HomeMy WebLinkAboutOP-06-2016-074071.TIF AV,A Th•-•\ CATAWBA COUNTY Q k '�o: r'=f 0 Case tl OP-06-2016-074071
,,f' �� Public Health Department ` ja. Subdivision
Environmental Health Division • �� PIN# 379002555029
�R�I . }
�1 PO Box 389. 100-A Southwest Blvd. Nekton. NC 28658 ° • . • , T I,OT4
�R42/V
D r:: r o
NAME ON PERMIT: GWENDOLYN CHRISTOPHER, 1117 GRAHAM ST, CLAREMONT NC 28610
Site Address: 6567 RUSSELL TAYLOR DR, CATAWBA NC 28609
Property Size: Square Feet:476,982.00 Acres:10.95
Directions: Hwy 10 E, right on Hudson Chapel Rd, right on Bolton, right on Russell Taylor, 1st brick on left
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.
Mike Bumgarner#2688 06/29/2016
SYSTEM INSTALLER INSTALLATION DATE
Jason Boyd 06/30/2016
AUTHORIZED STATE AGENT DATE OF OPERATION PERMIT
ISSUANCE Form F
ehpemiit 06/30/2016 08:48 Page I of
13A Permit# EHPR5-I6-23830
C ' G CATAWI3A COUNTY Name Gwendolyn Christopher
� a G Public Health Department
< ""a"":oc '1 Environmental Health Division Address 6567 Russell Taylor Dr Catawba
J ! ��ih�rc PO Box 389, 100A Southwest Blvd. Newton NC 28658 NC
1842 sm (828)465-8270 Fax (828)465-8276 TDD(828)465-8200 PIN# 379002555029
Site Plan Operation Permit
/\
Up rtN ('-'C 6.L0
h1/4--rw.
Y
_ - I ta (.� i3
r
Vr....PA-13 \---' Nc_J T n 013
S' ^
in ,
_ntc. STi." l6 D
- 1Job2 ‘ il∎ .x
5 ° -f` A L
"L$ a 1 2, , -I'rt. 4c,Lc.J
P te yrte ® N'.. \l /
G r v s t, W t.%
t
c... n s Q-1
to «IMP; Il N
u
wk
{'s , en A *PA5Fc 1Ie
+` I` 7
10 y w : lc t,
4 7, r A k_/-
r� 10r Or
6l zslr6
'2-1 -0 . v J
Scale
, , ,, ,__ 6,I