HomeMy WebLinkAboutRBPR-06-2017-26890.TIF
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CATAWBA COUNTY HEALTH DEPARTMENT
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6836
Type of System:
Septic Tank Size ------
Bed Size
Imp. Pnnt. ~Auth, to Const.
Well Pnnt.
Well Rpr. Pnnt.
Pump Tank Size -
Trench Width '--
Nitrification Field: Total Square Feet
Total Length of All Trenches
-
Number of Trenches
--
Trench Length -=-/ _/ -=-/.::=.../ ~/ -=- Feet on Center -
*DO NOT INSTALL SEPTIC WHEN WET*
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Topo ..s> % Slope
Texture C<:..I4-Yr"Y
Structure ,,>./9.6
Clay Min. J ;)
Soil Wetness
Soil Depth 4:2.
Restric, Hoz, at~
Available space@no
Overall Class 0-u
Comments:
Maximum Trench Depth -- Distance of Nearest Well .,...
*WELL RECORD REQUIRED AT COMPLETION*
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Riser required when I
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**NO GUARANT IS ' PLIED OR GIVE
WILL FUNCTION** ~~~
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*Improvement Permit has no expiration date and is transferable, but ma e revoked if site plans or intended use changes for the proposed
facility. An Authorization to Construct is valid for (5) five years from date issued and is not transferable. Well Permit valid for 5 years
provided site conditions do not change. Well location, installation, and protection must meet state and local regulations, and must be
inspected and approved by a representative of the Catawba County Health Department before any portion of the installation is put into use.
The siting of the well by the Health Department staff is to provide protection from known possible sources of contamination. No volume of
water is guaranteed at any site by the Health Department.. /".~' C
Permit Date U EHS l>-, ~.-A~ l!!.., ~ .
Owner/Agen Septic Tank Installed By
EHS Well Installed By
Well Head Approv I Date Date Sample Collected
Date of Results Results
White - Office Blue - Building Inspection Operation Permit
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AS TO THE PERFORMANCE OR LENGTH OF TIME THIS SYSTEM
Date
Well Grout Approval Date
Yellow. Owner/Agent
EHS
Green - Building Inspection Authorization to Construct