HomeMy WebLinkAboutOP-1-10-4236.TIF
OPERATION PERMIT , or ice se ny
r Catawba County Public Health Department YGDP File Number 3 4 5 7 ~
Environmental Health Division WLS2009-00572
P.0 Box 389, 100-A Southwest Blvd County ID Number:
Newton NC 28658 Evaluated For: NEW
Phone: (828)-465-8270 Fax: (828) 465-8276 Township: ®P- b' -)3
Applicant: PANSEY HELDERMAN Property Owner: MARK S HELDERMAN
Address: 3781 HELDERMAN RD Address; 3699 HELDERMAN RD
City NEWTON City. NEWTON
State/Z IV NC 28658 State/Zip: NC 28658
Phone Phone
Property Location & Site Information
(/Address/Road Subdivision. ROGER & PANSEY Phase: Lot: 1
3617 HELDERMAN ST gnVERWO
NEWTON NC Directions
HWY 16 S - TURN RIGHT ONTO BUFFALO
Structure: SINGLE FAMILY SHOALS RD - TURN RIGHT ONTO OLIVERS
# of Bedrooms: 3
CROSS ROADS -TURN LFT ONTO HELDERMAN
0 of People- 2 RD - PASS 2ND HOUSE ON RIGHT - CONTINUE
,'Water Supply EXISTING WELL ON GRAVEL RD - PROPERTY WILL BE ON RIGHT ~
'IP Issued by 2246 - Megen McBride 'System Classification/Description.-
TYPE III G. OTHER NON-CONV. TRENCH SYSTEMS
'CA issued by: 2246 - Megen McBride
Design Flow:
3 6 0 *Distribution Type: GRAVITY
Soil Application Rate: 0 3 'Pre-Treatment:
Drain field
( Nitrification Field 9 0 0 Sq It 'System Type: INFILTRATOR QUICK 4 STANDARD
No Dram Lines 3 Installer: Kenny Dellinger
Total Trench Length: 3 0 0 ft. Certification 1063
Trench Spacing: _ g Inches O.C.
~
-Feet O.C. EHS: t.752 -Phelps, Robert
Trench Width: 3 ()Inches
(D- Feet Date: 0 1/ 1 4/ 0 0 1 0
Aggregate Depth: Inches
Minimum Trench Depth: a 4
Inches
Minimum Soil Cover 1 G Inches Approval Status
Il
i Maximum 't'rench Depth: 3 0 Endres Q Approved [D Disapproved
Maximum Soil Cover-
1 8 `
Inches
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CDP File p~ lumber, 34572 Septic Tank County ID Number: WLS2009-00572
P anufacturer: Dellinger Lat. _
STB. 294 Long;
1000 Installer: Kenny Dellinger
Gallons:
Date: 1 0 / a 4 / a 0 0 9 Certification 1063
'EH S: 1952 - Phelps, Robert
'Filter Brand: POLYLOK PL-68
ST Marker ❑ Yes ❑ No Date: 0 1/ 1 4/ a 0 1 0
Reinforced Tank ❑ Yes ❑ No Approval Status
t Piece Tank: ❑ Yes ❑ No 0 Approved ❑ Disapproved
Pump Tank
/d Manufacturer: Installer:
PT: Certification
Gallons. 'EN S:
Date: Date:
Riser Sealed ❑ Yes ❑ No
Riser Height: ❑ Yes ❑ No (Min.6 in.)
Approval Status
`Reinforced Tank: ❑ Yes ❑ No 13 Appraved❑ Disapproved
1 Piece Tank: ❑ Yes El No Supply Line
Pipe Size: 3 inch diameter Installer: Kenny Dellinger
Pipe Length feet Certification 1063
`EH S: 1952 • Phelps, Robert
'Schedule: 40
Pressure Rated ❑ Yes ❑ No Date: 1 / 1 4 / a 0 1 0
Approved fittings ❑ Yes ❑ No Approval Status
t ❑ Approved ❑ Disapproved
Pump Requirement
Pump Type. Installer:
1
Dosing Volume: - Gal Certification #
Draw Down: Inches 'EHS:
'Chain:
Date:
Valves Accessible ❑ Yes ❑ No
Flow Adjustment Valve ❑ Yes ❑ No
Check-valve ❑ Yes ❑ No Approval Status
PVC Unions ❑ Yes ❑ No ❑ Approved ❑ Disapproved
Vent Hole ❑ Yes ❑ No
/
Anti-siphon Hole ❑ Yes ❑ No /
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CDP File Number. 34572 County ID Number: WLS2009-00572
Electric Equipment
NEMA 4X Box or Equivalent ❑ Yes ❑ No lnstaller:
r
Box 12 inches Above Grade ❑ Yes ❑ NO
Certification
Box Adj. To Pump Tank ❑ Yes ❑ No
Conduit Sealed ❑ Yes ❑ No 'EHS:
Pump Manually Operable ❑ Yes ❑ No
`Activation Method. Date_
Alarm Audible ❑ Yes ❑ No Approval Status
Alarm Visible ❑ Yes ❑ No ❑ Approved n Disapproved
1952 - Phelps, Robert
`Operation Permit completed by.
Authorized State Agent: AJA LP Date of Issue. 0 1 a 0/ a 0 1 0
This system has been installed in compliance with applicable NC General Statutes: Article 11, Chapter 130A. Rules for
Sewage Treatment and Disposal, 15A NCAC 18A .1900 et. Seq., and all conditions of the Improvement Permit and
Construction Authorization. This property is served by a TYPE III G. sewage septic system.
Rule .1961 requires that a Type TYPE III G. septic system meet the following criteria:
Minimum System Review By The Local Health Department: NIA
Management Entit OWNER
rvtinimurn System Inspection/Maintenance Frequency By Certified Operator:
N/A
Reporting Frequency By Certified Operator; NIA
Rule .1961 requires that a Type IV and V septic systems designed fora home/business owner must maintain a valid contract
with a public management entity with a certified operator or a private certified operator.for the life of the septic system.
Rule .1961 requires that Type VI septic systems designed fora home/business owner must maintain a valid contract with a
public management entity with a certified operator for the life of the septic system.
Rule. 1961 (2) (e) requires a contract shall be executed between the system owner and a management entity priorto the
issuance of an Operation Permit for a system required to be maintained by a public or private management entity, unless the
system owner and certified operator are the same. The contract shall require specific requirements for maintenance and
operation, responsibilities of the owner and systems operator, provisions that the contract shall be in effect for as long as the
system is in use, and other requirements for the continued proper performance of the system. ft shall also be a condition of
the Operation Permit that subsequent owners of the systems execute such a contract.
0Hand Drawing C )Import Drawing
**Site Plan/Drawing attached.**
Total Timei(HHNIA)
0 Hdurs Minutes
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CDP File Number: 34572 County File Number: WLS2009.00572
Drawing Type: Operational Permit Date: 0 1.2 0/ a 0 1 0
(jlnch
Scale: C)BIock
Drativinq
WSL
5
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1 °
n
0 { I~.,-9.{x{11. i
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