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OPERATION PERMIT
Catawba County Public Health Department 'GDP File Number a 4 4 0 7
Environmental Health Division WLS2008-00775
i " 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;
Applicant: Property Owner-. KEY BUILDERS, INC.
Address: Address: 1459 N ASPEN ST
City: City: LINCOLNTON
State/Zip: State/Zip: NC 28092
Phone Phone
Property & Site Information
Address/Road Subdivision: BROOKRIDGE Phase: Lot: 43
2311 DILLON DR
NEWTON NC Directions
Structure: MOBILE HOME 16S/ ST JAMES CHURCH RD/ LEFT ELLICK INTO
SUBDIVISION / LEFT ON DILLON / LOT ON LEFT
# of Bedrooms: 3
4 of People:
'Water Supply: PUBLIC
'IP Issued by: 1896-Lucas Sears `System Classification/Description:
TYPE III G. OTHER NON-CONY. TRENCH SYSTEMS
'CA issued by: 1896 -Lucas Sears Saprolite System? O Yes (DNo
Design Flow: 3 6 0 GRAVITY -SERIAL
Distribution Type:
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 4 Installer: Bobby Fuller
Total Trench Length: 3 0 0 ft. Certification 4: 1070
Trench Spacing: - 9 2Inches O.C.
Feet O.C. `EMS: 1952 -Phelps. Robert
Trench Width: 3 Inches
((-Feet Date: 0 3/ 0 4/.1 0 1 0
Aggregate Depth: inches
Minimum Trench Depth: a 4
Inches
Minimum Soil Cover. 1 a Inches Approval Status
Maximum Trench Depth: 3 0 Inches Approved Disapproved
Maximum Soil Cover: 1 8
Inches
Pagel of 4
CDP File Number 24407 Septic Tank County ID Number: WLS2008.00775
Manufacturer. Mull Lat.
STB: 821 Long:
1000 Installer: Bobby Fuller
Gallons:
Date: 0 1 / 1 3 / x 0 1 0 Certification 4: 1070
'EH S: 1952 - Phelps. Robert
"Filter brand: POLYLOK PL-68
Date: 0 3/ 0 4/ a 0 1 0
ST Marker: D Yes ❑ No
Reinforced Tank: ❑ Yes M NO Approval Status
t Piece Tank: ❑ Yes ❑ No LE Approved ❑ Disapproved
Pump Tank
Manufacturer Installer:
PT: Certification 4:
Gallons: `EH S:
Date: Date:
Riser Sealed ❑ Yes ❑ No
Riser Height: ❑ Yes ❑ No (Min, 6 in.) Approval Status
Reinforced Tank: ❑ Yes ❑ No ❑ Approved E3 Disapproved
t Piece Tank: ❑ YeS ❑ NO
L--
Supply Line
Installer: Bobby Fuller
Pipe Size: 3 inch diameter
Pipe Length: feet Certification 1070
`EH S: 1952 - Phelps, Robert
'Schedule: 40
Pressure Rated ❑ Yes ❑ No Date: 0 3/ 0 4/ a 0 1 0
Approved fittings ❑ Yes ❑ No Approval Status
EE Approved ❑ Disapproved
- 11 _J
Pump Requirement
Pump Type: Installer:
(Dosing Volume: - Gal Certification 4:
Draw Down: Inches 'EH S:
`Chain: / I
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
Page 2 of 4
CDP File Number 24407 County ID Number: WLS2008-00775
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 O No `EH S:
Pump Manually Operable ❑ Yes ❑ No
`Activation Method: Date.
Approval Status
Alarm Audible El Yes El No ❑ Approved O Disapproved
Alarm Visible ❑ YS ❑ NO
1952 - Phelps. Robert
'Operation Permit completed by: Q
Authorized State Agent: / Date of Issue: 0 3/ 0 5/ 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 llr G. septic system rneet the following criteria:
Minimum System Review ByThe Local Health Department: NIA
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 for a 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 entitywith 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 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.
GHand Drawing Olmport Drawing
**Site Plan/Drawing attached.**
Total Time:(HH:111.1)
0 Hours Hinutes
Page 3 of 4
OPERATION PERMIT 24407
Catawba County Public Health Department CDP File Number:
Environmental Health Division WLS2008-00775
P.0 Box 389, 100-A Southwest Blvd County File Number:
Newton NC 28658 Date : / /
Olnch
Scale: ON,A k = ft.
Drawing Drawing Type: 0
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