HomeMy WebLinkAboutOP-2-10-4403.TIF I r
OPERATION PERMIT or ice use ny
Catawba County Public Health Department *CDP File Number 3 .1 .2 a 3
Environmental Health Division WLS2009-00300
P.O Box 389, 100-A Southwest Blvd County ID Number:
Newton NC 28658 Evaluated For: NEW
Phone: (828)-465-8270 Fax: (828) 465-8276 Township: oP 0
Applicant: JCM CUSTOM HOMES, LLC Property Owner: CHUCKIE WARD
Address: 1998 KIRSTEN ST Address: 1555 BROOKSTONE DR
City: NEWTON City: HICKORY
State/Zip: NC 28658 State/Zip: NC 28602-897
Phone Phone
Pro ertLocation & Site Information
Address/Road Subdivision: RAINBOW HILLS Phase: Lot: 23
1191 DAISY LN
HICKORY NC Directions
Structure: SINGLE FAMILY HWY 10W/ TURN RT ZION CH RD/ TURN INTO
RAINBOW HILLS SUBDIV/ TAKE 2ND RT ON
# of Bedrooms: 4 RAINBOW HILLS DR/ GO TO THE END OF ROAD/
# of People: AT T-INTERSECTION TURN LF/ 1191 IS ON THE
Water Supply: PUBLIC RIGHT JUST B-4 THE CUL-DE-SAC
'IP Issued by: 9999 -Unknown `System Classification/Description:
TYPE III G. OTHER NON-CONY. TRENCH SYSTEMS
'CA issued by: 1896 - Lucas Sears
Design Flow:
4 $ 0 'Distribution Type: GRAVITY
Soil Application Rate: 3 'Pre-Treatment:
Drain field
Nitrification Field 1 a 0 0 Sq. ft' 'System Type: INFILTRATOR QUICK 4 STANDARD
No. Drain Lines 4 Installer: Maxs Digging Service
Total Trench Length: 4 0 0 ft. Certification 1127
Trench Spacing: _ 9 Inches O.C.
Feet O.C. 'EH S: 1919 - Susan Miller
Trench Width: _ 3 ()Inches
Feet Date: 1/ 1 5/ x 0 1 0
Aggregate Depth: inches
Minimum Trench Depth: 1 8
Inches
Minimum Soil Cover. 6 Inches Approval Status
Maximum Trench Depth: 1 4 ® Approved ❑ Dis,approved
Inches
Maximum Soil Cover: 1 a
Inches
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I
CDP File Number 32227 Septic Tank County ID Number: WLS2009-00300
Manufacturer. WF Lat.
STB: 1007 Long:
1000 Installer: Max's Digging Service
Gallons:
Date: 0 5 / x 0 0 9 Certification 1127
~EH S: 1919 - Susan Miller
"Filter Brand: POLYLOK PL-68
Date: 1/ 1 5/.1 0 0 9
ST Marker: ®YeS ❑ NO
Reinforced Tank: El Yes W NO Approval Status
1 Piece Tank: ❑ Yes ®No Approved ❑ Disapproved'
Pump Tank
Manufacturer. Installer:
PT: Certification
Gallons: *EH S:
Date: Date:
Riser Sealed ❑ Yes ❑ No
Riser Height: ❑ Yes ❑ NO (Min.6 in.) Approval Status
Reinforced Tank: ❑ Yes ❑ No ❑ Approved O Disapproved.
1 Piece Tank: El Yes El NO
Supply Line
Pipe Size: 3 inch diameter Installer: Max's Digging Service
Certification 1127
Pipe Length: 1 3 ;2 feet
"EH S: 1919 - Susan Miller
*Schedule: ao
Pressure Rated ❑ Yes W No Date: 1/ 1 5/ .2 0 1 0
Approved fittings ® Yes ❑ No Approval Status
Approved ❑ 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 Status
PVC Unions ❑ Yes ❑ No ❑ Approved. ❑ Disapproved
Vent Hole ❑ Yes ❑ No
,,"~Anti-siphon Hole ❑ Yes ❑ No
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CDP File Number 32227 County ID Number: wLS2009-00300
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 "EHS:
Pum p M an ually 0 perable ❑ Yes ❑ NO
'Activation Method: Date.
Approval Status
Alarm Audible ❑ Yes ❑ No ❑ ;Approved O ~Disapproyed
Alarm Visible ❑ Yes ❑ NO
1919 - Susan Miller
'Operation Permit completed by:
Authorized State Agent: aM A,IL` Date of Issue: 1 / a 9 / 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 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 home/business owner must maintain a valid contract
with a public management entity with a certified operator or a private certified operator forthe life of the septic system.
Rule .1961 requires that Type VI septic systems designed fora home/business owner must maintain avalid 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 prior to 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 _ It shall also be a condition of
the Operation Permit that subsequent owners of the systems execute such a contract.
O Hand Drawing *Import Drawing
**Site Plan/Drawing attached.**
Total Time:(H H:M M )
0 0 Hours 0 0 Minutes
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CDP File Number: 32227 County File Number'.
Drawing Type: Operational Permit Date: 0 1/ 2 9 /.2 0 1 0
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