HomeMy WebLinkAboutOP-12-2022-185875.tif �8' \ CATAWBA COUNTY Case# OP-12-2022-185875
1~ .t.li 4\ Public Health Department Subdivision MEADOWBROOK VILLAGE P
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� , '� Environmental Health Division PIN# 279118209381
PO Box 389,25 Government Drive,Newton,NC 28658 LOT# 67
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Site Address: 3418 S NC 127 HWY, HICKORY NC 28602
Name on Permit: SUSAN SMITH
Property Size: Acres 0.47
Directions: HWY 127 S BESIDE CHURCH OF NAZERENE
Operation Permit
Permit Category: Repairs Wastewater Flow: 360 g.p.d.
Type of Facility: Primary Residence-House
Basement? No Basement Plumbing? Bedrooms: 3
Water Supply: Public Water Maximum Occupants: 6
System Type: IIIG-OTHER NON-CONY TRENCH SYSTEMS
Description: 25%REDUCTION
System Code: IQ4 System Code Description: Infiltrator Quick 4 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:
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.
Gary Leatherman-#1111 09/05/2014
System Installer Installation Date
41/ A (114/(4
12/08/2022
Authorized State Agent Permit Issuance Date Form F
i2/08/2022 09:38
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Catawba County Environmental Health
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Parcel: 279118209381, 3418 S NC 127 HWY lin=40ft
HICKORY, 28602
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12/08/2022