HomeMy WebLinkAboutOP-09-2022-180473.tif C:1TAWBAC01:YIN Case# OP-09-2022-180473
FT .f. 1. Public I Icalth Department Subdivision DOUGLAS CORNERS
d '4 Environmental Health Division PIN# 268703241906
PO Box 389.25 Government Drive.Newton,NC 28658 LOT# 26
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Site Address: 3822 BANOAK RD, VALE NC 28168
Name on Permit: MICHELLE HODGE
Property Size: Acres 0.68
Directions: Hwy 10, Left on Banoak Rd, Land on Left
Operation Permit
Permit Category: New Septic Wastewater Flow: 360 g.p.d.
Type of Facility: Primary Residence-Mobile Home
Basement? No Basement Plumbing? No Bedrooms: 3
Water Supply: Private Well Maximum Occupants: 6
System Type: IIIG-OTHER NON-CONY TRENCH SYSTEMS
Description: 25%REDUCTION
System Code: IQ4PS System Code Description: Infiltrator Quick 4 Plus Standard
Types V and VI systems expire in 5 years.
Owner must contact Environmental Health 6 months prior to expiration for permit renewal.
System Installation Comments: -Installed new 1000 gal septic tank(Date: 6/25/22. Shoaf 190, STB 1000.)
-Installed 328 feet of 25%reduction product.
PERMIT CONDITIONS:
1.All maintenance, monitoring, &performance requirements shall be in accordance with 15A NCAC 18.1900, Rule.1961
2. Operation& Maintenance Specifics:
Subsurface system operator required? Yes No_X_
This system has been installed in compliance with applicable NC General Statutes,Rules for Sewage Treatment and Disposal,
Craig Thompson Grading (John Thompson)#590( 08/04/2022
System Installer Installation Date
°V)/44VL If)1°71#
09/16/2022
Authorized State Agent Permit Issuance Date
Form F
ehp.miii 09i19/2022 09'09
16f t- It- pat-- 31387
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