HomeMy WebLinkAboutEHPR-9-10-7225 (2).TIF
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CATAWBACOUNTYHEALTHDEPARTMENT N~. 7115
Telephone: (828) 465-8270 ]/DD: (828) 465-8200 ~
f>( 1\iJ.tl1. to Cqnst. ~ Rpr. Pont.. Opr. Pont._ "-.Sys. Type .s C Well Pont. W~ell~_ .Pont.
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SubdIvISIOn ~ ~ev-
Section/Block/Phase Lotff-x--
(jJJJ B,;/y ibrM-~ /,}y rk-J ~l f- 01r-
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Facility: House Mobile Home_ Business_Multi-tamily_ . Other: Tax Map 0 I umber "l'tPJ()'7-/Cr--t:,i7-,;,)qtJlJ
Other . Zoning Approval # 2-"'Jq,J 1.<1 "?it .
# Bedrooms ~ # Seats # Employees . Application Rate . ~"\' GPD Flow ..;rft:!
Hot Tub or Spa yes/no Special Fixtures Basemen~s/no . 100 % Repair Area yes/no
Basement Plumbing (?;/no Water Supply: Private Well~ Public_ Semi-Public_
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Type of Systein: Trench_ Bed_ Pump_ Pump/Panel_ Panel_ LPP _ ~ ~tJd If';;'d ~eJ.
Septic Tank Size IMtJ '1""'/ Pump Tank Size Nitrification Field: Total Square Feet 1.'3 So Depth of Slone . I z..
Bed Size Trench Width Total Length of All Trenches <!.J t, () Number of Trenches <.,
Trench Length 7'!:>/ _/_1_, 'Z..../ _ Feet on Center q Maximum Trench Depth a <j DlStaoce of Nearest Well Ion
*DO NOT INSTALL SEPTIC WHEN WET* *WELL RECORD REQUIRED AT COMPLETION*
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Topo 0. ~~ % Slope I I
Texturecr:ry ..., I s' ()
Structure I3{O'(kv 1 .'.t. I
Clay Min. I J-.) I .'
Soil Wetness 1'5 I'r,
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Soil Depth ') 4i( I
Restric. Hoz. at - I
Available space ~o I
Overall Class SUI ~ y
Coinments: : Cy" ~
T y-eo.>o k. .\)2.> lf~t0 \ 1- \,.:l .
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130' f"" SANd
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inches deep. I
**NO GUARANTEE OR WARRANTY IS IMPLIED OR GIVEN AS TO THE PERFORMANCE OR LENGTH OF TIME THIS SYSTEM
WILL FUNCTlON**
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Owner/Agent
Address
Lot Size
<< 55' /:I-c..... Directions: /1!,.5
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Filter Required
Riser required when
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*Improvement Permit has no expiration date and is transferable, but may -be 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 an rtion o(the installation is put into USp
The siting of the well by the Health Department staff is to provide protection from known poss' on es of contamination. No volurr/
water is guarantee at any site by the Health Department.. .....dZA.. 0 //
Permit Date / - Eo : . HIS. /' t/\
Owner/ nt Septic Tank Installed B
EHS Well Installed By
Well Head A roval Date Sample Collected
Date of Results Results ..."" _~O_ EHS
White ~ Office Blue ~ Building Inspection Operation ~ermit Yellow. Owner/Agent
r'
Well Grout Approval D.
.' " \
Green - Buildmg Inspection Authorization to Construcf \