HomeMy WebLinkAboutOP-2-10-4399.TIF
OPERATION PERMIT or Ice use ny
f . Catawba County Public Health Department `CDP Fde Number 3 7 0 0 4
t 1-" Environmental Health Division EHPR-11-09-2917
P.O Box 389, 100-A Southwest Blvd County ID NumberA- 140.i~_
Newton NC 28658 S Evaluated For: REPAIR.
Phone: (828)-465-8270 Fax: (828) 465-8276 Township; - ' " 9q
Applicant: Keith Hefner Property Owner Keith Hefner
Address: 4210 NW 6Th St. Address: 4210 NW 6th St.
CRY: Hickory City Hickory
State/Zip: NC 28601 State/Zip: NC 28601
~,_Phone Phone
Property & Site Information
Address/Road Subdivision: Everette And Alma Phase: Lot.
4210 NW 6Th St. p
Hickory NC 28601 Directions
Structure: SINGLE FAMILY
# of Bedrooms: 3
# of People: 2
Water Supply: EXISTING WELL
'IP Issued by. 'System Class ificaWn/Description
TYPE III B. SYSTEM W/SINGLE EFFLUENT PUMP
'CA issued by: 2246 - Megen McBride
Design Flow: 8 6 0 PUMP TO GRAVITY
Distribution Type'
Soil Application Rate: 0 3 `Pre-Treatment:
Drain field
N arification Field 9 0 0 Sq. ft *System Type: INFILTRATOR QUICK 4 STANDARD
No.DrainLines 5 Installer. Bryan Miller
Total Trench Length: a 9 6 ft- Certification 1 127
Trench Spacing: - 9 Inches O.C
Feet O.C. `EH S. 2246 - Megen McBride
Trench Width: 3 Inches
Feet Date: 0 1/ 0 5/ x 0 1 0
Aggregate Depth. inches
Minimum Trench Depth: 1 a
Inches
Minimum Soil Cover 1 a Inches Approval Status
Maximum Trench Depth: a 0 Inches EIVIL~ApprovedD (saWroved
Maximum Soil Cover. 0 8
Inches
Pagel of 4
CDPFileNumber 37204 Septic Tank County ID Number: EHPR-11.09-2917
Manufacturer. Lat.
it&
STB: Long:
Gallons: Installer:
Date: Certification
' EH S:
`Filter Brand:
ST Marker: ❑ Yes ❑ NO Date:
Reinforced Tank: ❑ Yes ❑ No Approval Status
1 Piece Tank: ❑ Yes ❑ No LD Approved ❑ Disapproved
Pump Tank
Manufacturer. Alexander Precast Installer: Bryan Miller
PT: Certification 1127
Gallons: 1000 `EH S: 2246 - Megen McBride
Date: Date: 0 1/ 0 5/ 2 0 1 0
Riser Sealed R Yes ❑ NO
Riser Height: NQ Yes ❑ No (Min.6 in.) Approval Status
Reinforced Tank: ❑ Yes ❑ No 11 Approved a 13fsapproved
1Piece Tank: ❑ YeS ❑ NO
Supply Line
Pipe Size: a inch diameter Installer: Bryan Miller
Pipe Length: a 3 feet Certification 1127
"EH S: 2246 - Megen McBride
`Schedule: 40
Pressure Rated FE Yes ❑ No Date: 0 1/ 0 5/'2 0 1 0
Approved fittings JR Yes ❑ No Approval Status
'.:Approved 0 Disapproved LJ
Pump Requirement
Pump Type- Zoeller, N152-B. 4110 HP Installer: Bryan Miller
Dosing Volume: - Gal Certification 1127
Draw Down: 7 Inches `EHS: 2246 - Megen McBride
Chain: ROPE Date: 0 1/ 0 5/ 2 0 1 0
Valves Accessible Yes ❑ No
Flow Adjustment Valve Yes ❑ No
Check-valve ® Yes ❑ No Approval Status
PVC unions 99 Yes ❑ No Approved ❑ Disapproved
Vent Hole R Yes ❑ No
Anti-siphon Hole ❑ Yes ❑ No
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CDP File Number 37004 County ID Number: EHPR-11-09-2917
Electric Equipment
NEMA 4X Box or Equivalent N Yes ❑ No Installer: Bryan Mauer
Box 12 inches Above Grade W Yes ❑ NO 1127
Certification
Box Adj. To Pump Tank [ Yes ❑ No
Conduit Sealed Q Yes ❑ No `EH S. 2246 - Megan McBride
Pum p M an ually 0 perable k Yes ❑ NO 0 1/ 0 5/ a 0 1 0
`Activation Method: Date:
Alarm Audible S Yes ❑ No Approval Status
Approved D Disapproved
Alarm Visible [ Yes ❑ No
2246 - Megan McBride
`Operation Permit completed by.
Authorized State Agent: Date of Issue 0 1/ a 6/ 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 Ili B. sewage septic system.
Rule .1961 requires that a Type TYPE 111 8, septic system meet the following criteria.
Minimum System Review By The Local Health Department 5YRS. TR
Management Entity: OWNER
Minimum 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 fife 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 it 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
**Site Plan/Drawing attached.**
Total Time (HH MM)
0 0 Hours 0 0 minutes
Page 3 of 4
CDP File Number: 37004 County File Number: EHPR-11-09-2917
Drawing Type: Operational Permit Date: 0 1/ a 6/ a 0 1 0
Q Inch
Scale: Q Block = ft.
Drawin Q N/A
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Page 4 of 4