HomeMy WebLinkAboutOP-5-11-18435.TIF ��A CATAWBA COUNTY C1se # OP-�-I I-18435
G Public Health De artmen[
Q k'� �� Environmental Health Division Subdivision
`�a `�' PO Box 389, 100-A Southwest E31vd, New[on, NC 286�8 Lot #
tg 2 �� PIN# 269801088806
ApplicantlOwner KELLY FULBRIGHT �
Site Address: 6072 W NC 10 HWY, Hickory, NC bl����
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Property Size: SF ACRES
Directions:
Catawba County Health Department Operation Permit
IIIG - OTHER NON-CONV TRENCH SYSTEMS
System Type:
(In accordance with Table Va)
Description: 25% REDUCTION
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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.
Leatherman's Septic OS/23/2011
SYSTEM INSTALLER INSTALLATION DATE
Susan Bumgarner - #1919 OS/30/2011
AUTIiORIZED S"I'ATG AGENT DATf' OF OPERATION PERMIT ISSUANCE Form F
0�/3 I/I I 10:40
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