HomeMy WebLinkAboutOP-11-09-2955.TIF
CTw~. pi OPERATION PERMIT or ice use ny
Catawba County Public Health Department "CDP File Number 3 5 7 3 8
Environmental Health Division 366602797845
P.O Box 389, 100-A Southwest Blvd County ID Number.
Newton NC 28658 Evaluated For, NEW
4r ~„ao`
Phone: (828)-465-8270 Fax: (828) 465-8276 Township: -~CI's s
Applicant: Jeffery Scott Korn Property Owner- Jeffery Scott Korn
Address: 4342 Laney Road Address: 4342 Laney Road
City: Maiden City Maiden
State/ZIP: NC StateiZip- NC
Phone 464-2662 Phone
Property & Site Information
Address/Road Subdivision: Phase: Lot.
4342 Laney Road V
Maiden NC 28658 NC Directions
Structure: Hwy 16 S to Buffalo Shoals Road on RT, LT Laney
SINGLE FAMILY Road, Lot on LT before Laney Farm Road
# of Bedrooms. 3
# of People. 5
*Water Supply: NIA
"IP Issued by: 1810 - Boyd, Jason *System ClassificationiDescription'
TYPE 111 G. OTHER NON-CONY. TRENCH SYSTEMS
*CA issued by: 1810 - Boyd, Jason
Design Flow. 3 6 0 *Distribution Type GRAVITY - SERIAL
Soil Application Rate: 3 "Pre-Treatment:
Drain field
Nitrification Field 9 0 0 S4. ft. 'System Type: EZFLOW EZ 1003T
No Drain Lines 3 Installer. S and L Grading Jonathan Lail
Total Trench Length: 3 6 0 ft Certification # 1801
Trench Spacing: _ 9 (DInches O.C
eet O.C. 'EH S. 1810 - Boyd, Jason
Trench Width: 3 Inches
WFeet Date. 1 1/ 1 7/ x 0 0 9
Aggregate Depth. inches
Minimum Trench Depth:
Inches
Minimum Soil Cover Inches Approval StaW
Maximum Trench Depth: a 4 Inches Approved0 Diisapp"ed
Maximum Soil Cover:
Inches
Pagel of 4
CDP File Number 35738 Se tic Tank County ID Number: 366602797845
Stroupe Lat
Manufacturer. .
794 Long
STB:
Installer:
Gallons: 1000
Date: Certification 1801
'EH S: 1810 - Boyd, Jason
'Filter Brand: POLYLOK PL-68
ST Marker: [Z Yes ❑ No Date: 1 1 / 1 7 / .1 0 0 9
Reinforced Tank. X Yes ❑ No Approval Status
Approved Di pp❑ rtle
1 Piece Tank: ❑ Yes ~'NO
Pump Tank
Manufacturer. Installer.
PT: Certification
Gallons: 'EH S
Date: Date:
Riser Sealed ❑ Yes ❑ No
Riser Height: ❑ Yes ❑ No (Min 6 in.)
Approval Stehts
einforced Tank: ❑ Yes ❑ No ❑ Approved 0 Disapproved
1 Piece Tank: ❑ Yes ❑ NO
Supply Line
Pipe Size: 3 inch diameter Installer.
Pipe Length: 1 0 feet Certification 1801
'EH S 1810 - Boyd, Jason
'Schedule: 40
Pressure Rated ❑ Yes O 'No Date: 1 1 / 1 7 / .2 0 0 9
Approved fittings j Yes ❑ No Approval Status
ifKApproved O Disapproved
Pump Requirement
Pump Type: Installer:
Dosing Volume: - Gal Certification
Draw Down: Inches 'EHS:
'Chain.
Date:
Valves Accessible ❑ Yes ❑ No
Flow Adjustment Valve ❑ Yes ❑ No
Check-valve ❑ Yes ❑ No Approval Steius
PVC Unions ❑ Yes ❑ No Q Approved ❑ "Disappt+t3~'
Vent Hole ❑ Yes ❑ No
Anti-siphon Hole ❑ Yes ❑ No
Page 2 of 4
CDP File Number 35738 County ID Number: 366602797845
Electric Equipment
NEMA 4X Box or Equivalent ❑ Yes ❑ No Installer.
Box 12 inches Above Grade ❑ Yes ❑ No
Certification
Box Adj. To Pump Tank ❑ Yes ❑ No
Conduit Sealed ❑ Yes ❑ No *EH S.
Pump Manually Operable ❑ Yes ❑ No
*Activation Method: Date.
Alarm Audible ❑ Yes ❑ No ~p~ral$71~pp"ed Q t't3fxt+E~ ❑ ~.Alarm
Visible ❑ Yes ❑ No
1810- Boyd. Jason
'Operation Permit completed by. ]
Authorized State Agent: 6 ` Date of Issue: 1 1/ 1 7/ a 0 0 9 - A- U
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 Entity: OWNER
Minimum System Inspection/Maintenance Frequency By Certified Operator.
NIA
Reporting Frequency By Certified Operator: NIA
Rule .1961 requires that a Type IV and V septic systems designed fora homelbusiness owner must maintain a valid contract
with a public management entitywith a certified operator or a prorate 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 ownerand 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. It shall also be a condition of
the Operation Permit that subsequent owners of the systems execute such a contract.
Hand Drawing Olmport Drawing
ite Plan/Drawing attached.**
Total Time (HH MM)
Hours Minutes
Page 3 of 4
CDP File Number: 35738 County File Number: 366602797845
Drawing Type: Operational Permit Date: 1 1/ 1 7/ 0 0 9
0Inch
Scale: QBlock = ft.
Drawing ON/A
a _
cz, t oU j
71 6-
LC-
400
Page 4 of 4