HomeMy WebLinkAboutEHPR-11-11-13303.tif
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~ q-~{)- O~ <f~TAWBA COUNTY~;'~~~~ DEPbTMENT (J05~
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Telephone: (8:t8) 465-8270 TOO: (828) 465-8200 WLS #?.OO':1.. -t)O Jl99
Opr. Prmt._Sys. Type 3r... Well Prml._ eplacemcnl Well_Well Rpr. Prmt.
Phone 8"2 ~- Sl6 -;-- t) ~ .:2r
ubdivision hJh<(E/~k'} hPA-,?J{v(!.
ectionlBlocklPhase LotH ;:L
5'OJQ.J) (;./) -fPP;20)l' JDn ~{o< Gd/>tt:~
Property Address I" c:
Facility: House_ Mobile Home_ Dusiness_Multi-familyX- . Other: Pin Numller 3?t:'L) O? 9'7 l/.,g-;:;'O
Other . Zoning Approval "5'4/3 ;)J')02 - 3?
# Bedrooms 11' # Seats # Employees . Application Rate GPO Flow 'I ff)
Hot Tub or Spa yes/@pecial Fixmres Basement y~ . 100% Repair Are @lIo
Basement Plumbing yesbID" Water Supply~ivate Well_ Publ cL Semi-Public_
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Type or System: Trenclt----. Ded~ Pump -- Pump/Panel===- Panel- LPP +-- Other :l.S9;::, /A~c77{)N ~V \
Septic Tank Size J 5DO Pump Tank Size __ Nitrification Field: Total Square Feet /O~'3 D Depth or Stone -
Bed Size ~ Trench Width 3 f Total Length of All Trenches Number of Trenches S-
Trench Length .~2./~5..J~/b.J-t6!L/-==- Feet on Center 9 ' Maximum Trench Dep .;;2.1)' '-I- Distance of Nearest Well NI.t9
"DO NOT INSTALL SEPTIC WHEN WET" "WEL ~ RECORD REQUIRED AT COMPLETION"
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Owner7'Agent
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inches deep. I
""NO GUARANTEE OR WARRANTY IS I
Topo 3 >' % Slope
Texture C~7'
Structure
Clay Min. I: /
Soil Wetness
Soil Depth J{,;;J.,...."
Restric. Hoz. atU''t-
A vailable space ~no
Overall Class S ~
Comments:
Filter Required
Riser required when
tank is more than 6
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ED OR GIVEN A E PERFORMA
C OR LENGTH OF TIME THIS SYSTEM
WILL FUNCTION*" I." ~ f.lIAILl I
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"Improvement Permit has no expiration date and is transferdble, but may' be revoked ir site plans or intended use changes ror the proposed
facility. An Authorization to Construct is valid ror (5) live years rrom date issued and is not t~ansrerable. Well Permit valid for 5 )"ears
provided site conditions do not change. Well location, installation, and protection must meetltate and local regulations, and must he
inspected and approved by a representative of the Catawha Count)" Health Department beror any portion of the installation is put into use.
The siting or the well by the Health Department starr is to provide protection from known po sible sources or contamination. No volume or
wate~ is guaranteed at any site the Health Department. ' /J
l~ernut Dale 0 EHS ~ ?::-. 5.
'\-;;wner/Age~t Septic Tank Instal ed By A1.~ Iv DateCf-.;tO-o,).
EHS Well Installed By M Well Grout Approval Date (/}//r;
Well Head pproval Dale Date Sample CoVe~ted I......... ____ "-
Date of Results Results . EHS ~~ ~ e s-
White - Oftiee Yelluw - Owner/Agent I'lllk - lluilding Inspeetiun Authorilatiun tu Cunstruet