HomeMy WebLinkAboutEHPR-04-2013-17244.TIF
CATAWBA COUNTY HEALTH DEPARTMENT fos~d
Telephone (828) 465-8270 TDD (828) 465-8200 WLS # cXtt)S- Oo;?lQ5
Improvement Permit~ AC~ Repair Permit._ Operation permit._ System Type_ Well Permit.~ Replacement Well~
Owner/Agent. -Se&d Ro~ds. .. Phone
Address 7<;f'1Y' M-NkJ.e~d l?c' Subdivision Cre.S(2,..rf .
~J-J ~ Section/Block/Phase Lot# I,:) 4
Lot Size .3 &/ n-c. Directions 16s ;WVwf! 12 l.. . b Btt.yj r
(g) /S~k/k~r1 /Rfl-,'}N- P,Jc! .' . . .
. Property Address 7f(tj'if ./f/r.vllV'/fd k!r
Facility. House~ Mobile Home_ Business_Multi-family_ Other: Pin Number 1"6tJt, -a)-S S - /87iJ
Other Zoning Approval #.
# Bedrooms ;../ . # Seats # Employees Application Rate . 35 GPD Flow .4' lrc1.
Hot Tub or Spa yes/no Special Fixtures. Basement 'f!}/no. 100% Repair Area ~/no . ,
Basement Plumbing v€~/no Water Supply: Pnvate Well---bL- Pubhc_ Seml-Pubhc_
*****************~********************************************************~********************************************
Type of System: Trench_ Bed_ Pump~ Pump/Panel~ Panel_ LPP --.-- Other
Septic Tank Size I6bO't1l' \ Pump Tank Size IllOOt:jJ) ( Nitrification Field. Total Square Feet 0W'0 Depth of Stone U/4
Bed Size Trench Width .3 (, Total Length of All Trenches &3 D Number of Trenches L.j
TrenchLength5Y' /5f{ 15ft /58" /~/~FeetonCenter 1 MaximumTrenchDepth3t',-3b Distance of Nearest Well So r
*DO NOT INSTALL SEPTIC WHEN WET* *WELL RECORD REQUIRED AT COMPLETION*
*********************~********************~***********************************************~*************************
Topo % Slope (,j:!.J II () l CJ:l ~ - ~ \
Texture I - '""t() ff'l"-t{l S \JO\f - 3 (.ao.f wl~.f> "'1fe.vl'~
Structu~e I _ I;).' f\t\.lf6/ t....r'; eLf:< kl ~ {:>r<s \""^ _ C 33 ..5A1Jd
Clay Mm. If.. ~. j . ..".Iev-"t"
Soil w. etness "I I 3ft (; \'\,() \t I"QAN! \ 5 d (Z-t- &r e~~1 If
Soil ~epth " I I t I..;; F, II O'-V ~ \\ () ~
Restnc Hoz. at I <:l {.
Available space yes/no .~.r. "-..... _ 1/Vlt?w..sk/N-\~"h...~..
Overall Class S l 1> k I, (f')t ~ ~r c. rh-q~'N-O\--~
Comment I 506 ~ I A, I~ . I e~
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**NO GUARANTEE OR WARRANTY IS IMPLIED OR GIVEN AS TO THE PERFORMANCE OR LENGTH OF TIME THIS SYSTEM
WILL FUNCTION**
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Riset required when
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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 years from date issued and is not transferable. Well Permit valid for 5 years
provided site conditions do not change. Well location, installation, and protection must meet state and local regulatioQ.s, and must be
inspected and approved by a representative of the Catawba County Health Department before any portion of the installation is put into use.
The siting of the well by the Health Department staff is to provide protection from known pie sources of contamination. No volume of
water is guaranteed at any s. ite by the Health Departmen~. n I'?-f' '
Permit Date 3- / ~- 5 EHS ~ Ie I IC--<
Owner/AgentfJI,LtiJJt!J.(J.1t.u{ , Septic Tailk Install
EHS Well Installed By
Approval Date Date Sample Collected
Date of Results Results
White - Office
Well Grout Approval Date
Date
Well Head
EHS
Yellow -Owner/Agent
Pink - Building Inspection Authorization to Construct
DEPJ\RTME'NT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF ENVIRONMENTAL HEALTH
ON-SITE WASTEWATER SECTION
Sheet L oiL
P~PERTY ill #. . .
Ii COUNTY ~.
~~tJ6 _d9,r SS -/ [) ~
SOIL/SITE EV ALUA TION
for ON-SITE W ASTEW A TER SYSTEM
OWNER. . APPLICATION DATE 3-/0-$
ADDRESS: ?O y 3dS t:1'VC(JI:";/e-/ '
PROPOSED FACILITY j" ~ J fROPOSED DESIGN'FLOW (1949): L.I .
LOCATION OF SITE. ")157<K' &v/lk.,.! /Pc',. ~
WATERSUPPLY g.private .0 Public DWell 0 Spring 0 Other.
EVALUATION METHOD' ~Auger Boring 0 Pit 0 Cut
TYPE OF WASTEWATER. af.-sewage 0 Industrial Process D Mixed
DATE EVALUATED' 3...../5-..:5
PROPERTY SIZE. , ") 5"",-
PROPERTY RECORDED' .
............................ ... ....................... ............................ ..........,.,.... ....................
............................ ......... ......................................................... ................. ....................
............................ ,................................................. ....... ................. ....................
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DESCRIPTION INITIAL SYSTEM REPAIR. SYSTEM OTHER FACTORS (.1946):
Available Space (1945) r5 €S SITE CLASSIFICATION ( 1948)'
System Type(s) :?}J,8;PS ffJ3P5 EVALUATED BY ~
OTHER(S) PRESENT
Site LTAR r-55 f 3<:>
COMMENTS.
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:t ,/<',
. '. q. ""
LANDSCAPE POSITION
,,".J,
,,/ ,.~. 2""" ',. _ .....
:t.€C (EoncaveISlcip.e)
cv (Convex Slope)
6(o~age'Way)' .
t- DS\(I?ebfiSSlirinp)i
Fp'(F106dPburi)~
~ F,:S (Fo.o!,SI~peL.1
,;", H'(Hc:adSlope)
L(Liilear Slope)
}t(N~s~ Siope)
R (Ridge)
S(Spoulc!crSlope)
:;,'.T: 0" eriace}
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GROUP
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LEGEND '
standard'abbreviations
,usethe
SOIL
TExTURE
.~
r
CONVENTIONAr: LPP
',I955LTAR* .1957LTAR* r
\..
,1,1 I, "'j.
,'~ is (Sand)
.LS{Lo.amySand)
SL'(Siilidy,Loam) ,
L (U;~)' .
"II'
III
"t".,
_t
~~t;.
"
S€L (Sandy Clay Loain)' ,
SiL(SWLoam)" :
CL (Clay Loam) I
SiCL (Silty Clay Eoam)
.Si:(Silt)' 1
...... i.......~........:. ..... .:."h...~.......i..!...; ~...... .i.... ..... ""i" ':' ......
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DENR (###iI##)
Review (####If)
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0.6 "0:3
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r
0.6 - 0.4
0:4' - 0.3
0.3 - 0.15
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TMrNERALOGYI I
I CONSISTENCE STRUCfURE
~ ,
~ (Non-eigJaft~iv.e) .~i! (;.(Single Grain)', . "
.~Ip(P (SlightJ~ Exp;p,siY~) 'M(Massive) '''',
~. EXP'(Exp~sive) ~. ; '} ,CR (GlUIpb)f., .
r GR(Gf3nular) .., !
SBK,(Subangw.u- 1?19CJSy)
. ~K(Ai1guUi'r.BJo.ckyf
." .. PL, (~J:1ty) .
PR(Piismatic)
I'
J l'jf'
,..;...~'t'.,~
"', ~OJ~l'.,
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..
., ~
'\,,',
WET
~
,-F
'N~JNon-sticky)
SS(~lig~dYStiCky)
'S (Sticky) ,
VS.(Y~r'y.~licky)) ,
NP,(No.;:,pl....tic\'
sp,(siiilhtly p~icr
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P (Plastic)
,vp cYerypi",,~c)' .
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