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HomeMy WebLinkAboutOP-08-2016-076123.TIF nA CATAWBA COUNTY ❑e ' vo. •f 0 Case# OP-08-2016-076123 `i r+2 f Public Health Department , ' Subdivision 4 �t ,;1, Environmental Health Division k`f r PI N# 471003147143 t' PO Box 389, 100-A Southwest Blvd,Newton, NC 28658 '� LOT# 2 18.2 s. - - {.-. M1 NAME ON PERMIT: DANA JOHNSON, 7257 SHERRILLS FORD RD, SHERRILLS FORD NC 28673 Site Address: 8270 MONBO RD, CATAWBA NC 28609 Property Size: Square Feet:570,636.00 Acres:13.1 Directions: from Sherrills Ford Rd /turn on Molly's Backbone/go to end of road & turn right on Monbo/ property approx 1.5 miles on left just past new long concrete drive/ entrance cut in 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 forpermit 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. Wendell Caldwell#1044 08/24/2016 SYSTEM INSTALLER INSTALLATION DATE Jason Boyd 08/25/2016 AUTHORIZED STATE AGENT DATE OF OPERATION PERMIT Form F ISSUANCE ehpennit 08/25/2016 10:07 --PA CATAWBA COUNTY Permit# RBPR-10-15-2514 �". GZ Name Dana Johnson 57 e ft& ' Public Health Department — Address 8270 Monbo Rd Catawba NC �• in t4,' c; Environmental Health Division PIN# 471003147143 , ' PO Box 389, 100A Southwest Blvd, Newton NC 28658 /842 sm (828)465-8270 Fax (828)465-8276 TDD(828)465-8200 Site Plan Operation Permit \ yt/lenI'D o R � /\ - ® (/is 1-1L/ CyIJI" • 1-N� Afp" e G 15ffoR) 6 r ,... .......--ty Li. I 1\95 �� i V \\-- Ge e c 16 "r11'1 3Ll) lo.a,(, TciiC- 1j i ' ���' / �� r- � v �5 ° p,-. CD irt_.tJ V 7°' -- - — - 3CiI + ° S4 -.a ,• 0 Scale