HomeMy WebLinkAboutOP-06-2016-074070.TIF r- ._
gS3A • CATAWBA COUNTY El •, ;o-7j 5 0 Case# OP-06-2016-074070
Public Health Department T• -PLY. Subdivision
ivision
< ,2 � Environmental Health Division PIN# 363815531756
PO Box 389. 100-A Southwest Blvd,Newton.NC 28658 ? r LOT# 1
H,2 61 4i
h
.
•
NAME ON PERMIT: PEDRO ALDAMA HERNANDEZ, 2955 SIGMON DAIRY RD, NEWTON NC 28658
Site Address: 2966 SIGMON DAIRY RD, NEWTON NC 28658
Property Size: Square Feet: 144,619.20 Acres:3.32
Directions: Startown Rd to Sigmon Dairy Rd/ lot on 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: IQ4W System Code Description: Infiltrator Quick 4 Standard W
Types V and VI systems expire in 5 years.
Owner must contact health de•artment 6 months •rior to ex•iration for •ermit renewal.
System Installation Comments: No home or well at time of inspection. Used Infiltrator tank.
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
Chunk Jenks#4882 06/23/2016
SYSTEM INSTALLER INSTALLATION DATE
Jason Boyd 06/30/2016
AU I IORIZED STATE AGENT DATE OF OPERATION PERMIT
ISSUANCE
Form F
ehpemut 06/30/2016 08:43 Page I of 3
�V3A G CATAWBA COUNTY Permit # RBPR 6-16-24030
/Q Name Pedro Aldama Hernandez
_ a '2 Public Health Department
Q """�".�i .? Environmental Health Division Address 2966 Sigmon Dairy Rd Newton
�(,J Zr
Dir. PO Box 389, 100A Southwest Blvd, Newton NC 28658 NC
\ �/ �� PIN# 363815531756
4�' zM11 (828)465-8270 Fax (828)465-8276 TDD(828)465-8200
Site Plan Operation Permit
lit - c o ' -D ���, o., Oc -T .� 2J
Ma L• ev,t u r v.) A... 11
0
e4 -} .;‘,.e., -a C
1
\^ , OQC.\-,a ^ 1(t IC
-V
A,P ro / 1,ft 5k-, 11 ,) �� t
cc lc 191 Pro —, 5 1°k,
_9 Lei
i
I,-( U
{
le '
(1g
ge_pa. '/` 1 z_ 4° '2) (514 4�EA
1c-,k l
lcrt.c,. k 0n,,,v. Co.S,aktrG
L�I' 1� ,M ^�-
7
r
V
0 ,2 A f N I /DD .
Scale t 0 IN N S U L T A 61,