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OPERATION PERMIT or ice use ny
Catawba Courtly Pubic Health Department *CDP Fite Number 9 5 $ 5
Environmental Health Division WLS2009.00152
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:
DP, > o
Applicant: ` Property Owner: ROBERT PHILLIPS
Address: Address: 5078 ASHFORD CREST LN
City: City: CHARLOTTE
State/Zip: State/Zip: NC 28226-352
Phone Phone
Property Location & Site Information
Address/Road: Subdivision: Phase: Lot: 74&AD
3743 REID CIR
SHERRILLS NC Directions
Structure: SINGLE FAMILY 16S/ LF CAMPGROUND RD/ TURN LF SHERRILLS
FORD RD/ TURN LF BEATTY RD/ TURN LF REID
# of Bedrooms: 3 CIRCLE/ WHEN YOU COME TO Y IN ROAD GO
# of People: RIGHT APPROX 1 MILE ON RIGHT
"Water Supply: EXISTING WELL
'IP Issued by: 2246 - Megen McBride "System Classification/Description:
TYPE III G. OTHER NON-CONY. TRENCH SYSTEMS
'CA issued by: 2246 - Megen McBride
Design Flow: 3 6 0 'Distribution
Type- GRAVITY -SERIAL
Soil Application Rate: 0 3 'Pre-Treatment:
Drain field
Nitrification Field 9 0 0 Sq. ft, System Type; INFILTRATOR QUICK 4 STANDARD
No. Drain Lines 3 Installer: Steve Jordan
Total Trench Length: 3 0 0 ft. Certification 1853
Trench Spacing: _ 9 OInches O.C.
)Feet O.C. 'EHS: 1952 • Phelps. Robert
Trench Width: 3 (-)Inches
(Feet Date: 0 1/ l a/ a 0 1 0
Aggregate Depth: Inches
Minimum Trench Depth: 1 8
Inches
Minimum Soil Cover Inches Approval Status
f0axlmum Trench Depth: 3 0 Cl Inches Approved D Disapproved
9aximum Soil Cover, ~ inches
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CDPFileNumber 29585 Septic Tank County ID Number: vvt_s2009-00152
Manufacturer. Lat.
Long:
STB:
1000 Installer: Steve Jordan
Gallons.
Date: Certification 1853
' E H S 1952 - Phelps, Robert
''Filter Brand; POLYLOK PL-68
Date: 0 1/ 1 1/ a 0 1 0
ST Marker, ❑ Yes ❑ No
Reinforced Tank ❑ Yes ❑ No Approval Status
t Piece Tank: ❑ Yes ❑ No El Approved ❑ Disapproved
Pump Tank
' Manufacturer Installer:
PT. Certification
Gallons: 'EH S:
Date: Date:
Riser Sealed ❑ Yes ❑ No
RiserHeight: ❑ Yes ❑ N0 (Min.6 in.) Approval Status
Reinforced Tank: ❑ Yes ❑ No ❑ Approved n disapproved
1 Piece Tank: ❑ Yes ❑ No
Supply Line
Pipe Size. 3 inch diameter Installer: Sieve Jordan
Pipe Length: feet Certification 1853
'EH S: 1952 - Phelps, Robert
'Schedule: 40
Pressure Rated ❑ Yes ❑ No Date: 0 1 / 1 / a 0 1 0
Approved fittings ❑ Yes ❑ No
I CD Approval Status
Approved ❑ Disapproved
Pump Requirement
Pump Type. Installer:
Dosing Volume: - Gal Certification m:
Draw Down. Inches 'EHS:
'Chain:
Date:.
Valves Accessible ❑ Yes ❑ No
Flow Ad►ustment Valve ❑ Yes ❑ No
Check-valve ❑ Yes ❑ No Approval Status
PVC Unions ❑ Yes ❑ No ❑ Approved ❑ Disapproved
Vent Hole ❑ Yes ❑ No
i~ Anti-siphon Hole ❑ Yes ❑ No
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CDP File number 29585 County ID Number: WLS2009-00152
Electric Equipment
~fNEMA 4X Box or Equivalent ❑ Yes ❑ No Installer.
Box 12 inches Above Grade ❑ Yes ❑ No
Certification 9:
Box Adj. To Pump Tank ❑ Yes ❑ No
Conduit Sealed ❑ Yes ❑ No 'EMS:
Pump (A anually Operable ❑ Yes ❑ No
'Activation Method. Date.
Alarm Audible ❑ Yes ❑ No Approval Status
❑ Approved [J Disapproved f
Alarm Visible ❑ Yes ❑ No
1952 - Phelps. Robert
'Operation Permit completed by.
Authorized State Agent: Date of Issue. 0 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 iuA
Management Entity: OWNER
Minimum System Inspection/Maintenance Frequency By Certified Operator:
NIA
Reporting Frequency By Certified Operator: N/A
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 entitywith a certified operatoror a private certified operator forthe life of the septic system,
Rule .1961 requires that Type VI septic systems designed fora homelbusiness 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 enthy, unless the
system owner and certified operator are the same. The contract shall require specific requirements formaintenance and
operation, responsibilities of the owner and systems operator', provisions that the contract shall be in effect for as long as the
system is to use, and other requirements for the continued proper performance of the system. It shall also be a condition of
the Operation Penn it that subsequent owners of the systems execute such a contract.
Olland Drawing Olmport Drawing
**Site Plan/Drawing attached.**
Total Time:(HHJA1J)
0 Hours r,i mutes
Page 3 of 4
CDP File Number: 29585 County File Number: wLs20000152
Drawing Type: Operational Permit Date: 0 1 2 9 0 1 0
finch
Scale: (DBlock = ft.
Dra-vvin14 IN/A
Q,.r
~Y
N
N
I
Y 0
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