HomeMy WebLinkAboutAUTH-07-2016-074369.TIF ,v,A CATAWBA COUNTY
‘3,-..„At Public Health Department Subdivision MOZON LITTLE HEIKS
C Environmental Health Division PINK 460604814060
try PO BON 389. 100-A Southwest Blvd.Newmn,NC 28658 LOT# 3
/g.2 ,.
NAME ON PERMIT: CHRISTOPHER PEARCE, 13219 PONTCHATRAIN AV, CHARLOTTE NC 28273
Site Address: 7819 LUCY LN, SHERRILLS FORD NC 28673
Property Size: Square Feet:20,908.80 Acres:0.48
Directions: Hwy 150 to Lake Norman, turn right on Slanting Bridge Rd, turn left on Keistler Storwe RD turn right on Lucy
LN, lot on left.
Owner/Authorized Representative Acknowledgement of Permit Receipt
I certify that I am the owner or authorized agent(owner's authorization required) representing the owner of the
property described above.
viAs the property owner or authorized representative, I have received the above referenced permit(s) as
requested in the application for service RBPR-06-2015-21818 by the following method(s):
Received in Person
Facsimile Transmittal (Return form with signature required)
Electronic Image Transmittal/ E-mail (Return receipt required)
(h"'v As the property owner or authorized representative I have reviewed and understand the specific conditions
of the permit issued, and further understand that all applicable regulatory requirements specified under the North
Carolina Laws and Rules for Sewage Treatment and Disposal Systems (15A NCAC 18A .1900), and/or
Well Construction Standards (15A NCAC 2C .0100), shall apply to the issuance of this permit and the
construction of the wastewater system and/or water supply well permitted.
Permit Issue Date: 07/11/2016 ' ii
1
Owner/Authorized Representative Signature A._ I/A .
Date 7i131re
Documentation of Permit(s) Transmittal
(permit transmitted by electronic or other means)
Permit transmitted by ('name of person sending permit)
Signature Date/Time
Method: Fax Email US Mail Other
Owner's request to send by the above indicated method of transmittal in lieu of signature
We want to hear from you. Please take a few moments to complete our customer service survey at:
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rhpcm+it 07/11/2016 11:32
QUA--01)- a016-0T/13b9
David Currier Date of Inspection:
Owner of: LAKE ,NORMAN 5/24/24
LAKE NORMAN SEWER AND SEPTIC
PO BOX 889
D QQ.� ®Initial 06 Months
Denver, NC 28037
(704)-483-5125 Of:
Field location:
License Number:995940 SEPTIC
®Onsite 0 Offsite
Subsurface Wastewater Inspection Form Offsite septic lot#:
Name &Address of Owner: Control panel:
Ryan Pearce TYPE OF SYSTEM:
7819 Lucy Lane Conduit sealed: OYES 0 NO
❑Polystyrene
Sherrills Ford, NC 28673 Alarm operating: ®YES 0 NO ❑Chamber
Panel location: ®Panel ❑LPPBS
SEPTIC TANK:
®Wall ❑Post 24 inches High
Size of Septic Tank: 1000 Gallons ❑Gravel ❑LPP
Counter- Cycle: Hour: ❑Large diameter pipe
Risers Readily Accessible: DYES 0 NO ❑Other:
Signs of Infiltration: OYES ® NO REDUCTION TYPE:
PUMP Tank:
Structurally Sound: ®YES 0 NO ®Type IV(50%reduction)
Size of Pump Tank: 1000 Gallons
Filter(s)Cleaned: ®YES ❑ NO ❑Type III(25%reduction)
Pump Model: Zoeller
Surface Water Diverted: ®YES 0 NO ❑ None
Pump HP:
Scum Level: 3" Pump Voltage: 115v-120v(in panel)
Head Settings:
Sludge Level: 7" Pipework in good condition:isms ❑NO
Scum plus Sludge level: 10" 1:02' 0 3' Dother:
Liquid Depth:52" Control floats operating: OYES ❑ NO
Distribution Set @ inspection:
TANK NEEDS PUMPING: DYES I81 NO Effluent free&clear of solids: ®YES D NO ®YES ❑NO
TANK NEEDS PUMPING: DYES ® NO Drain field:
Effluent surfacing:DYES ®NO
Notes and/or Corrective Action Needed: Traffic Protected:OYES ®NO
Our technicians performed a Type Iv inspection. Repair Area Reserved:
They noted that one valve cover is at the edge DISTRIBUTION TYPE: DYES ®NO
of the gravel drive. The cover could be Surface Water Diverted:
®Manifold ❑Individual valves ®YES ❑NO
damaged if not protected. We will be back out Line Cover Maintained:
in 6 months to perform the septic ❑Serial/drop boxes ❑Distribution box EYES ❑NO
inspection.Thanks! LOW PRESSURE SYSTEM:
Pump draw down:
Turn-ups and/or Valves Located/
Gallons per cycle: 147
Protected:DYES ®NO
❑ Draw down length:7.3
�dw:�✓., Tether length if wide angle
INSPECTOR SIGNATURE: � Laterals Free of Excess solids:EYES NO
Laterals Flushed:EYES ❑NO float: 3.75"
niA_Er). ao►6-on Yo9
David Currier Date of Inspection:
Owner of: LAKE NORMAN 11/13/24
LAKE NORMAN SEWER AND SEPTIC
PO BOX 889 ❑Initial ®6 Months
Firk
Denver, NC 28037
(704)-483-5125 OG N'
Field location:
License Number:995940 SEpiric
®Onsite 0 Offsite
Subsurface Wastewater Inspection Form Offsite septic lot#:
Name&Address of Owner: Control panel:
Ryan Pearce TYPE OF SYSTEM:
Conduit sealed:DYES 0 NO
7819 Lucy Lane ❑Polystyrene
Sherrills Ford, NC 28673 Alarm operating:®YES 0 NO ❑Chamber
Panel location: ®Panel DLPPBS
SEPTIC TANK:
®Wall ❑Post 24 inches High
Size of Septic Tank: 1000 Gallons ❑Gravel ❑LPP
Counter- Cycle: Hour: ❑Large diameter pipe
Risers Readily Accessible: ®YES 0 NO ❑Other:
Signs of Infiltration: OYES ® NO REDUCTION TYPE:
PUMP Tank:
Structurally Sound: ®YES 0 NO ®Type IV(50%reduction)
Size of Pump Tank: 1000 Gallons
Filter(s)Cleaned: ®YES 0 NO ❑Type III(25%reduction)
Pump Model: Zoeller
Surface Water Diverted: DYES ❑ NO 0 None
Pump HP:
Scum Level: 2" Pump Voltage: 115v-120v(in panel)
Head Settings:
Sludge Level: 3" Pipework in good condition:EYES 0 NO
Scum plus Sludge level:5" ®2' 0 3' Dother:
Liquid Depth:52" Control floats operating:EYES 0 NO
Distribution Set @ inspection:
TANK NEEDS PUMPING: OYES ® NO Effluent free&clear of solids: ®YES 0 NO EYES 0 NO
TANK NEEDS PUMPING: OYES ® NO Drain field:
Effluent surfacing:OYES E NO
Notes and/or Corrective Action Needed: Traffic Protected:EYES 0 NO
We performed your 2"I Type IV inspection for Repair Area Reserved:
the year. We removed and cleaned the outlet DISTRIBUTION TYPE: EYES 0 NO
Surface Water Diverted:
filter. We purged out the drain field lines and EYES 0 NO
®Manifold ❑Individual valves
reset the head pressures. We have completed Line Cover Maintained:
both inspections for the year 2024. ❑serial/drop boxes ❑Distribution box EYES ❑NO
LOW PRESSURE SYSTEM: Pump draw down:
Turn-ups and/or Valves Located/ Gallons per cycle: 147
Protected:EYES 0 NO
Draw down length:7.3
n ; �� v Laterals Free of Excess solids: YESE 0 NO Tether length if wide angle
(vJ/ r,e
INSPECTOR SIGNATURE. �J Laterals Flushed:Eves ❑No
float: 3.75"
Oa - O`1- 011 - '13
David Currier Date of Inspection:
Owner of: LAKE NORMAN 6/19/25
AVE NORMAN SEWER AND SEPTIC
PO BOX 889
®Initial ❑6 Months
Denver, NC 28037
(704)-483-5125 sEpiric
I Field location:
License Number: 995940 J
®Onsite ❑ Offsite
Subsurface Wastewater Inspection Form Offsite septic lot#:
Name & Address of Owner: -ontrol panel:
Ryan Pearce "YPE O_F SYSTEM._
Conduit sealed: ®YES ❑ NO
7819 Lucy Lane
❑Polystyrene
Sherrills Ford, NC 28673 Alarm operating: ®YES ❑ NO ❑Chamber
Panel location: ®Panel ELPPBS
SEPTIC TANK:
®Wall ❑Post 24 inches High
Size of Septic Tank: 1000 Gallons ❑Gravel ❑LPP
Counter- Cycle: Hour: ❑Large diameter pipe
Risers Readily Accessible: ®YES ❑ NO ❑Other:
Signs of Infiltration: EYES ® NO REDUCTION TYPE:
Structurally Sound: ®YES ❑ NO ®Type IV(50%reduction)
Size of Pump Tank: 1000 Gallons
Filter(s) Cleaned: ®YES ❑ NO ❑Type III (25%reduction)
Pump Model: Zoeller
Surface Water Diverted: EYES ❑ NO ❑ None
Pump HP:
Scum Level: 3" Pump Voltage: 115v-120v(in panel)
lead Settings'
Sludge Level: 3"
Pipework in good condition:DYES ❑NO
Scum plus Sludge level: 6" ®2' ❑ 3' ❑other:
Liquid Depth: 52" Control floats operating: EYES ❑ NO
Distribution Set @ inspection:
TANK NEEDS PUMPING: DYES ® NO Effluent free &clear of solids: ®YES ❑ NO EYES NI NO
TANK NEEDS PUMPING: EYES ® NO Drain field:
Effluent surfacing:OYES ®NO
Notes and/or Corrective Action Needed: Traffic Protected:®YES ❑NO
We performed your 1' Type lv inspection for Repair Area Reserved:
2025. We removed and cleaned the outlet DISTRIBUTION TYPE: ®YES ❑NO
filter. The pump tank lid is cracked. We found Surface Water Diverted:
®Manifold Elndividual valves DYES 0 NO
no issues at this time. We will be back out in 6 Line Cover Maintained:
months to perform the 2nd inspection. Thanks! ❑Serial/drop boxes ❑Distribution box ®YES 0 NO
LOW PRESSURE SYSTEM: Pump draw down:
Turn-ups and/or Valves Located/
Gallons per cycle: 147
Protected:®YES ❑NO
Draw down length:7.3
Laterals Free of Excess solids:EYES ®NO
:��� Tether length if wide angle
INSPECTOR SIGNATURE:+ /�'� Laterals Flushed:EYES ®NO
float: 3.75"
aLA-1+1 - v� •,4o)G6. 07)y31,
David Currier Date of Inspection:
Owner of: LAKE NORMAN 12/16/25
LAKE NORMAN SEWER AND SEPTIC
PO BOX 889SEWE
❑Initial I1]6 Months
Denver, NC 28037
(704)-483-5125 sEpTic.
-field Location:
License Number: 995940
®Onsite ❑ Offsite
Subsurface Wastewater Inspection Form Offsite septic lot#:
Name & Address of Owner: Control panel:
Ryan Pearce YPE OF SYSTEM:
7819 Lucy Lane Conduit sealed: ®YES ❑ NO
❑Polystyrene
Sherrills Ford, NC 28673 Alarm operating: ®YES ❑ NO ❑Chamber
Panel location: ®Panel ❑LPPBS
®Wall ❑Post 24 inches High
Size of Septic Tank: 1000 Gallons ❑Gravel ❑LPP
Counter- Cycle: Hour: ❑Large diameter pipe
Risers Readily Accessible: ®YES ❑ NO ❑Other:
Signs of Infiltration: DYES ® NO REDUCTION TYPE:
PUMP Tank:
Structurally Sound: ®YES ❑ NO ®Type IV(50%reduction)
Size of Pump Tank: 1000 Gallons
Filter(s)Cleaned: ®YES ❑ NO ❑Type III(25%reduction)
Pump Model: Zoeller
Surface Water Diverted: EYES ❑ NO ❑ None
Pump HP:
Scum Level: 3" Pump Voltage: 115v-120v(in panel)
Head Settings:
Sludge Level: 5" Pipework in good condition: ®YES ❑NO
Scum plus Sludge level: 8" ®2' ❑ 3' ❑other:
Liquid Depth: 52" Control floats operating: ®YES ❑ NO
Distribution Set @ inspection:
TANK NEEDS PUMPING: OYES ® NO Effluent free&clear of solids: EYES ❑ NO ®YES ❑NO
TANK NEEDS PUMPING: OYES IS] NO Drain field:
Effluent surfacing:OYES ®NO
Notes and/or Corrective Action Needed: Traffic Protected:®YES ❑NO
Repair Area Reserved:
We performed your 2nd Type IV inspection for DISTRIBUTION TYPE: EYES ❑NO
the year 2025. We removed and cleaned the Surface Water Diverted:
outlet filter and check over the system. We ®Manifold ❑Individual valves ®YES ❑NO
Line Cover Maintained:
blew out the drain field lines and reset the ❑Serial/drop boxes ❑Distribution box ®YES ❑NO
heads pressures. At this time the system is
functioning as intended. LOW PRESSURE SYSTEM:
Jump draw down:
Turn-ups and/or Valves Located/ Gallons per cycle: 147
Protected:OYES ❑No
Draw down length:7.3
(///� (/� Laterals Free of Excess solids:®YES ❑NO Tether length if wide angle
INSPECTOR SIGNATURE t"-fir �� ' '" Laterals Flushed:®YES ❑NO float: 3.75g,