HomeMy WebLinkAboutRBPR-09-2014-19878.TIF
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rz:eo CATAWBA COuNTY-HEALTH DEPARTMENT
Telephone: (828) 465-827VDD: (828) 465~0,9 .
. PnTIl. Opr. Pnnt.-b.-Sys, Typ<: (j' Well Pnnt._Wdl Rpr. Penll,
Phone
Subdivision -p, Y" 0 0 k'v ; d.)' <2-
Section/BI Phase Lot#
" ~~
N~
6084 ~
\l'v'J
Imp, +'rmt.
Owner/Agent
Address
B'O
Facility: House_Mobile Home Business Multi-family ,Other: Tax Map or Pin Number
Other - - ,Zoning Approval # 2 't9 fL CJ
# Bedrooms g # Employees , Application Rate ~~r
Hot Tub or Spa ye Ino Basemenl yes€), 100% Repair Are yes! 0
Basement Plumbing Water Supply: e Well_
******************* ***************************************..***************************************~
Type of System: Trench"y Bed_ Pump_ Pump/Panel_ Panel_ LPP _ Other "2:1 D
Septic Tank Size { ntJo Pump Tank Size Nitrification Field: Total Square Feet 71CJ Depth of Stone N f/"J
Bed Size Trench Width -;: (4 f/ Total Length of All Trenches "I 2- $"6 Number of Trenches ~
tl
Trench Length '11.-, !dl.J.!:1l/!Jl./!il../ IT Feet on Center Maximum Trench Depth L 4 Distance of Nearest Well~
"DO !'iOT I!'iSTALL SEPTIC WHEN WET" .WELL RECORD REQUIRED AT COMPLirriON.
;:~:".~~.t:"~";l:~:."~.......:::{...;f:...~~::::~.~...~::;;...~.~~.~."~~."".i;;;;;""~".."......."...."..."
Texture ~, I eb . 0 f ~ b 'I d d
~\~;~i~, I: ( I ('-'\.t-- t,uAJ. vf,.... . ~J 7JO @ 'to I..~ 1M a. yv1
So~l Wetness -: ~" 1,"0\- _L P --.. , +- ..tWI~t- m i t::ttA,;fi v-r to
SOli Depth 2fJ rr, 10 ~ U I
Restric, Hoz, at -"- ~U-\Il' - ; KM
Available spac~o I\J. I tJ' @
Overall Class~ I
Comments: I Ll ()
I~I-h-~: i t.rOII \0' ~ - (a.n- t-~UL
1_ I LJ " 11A-J\ '---
- ~ ;"<A c:::J d/ I 1(1 l( l( fUA~c#lL 24" t~~-7;tl
q ~ I _ 2 ("' /d 'I
fl-dud;~ i l "I d~~
" Ral/".n2 oltsl-. I 'S (be. <.j <J () I
fL7d;Jf. ba X I , ~y,: \~
I :20'
I
'II o~~l
Filter Required
Riser requirecl when
tank is more than 6 I I' ,
inches deep. I, 1)-t ( I ro.y-r S t. \
"NO GUARANTEE OR WARRANTY IS IMPLIED OR GIVEN AS TO THE PERFORMANCE OR LENGTH 0 TIME THIS SYSTEM
WILL FUNCTION""
GPD Flow
'312 ()
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"Improvement Permit has no expiration date and is transferable, but may be revoked if site plans or intended use changes for the proposed
facility. An Authorization to Construct is valid for (5) five }'ears from date issued and is not transferable. Well Permit valid for 5 vears
provided site conditions do not chanJ:e. Well location, installation, and protection must meet state and local regulations, and must be
inspected and appro\'ed by a representath'e of the Catawba County Health Department before an)' portion of the installation is put into use.
The sitinJ: of the well b)' the Health Department staff is to provide protection from known possible sources of contamination. !'io volume of
wate~ is guaranteed at' y silqbJ e ealth Department. ~~~~.
PenrutDate L , EHS m-~'-' ~ I J ~
Owne e Septic Tank Ins d y. '.I, J;;, Date 1-1./; . T '-
EHS . Well Installed By Well Grout Approval Dale
Well H Date Sample Collected
Dale of suit. esults r EHS
While - Office Blue. Building Inspection Operation Permil Ydlow - Owner/Agent GfL'CO - Building Inspection Authorization to ConslruCt