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Home My WebLink AboutAUTH-11-09-2587.TIF %.VI IO I mut.. I I%JIV AUTHORIZATION `GDP File Number 3 5 9 4 8 Catawba County Public Health Department County ID Number: EHPR-10-09-2010 Environmental Health Division Evaluated For. REPAIR P.0 Box 389, 100-A Southwest Blvd 1,11Township: . '10 Newton NC 28658 PERMIT VALID UNTIL: Phone: (828)-465-8270 Fax: (828) 465-8276 1 1/ 1 1/ x 0 1 4 Applicant: Dollie Johnson Property Owner: Dollie Johnson OS Address: 4173 Winona Drive Address: 4173 Winona Drive City: Maiden City: Maiden State/Zip: NC State/Zip: NC Phone (704) 483.5909 Phone Property Location & Site Information Address/Road Subdivision: Phase: Lot: 4173 Winona Drive Maiden NC Directions Structure: SINGLE FAMILY Hwy 16 S, LT Mt. Beuhlah Rd, 2nd home on RT at intersection of Winona Dr. # of Bedrooms: 4 # of People: 1 'Water Supply: COMMUNITY s em eci ica Ions Minimum Trench Depth: Inches 'Site Classification: PS Minimum Soil Cover. Inches Design Flow: 4 8 0 Maximum Trench Depth: a 4 Inches (Soil Application Rate: 3 Maximum Soil Cover: 1 a Inches 'System Classification/Description: "Distribution Type: GRAVITY - SERIAL TYPE III G. OTHER NON-CONV. TRENCH SYSTEMS Septic Tank: Gallons "Proposed System: 25% REDUCTION 1-Piece: QYes QNo Nitrification Field 1 '2 0 Pump Required: QYes 0o OMay Be Required 0 Sq, ft. No. Drain Lines Pump Tank: Gallons ti 1-Piece: QYes ()No Total Trench Length: 4 0 0 ft. GPM-vs-- ft. TDH Trench Spacing: 9 Qjnches O.C. - eet O.C. Dosing Volume: _ Gallons Trench Width: _ 3 Ojnches P IF eet Aggregate Depth: Grease Trap: Gallons inches Pre-Treatment: O N SF OTS-1 O TS-11 Septic Tank Installer Grade Level Required: Z I OI I 0111 ON Pagel of 3 GDP 1-ile Number 30y46 County It) Number: ❑ Open Pump System Sheet Repair System Required:OYes ONo ONo, but has Available Space Trench Spacing. Inches O. assificati on: Feet O.C. -8 rDesioCn ir System Trench Width: Inches Flow: _ Feet Soil Application Rates Aggregate Depth: inches Minimum Trench Depth. *System Classification/Description Inches Minimum Soil Cover Inches *Proposed System Maximum Trench Depth: Inches Maximum Soil Cover Nitrification Field Sq. ft Inches . No. Drain Lines *Distribution Type Total Trench Length ft Pump Required: Oyes ONo OMay Be Required Pre-Treatment. ONSF OTS-1 OTS-11 'Site Modifications No grading or construction activity is allowed in areas designated for system and repair without approval of Health Department. 'Permit Conditions The issuance of this permit by the Health Department in no way guarantees the issuance of other permits. The permit holder is responsible for checking with appropriate governing bodies in meeting their requirements. 'All parts of septic must be minimum: 100' from any well, 15' from home, 5' from building foundation, 10' from proeriy lines'Lines to be installed on coniour'Do not grade drive or fill over repair sysiem'Lots combined and new survey provided to Environmental Health on 11/02/09 This Authorization for Wastewater system Construction shall be valid for a person equal to the period of validity of the Improvement Permit; not to exceed five years, and may be issued at the sametime the improvement Permit issued (NCGS 134A-336(b)~ If the installation has not been completed during the period of validity of the Construction Permit, the information submitted in the application for a permit or Construction Authorization Is found to have been Incorntct falsified or changed, or the site Is atter+ed, the permit or Constructlon Authorization shall become invalid, and may be suspended or revoked (.1937(8)). The person owning or controlling the system shall be responsible for assuring compliance with the laws, rules, and permit conditions regarding system location, installation, operation, maintenance, monitoring, reporting and repair (1838(b)). ApplicanVLegal Reps. Signature Required) Yes C)No -~/Applicant/Legal Reps. Signature 1v ate l26 'Issued By: 1810- Boyd. Jason pp Date of Issue: 1 1 / 1 1 / a 0 0 9 Authorized State Agent- F~ Malfunction Log Oyes F 'Hand Drawing Olmport Drawing Total Time (HH MM) **Site Plan/Drawing attached.** Page 2 of 3 Hours st mutes CDP File Number: 38948 County ID Number: E"PR-10-09-2010 Drawing Type: Construction Authorization Date: 1 1/ 1 1/ a 0 0 9 Inch Drawing Scale: 1 QBIock = 0 6 Oft. Q N /A ~ i IL r I ' I i! 1, f , i I _ I N P } s4 rc-) 4-1 o - ! y t f..- _ - s l IL - , II ~T ♦ J Imo. ^ _ ~ _ ~ ~ I t I.-. I I Pa , n 4- , , i I VV 1 f n I ~ ' I i I I. i Page 3 of 3 NCDENR Division of Environmental Health On-Site Wastewater Section 'Date: i i l> i l e o 9 Soil/Site Evaluation `File 3 5 9 4 8 For On-Site Wastewater System PIN EHPR-10-09-2010 'Owner Dollie Johnson Proposed Facility SINGLE FAMILY Proposed Design Flow (.1949) 4 8 o Location of Site 4173 Winona Drive Property Size 0,91 Water Supply COMMUNITY Evaluation Method Auger 1,940 Horizon SOIL MORPHOLOGY Profile# Lan scape Depth .1941 Other Profile POS Slope % (IN) Mineralogy Matrix Mottle Factors Texture Structure Consistence Color Color 1 L 0-40" SCL sbk fir ss sp .1942 Wet. 8 % .1943 Depth 4 0 Ps GPs Saprolite: (in) .1944 Rest. Horizon EHS .1947 Class Ps Boyd, Jason Profile 3 LIAR _ .1942 Wet. % .1943 Depth CPS Saprolite:(in) .1944 Rest. Horizon EHS 1947 Class Copy rofile Profile LTAR _ .1942 Wet. % .1943 Depth GPs Saprolite:(in) 1944 Rest. Horizon EHS 1947 Class Copy. Profile Profile LTAR .1942'N et. % .1943 Depth GPS Saprolite:(in) .1944 Rest. fQ~ Horizon EHS 1947 Glass Copy Profile IProfile LTAR .1942 Wet. % .1943 Depth GPS Saprolite:00 .1944 Rest. Horizon .1947 Class EHS Copy ofile Profile LTAR Available Space (.1945) PS Other Factors(.1946) Site Classification (.1948) Initial LTAR: Repair LTAR: . 3 Others Present: Comments: Evaluated lot with Megen McBride Evaluated By: Boyd, Jason NCDENR Division of Environmental Health On-Site Wastewater Section Date: 1 1/ 1 1/ a e e 9 Soil/Site Evaluation File 3 5 9 4 8 For On-Site Wastewater System PIN E H P R- 1 e- e 9 1940 Horizon SOIL MORPHOLOGY Protile# Landscape Depth 1941 Other Profile POS Slope % (IN) Mineralogy Matrix Mottle Factors Texture Structure Consistence Color Color .1942 Net. % .1943 Depth GPS Saprolite:(in) .1944 Rest. Horizon EHS 1947 Class Copy Profit Profile LTAR .1942 Wet. % .1943 Depth GPS Saprolite:(in) .1944 Rest. Horizon EHS 1947 Class Copy,.P,rotile Profile U LTAR .1942 W of, % .1943 Depth GPS Saprolite:(in) .1944 Rest. Horizon EHS 1947 Class Copy rotil Profile ILTAR .1942 Wet. orb .1943 Depth GPS Saprolite:(in) .1944 Rest. Horizon .1947 Class EHS Copy PProtile Profile LTAR .1942 Wet. % .1943 Depth CPS Saprolite:(in) .1944 Rest. Horizon EHS 1947 Class Copy~rofil Profile LTAR Comments: Attach Image The "Open Drawing Form" button, opens the the drawing form. } The "Import" button, attaches the drawing, or other image into the space below. Open Drawing Form Profile: 1 Q X Y Z Profile: f, 11% X Y Z Profile: X Y Z Profile: X Y Z \Uj Profile: Q X Y Z Profile: Q X Y Z Profile: X Y Z Profile: Q X Y Z Profile: X Y Z Profile: X Y Z