HomeMy WebLinkAboutOP-02-2023-189417.TIF �$: ('A'I'AWBA COUNTY
tCase 1� OP-02-2023-I894I 7
,i. Public I lealth Department Subdivision STARMONT VILLAGE
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C ronmental IIcalth Division PIN;I 363909151623
P(1 Box 389,25 Government Drive.Newton.NC 28658 1.017YY 1
1 SM
Site Address: 1735 SHADY LN, NEWTON NC 28658
Name on Permit: SHELIA GORE
Property Size: Acres 0.46
Directions: NC 10, right onto Sigmon Dairy Rd,left onto Shady Lane,4th house on the right
Operation Permit
Permit Category: Repairs Wastewater Flow: 360 g.p.d.
Type of Facility: Primary Residence-
Basement? Yes Basement Plumbing? Yes Bedrooms: 3
Water Supply: Community 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(GST 1000, STB 160, Date: 10/11/22).
*Existing septic tank used as settling tank, filter added to tank.
*Installed 330 feet of 25%reduction product(chambers).
PERMIT CONDITIONS:
1.All maintenance, monitoring,&performance requirements shall be in accordance with 15 A NCAC 18.1900, Rule.1961
2.Operation&Maintenance Specifics:
Subsurface system operator required? Yes NoX_
This system has been installed in compliance with applicable NC General Statutes,Rules for Sewage Treatment and Disposal.
Shuler Builders (Johnny Shuler)#3791 02/08/2023
System Installer Installation Dale
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0 2/1 712 02 3
Authorized State Agent Permit Issuance Date
Form I'
ehpenui 03,1 0/2023 12:14