HomeMy WebLinkAboutOP-08-2016-075876.TIF s�A CATAWBA COUNTY Qe - `NEP?5 El Case it OP-08-2016-075876
.T w!�tit c..-; Public Health Department + � . . Subdivision
4 i Environmental Health Division -a •r r . PIN# 365701098406
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'+^ PO BON 389. 100-A Southwest Blvd, Newton.NC 28658 ° - ° ° LOT#
/842 s• - • v1 - • 4
❑� riliS •L 7 ter.
NAME ON PERMIT: CHARLES PRICE, ,
Site Address: 3640 PROVIDENCE MILL RD, MAIDEN NC 28650
Property Size: Square Feet: 108,464.40 Acres:2.49
Directions: 16 S/ right Providence Mill Rd/to past Providence Rd Baptist Church/ 1 mile on left/White house Red Roof
Catawba County Health Department Operation Permit
System Type: IIIG - OTHER NON-CONN 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: Installed 4 x 90 trenches with a subsurface drain around upper permiter of lines
approximate 48" deep.1000 gallon tank STB 794.
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.
Kenny Dellinger#1063 08/17/2016
SYSTEM INSTALLER INSTALLATION DATE
Jason Boyd 08/18/2016
AUTHORIZED STATE AGENT DATE OF OPERATION PERMIT
Form F
ISSUANCE
elipermit 08/18/2016 10:23
•
tiP Permit# RBPR-2-16-23175
CATAWBA COUNTY Pr,,�, i)c- ^ L�
ftin2 Public Health Department a_) Name Charles Price
..] �. 1 Address 3640 Providence Mill Rd Maiden
Q *rival Environmental Health Division
� vr� �, PO Box 389, 100A Southwest Blvd, Newton NC 28658 NC
/84%w (828)465-8270 Fax (828)465-8276 TDD(828)465-8200 PIN# 365701098406
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