HomeMy WebLinkAboutOP-03-2023-192546.tif • CATAWBA COUNTY Case# OP 03
Public Health Department Subdivision KISER
Environmental Health Division-�1
PIN# 2023 19C2546
460903245467
PO Box 389,25 Government Drive,Newton,NC 28658 LOT# 21 &PT 20
Site Address: 1876 ROLLINS DR, CATAWBA NC 28609
Name on Permit: JEFF WILLIAMS
Property Size: Acres 1.13
Directions: Hopewell Ch Rd, right onto Wooten St, right onto Rollins Dr,turn left, property on the right
Operation Permit
Permit Category: Repairs Wastewater Flow: 480 g.p.d.
Type of Facility: Primary Residence-
Basement? No Basement Plumbing? No Bedrooms: 4
Water Supply: Private Well Maximum Occupants: 8
System Type: IIA-CONV SYSTEM (SINGLE-FAMILY OR 480 GPD OR LESS)
Description: REPLACEMENT OF SEPTIC TANK ONLY
System Code: GBD System Code Description: Gravel Bed
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: septic tank; mu111000,stb821, 12/19. new septic tank only, old tank filled in.
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.
jeff williams#9375 02/16/2023
System Installer Installation Date
,
i P.-.....4._
03/29/2023
Authorized State Agent Permit Issuance Date Form F
ehpennit 03/29/2023 11:52