HomeMy WebLinkAboutOP-5-11-18433.TIF `a �A CATAWBA COUNTY Case # pP_5-11-18433
Public Health Deparunent
�., � 2 Subdivision
- Environmental Health Division
d o� `C' PO Box 389, 100-A South�vest Bh�d, Newton, NC 286�8 LoY #
�g 2 s� PIN# 2791157401�9
ApplicantlOwner CHESTER WRONSKI C�
Site Address: 5322 LISA LN, Hickory, NC ���� �� ��� 0
I Property Size: SF ACRES
Directions:
Catawba County Health Department Operation Permit
System Type: **** no system class assigned **** Q
(In accordance with Table Va)
Description: REPLACEMENT OF SEPTIC TANK ONLY
��
(�
Types V and VI systems expire in 5 years. �-
Owner must contact health department 6 months prior to exiration for permit renewal.
System Installation Comments:
PERMIT CONDITIONS:
1. All maintenance, monitoring, and performance requirements shall be in accordance with
15A NCAC 18.1900, Rule .1961
2. Operation & Maintenance Specifics:
Subsurface system operator required? Yes No_X_
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
This system has been installed in compliance with applicable North Carolina General Statutes, Rules for Sewage
Treatment and Disposal, and All conditions of the Improvement Permit and Construction Authorization.
Mike Bumgarner OS/24/2011
SYSTEM INSTALLER INSTALLATION DATE
Susan Bumgarner - #1919 OS/30/2011
AUTHORIZGD STATE AGENT DATB OF OPERATION PERMIT ISSUANCE Form F
OS/31/I I 10:54
�� �������.R��aa� ��i�n�i
; �{�� _r�.�� ����c:�� I—�►'�?J
�-u, - 5— ► i — � g I �:3 (, ►
���5��1 -1�4-33
� � ,,
.C(Y
�.._._. ....._....,. „,..�
�..� 1
r I ��--_. ,;�� ,
r '� 5 � ` •� � �a.,� � �"
� � �i ��
I � '... �C:f � iD� v ��"�
�. i `� C��� 1
( y , �bl �� I �
C � ,.._.-.�II �P� C ' � // V
• ' J� � �r
I�
I ^ i �„i �
�a��, , �...__.� .
�. .. .
� :
F'
' .�. .... �.I... �� �• .�..�•.���
, I. �. ��'� L.. ��