISSUANCE
ehpermit 06/17/2016 09:18 Page 1 of 3
��A • CATAWBA COUNTY Permit # RBPR-4-16-23572
��a�� Public Health Department Name dr Jacob Dale Killian
�� .� Address 1513 Prison Camp Rd Newton
d 7711 ra `C Environmental Health Division NC
si PO Box 389, IOOA Southwest Blvd, Newton NC 28658
^ (828)465-8270 Fax (828)465-8276 TDD(828)465-8200 P1N# 364807670722
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