HomeMy WebLinkAboutOP-10-2022-181787.TIF �$: • CA'1'AWBACOUN'TY Case/t OP-10-2022-I81787
r~ .t.ii ,1 Public I Iealth Department Subdivision RALPH N DRUM
mil') C Environmental health Division PINt 460701078459
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PO Box 389,25 Government Drive,Newton.NC 28658 1,017, 6
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Site Address: 3553 TEE ST, SHERRILLS FORD NC 28673
Name on Permit: WILLIAM LAZARUS
Property Size: Acres 0.48
Directions: Hwy 150 E, left Mt Pleasant Rd, left Tee St,
Operation Permit
Permit Category: Repairs Wastewater Flow: 360 g.p.d.
Type of Facility: Prim ReslAcc Structure-3-bedroom house& bathhouse with sink,toilet, shower, NO bedrooms or Kitchen
Basement? Yes Basement Plumbing? Yes Bedrooms: 3
Water Supply: Private Well Maximum Occupants: 6
System Type: IIA-CONV SYSTEM (SINGLE-FAMILY OR 480 GPD OR LESS)
Description: REPLACEMENT OF SEPTIC TANK ONLY
System Code: System Code Description:
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: replacement of septic tank only. original septic tank crushed and filled in. new septic
tank is 1,000 gallon plastic infiltrator tank. added new d-box with one outlet feeding
original bed and other outlet feeding repair bed installed in 4/13/95(permit 05647 issued
4/19/93).
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.
greenway waste solutions#5094 09/27/2022
System Installer Installation Date
if.--........7._
10/06/2022
Authorized State Agent Permit Issuance Date
Form F
I(I%14/2022 12:55
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Parcel: 460701078459, 3 TEE ST * well I kcaxed on e 3512 Tee,
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10/06/2022