HomeMy WebLinkAboutEHPR-4-11-10473 (2).TIF Case # - "� "
�$ CATAWBA COUNTY Subdivision o r� �
E, - Public Health Department Section/BUPh1Lot#
d '"" Environmental Heslth Division PM# I �
PO Box 389,100A Southwest Blvd, Newton NC 28658
8 � (g28)46S-8Z�0 Fax (828)465-8276 TDD (828)465-8200
A licant/Owner �r �
Site Address: Y
Size: . S
Dircctions:
EXISTING SYSTEM IN5PECTION REPORT
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ype of Facility : House
Mobile Hoa�e �—Q--- # � O° � �'—'
Business __.u___ S��'
Other �..,� SP��'
� a' x 1 z' covv c�_�� cuer p x�is -4�i�w► e�k
roposed Additions/Accessory Stinicture: .�
�PP�ved ❑ I_
Not Approved � Reason Ce ���CY Ot1S G
vidence of System Malfunction : YES .[�.--- NO � Sysem Type�DescriPtion (bY\Uth �Il �1t� -
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AUTfiORIZED ST AGENT APPROVAL DATE
NOT FOR LOAN. �PPROVAL
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% t, . :� 3•'pp /� N° 3874
CATAWSA COUNTY �-iFFiLTH DE A MENT �
( 704 ) 465 ;8270
Lot Eval. Improve. Permit Repair Permit �� Cert. of Comp. Permit Oper. Permit
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Oc•mer/Agent � Phone �.Q � -- �� � l�
Address ` Subdivision
Section/Block Lot#
Lot Size Direc ions: '
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Facility: House t-lobile Home Business . Other: Zoning A proval yes,[.�o # �
tiulti-family Other . 100e Repair Ar y s/
Bedrooms Seats Employees . GPD Flow cation Rate
Hot Tub or Spa yes/no Special Fixtures . REPAIR NOTI REPAIRS MIST BE FIITHIN
Basement yes/no Basement Plumbing yes/no . 30 DAYS OR �AYS FROH DATE OF
Water Supply: Private Public l/ . PERlffT.
Ai►*Afl*1t**11*A#t*f�RA1tfY�t►�►ftR�*f*}#M1F*R#YtAfltfYli►�R'R*AA*f�R******lAk�11RltRfllt#*RiRf*f'RRfkRR�RRR'RR1!#Rtf
Type of System: Trench Bed v Pump Pump/Panel Panel LPP Other
Tank Size: Septic Tank C�r/..LQ_ �� Pump Tank
Nitrification Field: Total Square Feet ��Q Depth of Stone�� Bed Size��� /!
Trench Width Total Length of All Trenches Number of Trenches
Individual Trench Length_/_/_/_/, Feet on Center l4aximum Trench Depth
Distance of Nearest Well__�J��� Lot Eval.uation: Approved yes/no (Void After 24 months)
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Topo s Slope � Sketch of lot Evaluation Site - System Design - Final
Texture ( .
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Structure �
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Clay �
Soil I^ ness " �
Soil pth " �
Rest ic. Hoz. at r " �
Available space yes/no�
Overall Class S PS U �
Comments: �
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*'`NO GUARANTEE OR {9ARRANTY IS ItiPLIED OR GIVEN THROUGH THE ISSUANCE OF THIS PERIiIT'` *
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Fe nnit Date '— (Improvement Pe nnit void after 60 months?
Oc•nier/Agent Sanitarian �
Installed By � Date /►[� y q Z Sanitarian
(NntP �ny rhanaps/inf�rmation in> rPd �r hy skPtrh �n hark) �.
Wt�ite-Office Blue-Bldg. Insp. Comp. Yellow-Owner/Agent Green-Bldg. Insp.I.P.