HomeMy WebLinkAboutOP-09-2016-076800.TIF • CATAWBA COUNTY ❑e ' ❑e Case# OP-09-2016-076800
y r'flPublic Health Department ' Subdivision WOODLAND OAKS
2 4slY� Environmental Health Division I PIN 376004933363
84Z PO Box 389. 100-A Southwest Blvd,Newton, NC 28658 _ Lon7& PT 6
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NAME ON PERMIT: STEVEN SHUMAN, 3953 ENGLEWOOD ST, CLAREMONT NC 28610
Site Address: 3953 ENGLEWOOD ST, CLAREMONT NC 28610
Property Size: Square Feet:47,916.00 Acres:1.1
Directions: E NC Hwy 10, Right onto Balls Road, Right onto Love Rd, Left onto Broadway St, Right onto Dover St, Left
onto Englewood St, 2nd house 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: 104W 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#1829 09/06/2016
SYSTEM INSTALLER INSTALLATION DATE
Jason Boyd 09/14/2016
AUTHORIZED STATE AGENT DATE OF OPERATION PERMIT Form F
ISSUANCE
ehpermlt 09/14/2016 09125
4 A \ CATAWBA COUNTY Permit# EHPR6-l6-24035
G Name Steven Shuman
� � a Public mens Department Address 3953 Englewood Claremont NC
< """"`"Ir, o- �, Environmental Health Division PIN# 376004933363
1-,, ,1" 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
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