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HomeMy WebLinkAboutOP-3-10-5104.TIF OPERATION PERMIT or ice s~ ny. CDP File Number ~)X Catawba County Public Health Department 3 7 8 9 0 Environmental Health Division p~ 1 ~ ~ .r ~l 7 ~ t0 EHF'P-1-10-327 P.O Box 389, 100-A Southwest Blvd o'~~ County ID Number. t Newton NC 28658 Evaluated For. NEW Phone: (828)-465-8270 Fax: (828) 465-8276 Tati^rnship.. 3-10.~ Applicant: Ricky Coffey Property Owner, Ricky Coffey Address: 1683 Springfield Rd Address: 1683 Springfield Rd City: Hickory City: Hickory State/Zip: NC 28602 State/Zip'. NC 28602 Phone (828) 310-6943 Phone Property & Site Information rr ~ Address/Road Subdivision: Phase: Lot: W 1683 Springfield Rd Hickory NC 28602 Directions Structure: SINGLE FAMILY Bethel Ch Rd, R Spriingfield Rd(beside Zion Lutheran Church), 1st house on roght 9 of Bedrooms: 1 # of People: 1 'Water Supply: EXISTING WELL. 'IP Issued by: 1919 - Susan Miner 'System Class ifiication/Description: TYPE III G. OTHER NON-COW. TRENCH SYSTEMS 'CA issued by: 1919 - Susan Miller Saprolite System? (D Yes 0~- No Design Flow: a 4 0 GRAVITY -SERIAL Distribution Type: Soil Application Rate: 0 3 5 : "Pre-Treatment: Drain field Nitrification Field 5 0 8 Sq. ft. 'System Type: INFILTRATOR QUICK 4 STANDARD No. Drain Lines a Installer: Kenny Dellinger Total Trench Length: 1 7 6 ft. Certification 1063 Trench Spacing: - g Inches O.C. 1 Feet O.C. 'EH S: 2246 - Megen McBride Trench Width: 3 Inches Feet Date: 0.2 / 1 1/ x 0 1 0 Aggregate Depth: inches Minimum Trench Depth: Inches Minimum Soil Cover. Inches 11~, Gio. Stylus Maximum Trench Depth :3 6 Inches approved Disapproved Maximum Soil Cover: 2 4 Inches Page 1 of 4 CDP File Number % 37890 County ID Number. EHPR-1-10-3278 Se tic Tank Lat. Manufactures Dellinger STB: 794 Long: 1000 Installer: Kenny Dellinger Gallons: Certification 1063 Date: 1 0/ a a l a 0 1 0 'EH S: 2246 - Megen McBride 'Filter Brand: POLYLOK PL-68 ST Marker. ED Yes ❑ No Date: 0 a 1 1 a 0 1 0 or Reinforced Tank; ❑ Yes El NO A p oJ ~1 S t a 'ifs ~1 Piece Tank: ❑ Yes ❑ No f Approved!__ ' Disapproved Pump Tank Manufacturer. Installer: PT: Certification Gallons. *EH S.- Date: Date: Riser Sealed © Yes ❑ No Riser Height: ❑ Yes ❑ No (Min.6 in,) F~,~~ Stal115 Reinforced Tank: ❑ Yes ❑ No App roved' Disapproved Piece Tank: ❑ Yes ❑ NO 1' Supply Line Pipe Size: inch diameter Installer: Pipe Length; feet Certification `Schedule: 'EH S: Pressure Rated ❑ Yes ❑ No Date: / Approved fittings ❑ Yes ❑ No A,.Pro"'_~I Slahis Approved Disapproved Pump R uirem_ t Pump Type: Installer: r sing Volume: - Gal Certification Draw Down: Inches "EHS: 'Chain: Date: Valves Accessible ❑ Yes ❑ No Flow Adjustment Valve ❑ Yes ❑ No Check-valve ❑ Yes ❑ No - - A;-, ;,rrrd<,I 'S ial~_, PVC Unions ❑ Yes ❑ No =1 Approved n Disapproved vent Hole ❑ Yes ❑ No - - - - - ; Anti-siphon Hole ❑ Yes ❑ No Page 2 Of 4 CDP File Number 37890 County ID Number: EHPR-1-10.3278 Electric E ui ment NEMA 4X Box or Equivalent ❑ Yes 0 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 ❑ Na Date* `Activation Method.- ;1p1)rov21 S12iu Alarm Audible ❑ Yes ❑ No proved ❑ Disapproved i Alarm Visible El Yes ❑ No 2246 - Megan McBride "Operation Permit completed by: Authorized State Agent: WV1 Date of Issue: 0 3/ 0 3 1 2 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 Ili G. septic system meet the following criteria: Minimum System Review By The Local Health Department: N/A Management Entity, OWNER Minimum System Inspectiongvtaintenance Frequency By Certified Operator: N/A Reporting Frequency By Certified Operator: N/A 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 operatoror 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 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 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. (gMand Drawing 01mport Drawing **Site Plan/Drawing attached.** Total Time -.(H H:tA M) 0 0 Hours 0 0 Minutes Page 3 of 4 OPERATION PERMIT 7890 Catawba County Public Health Department GDP File Number: Environmental Health Division EHPR-1-10-3278 P.O Box 389, 100-A Southwest Blvd County Fide Number: Newton NC 28658 Date: 0 3 / 0 3 / a 0 1 0Inch Drawin? Scale: ()Block = ft. N/A ( i f 3 ~ I 1 F ~ I It( i i .e....~.,.,..f ._.......~1.....a...,....e vu- E_~.....a.. _.3-^.. - .~............e- ..a..t~.._._...,.~ d,...,,... . w..«......_. .,.v.. _ w..... .,....-_.~d..s......x~ r l ~ ~ f i ~ E 1 F 1 ~ y~ t t ~ v, ~ ...i.„4.... i ~ a .,....j»._..,._... } ...,»i ~ _ t . F a € , r _ i ~ 3 101 C~ 3 j i I ? - _ 1 } 1 M { 1~ J d i I r ~ I ~ ~ a 3 ~ t e, t 3 t f ! F 3 s { r S~ rig t~ i f o ; Page 4 of 4 P 1 P2 P3