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HomeMy WebLinkAboutAUTH-2-10-4644.TIF CONSTRUCTION For Office Use Only ,,,t - r, AUTHORIZATION *CDP File Number 3 8 9 4 a 1, o, EHPR-1-10-3636 ` Catawba County Public Health Department County ID Number. %t ~ ~,1 Environmental Health Division Evaluated For: REPAIR ~ P.0 Box 389, 100-A Southwest Blvd Township: / ► u~ Newton NC 28658 PERMIT VALID UNTIL Phone: (828)-465-8270 Fax: (828) 465-8276 0 a 1 0/ a 0 1 5 Applicant: Marvin & Elaine Pope Property Owner: Marvin & Elaine Pope Address: PO Box 701 Address: PO Box 701 City: Asheville City: Asheville State2ip: NC 28802 State/Zip: NC 28802 Phone Phone Property Location 8~ Site Information Address/Road Subdivision: Phase: Lot: 1259 Sand Pit Rd. Hickory NC Directions Structure: SINGLE FAMILY HWY 127 S - Turn left onto Huffman Farm Rd. - Turn right onto Pittstown Rd. - Turn right onto Dirt Rd. - Bear right at # of Bedrooms: 3 fork - House at end of road # of People: 4 *Water Supply: EXISTING WELL s em ec1 Ica tons Minimum Trench Depth: 1 $ Inches *Site Classification: PS Minimum Soil Cover. 0 6 Inches Design Flow: 3 6 0 Maximum Trench Depth: a 4 _ Inches Soil Application Rate: 0 3 Maximum Soil Cover: 1 a inches *System Classification/Description: *Distribution Type: GRAVITY - SERIAL TYPE III G. OTHER NON-CONV. TRENCH SYSTEMS Septic Tank: 1 0 0 0 Gallons *Proposed System : 25% REDUCTION 1-Piece: O Yes ()No Nitrification Field Pump Required: OYes &No OMay Be Required 9 0 0 - Sq_ ft, Pump Tank: Gallons No. Drain Lines 3 1-Piece:OYes QNo Total Trench Length: 3 0 0 ft. GPM-vs- ft. TDH Trench Spacing: 9 Inches O.C. $Feet O.C. Dosing Volume: _ Gallons Trench Width: 2Inches 3 Feet Aggregate Depth: Grease Trap: Gallons inches Pre-Treatment: ONSF OTS-1 OTS-II Septic Tank Installer Grade Level Required: (S)I Oil 0111 OIV Pagel of 3 CDP File Number 38942 County ID Number: EHPR-1-10-3636 ❑ Open Pump System Sheet Repair System Required: 0 Yes ()No ONo, but has Available Space Trench Spacing: Q Inches O.C. fication: - o Feet O.C. r-Des System Trench Width: OInc, hes : - Feet Soil Appli cation Rate: Aggregate Depth: inches u Minimum Trench Depth: *System Classification/Description: Inches Minimum Soil Cover. Inches Maximum Trench Depth: *Proposed System: Inches Maximum Soil Cover: N itrification Field Sq. ft Inches . No. Drain Lines *Distribution Type: Total Trench Length: ft Pump Required: QYes 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 bythe 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. It is OK to use the existing septic tank so long as it is found to be in tact and structurally sound. If it is found to be otherwise compromised, properly abandon it and install a new 1000 gal. tank. If the old tank is used, install a new T and filter. Disconnect old drainfield. Septic system must be at least 50 ft. from any well, 10 ft. from property lines, 5 it. from structures. Keep system out of all utility easements and/or right-of-ways. Install on contour. Do not drive, grade, cut, or fill over septic system. This Authorization for Wastewater System Construction shall be valid for a person equal tothe period of validity ofthe Improvement Permit, not to exceed five years, and may be issued at the sometime the Improvement Permit issued (NCGS 130A-336(b)~ If the installation has not been completed during the period of validity of the Construction Permit, the information submitted in theapplication for a permit or Construction Authorization is found to have been incorrect, falsified or changes, or the site is altered, the permitor Construction Authortzation shall become invalid, and may be suspended or revoked (.1937(g)). 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 (1938(b)). Applicant/Legal Reps. Signature Required? Oyes ONo Applicant/Legal Reps_ Signature- Date: `Issued By: 2246 - Megan McBride Date of Issue: 0 1 1 0 1 0 1 0 Authorized State Agent: NA~tt 4 Malfunction Log Oyes &Hand Drawing Olmport Drawing Total Time:(H H:M M) **Site Plan/Drawing attached.** Hours tt inures Page 2 of 3 CDP File Number: 38942 County ID Number: EHPR-1-10-3636 Drawing Type: Construction Authorization Date: pinch Drawing Scale: pBlock = ft. QN/A w~~(1 3- Iob-. 4rtptc{Ae 5 6-61-h%L o dvmi4~ etl, as 56owK . ~ (~iSCOnrcC-~ dl~ dt►a,i ~i e~~ we11 Addy o ~ vcgv%venw"J5 bn re U ~ ov5 ai P P 01~ SE► ~.~y i~av~ Soi ~ aJCv J Sloe a Svr~acc aWa~/ t ` -{ro M S~r~lMn. 400' -o 0 O dab' +o Q~Q• TO SOY4 M M. Page 3 of 3 NUUtNK Division of Environmental Health 'Date: a ©s /20 10 On-Site Wastewater Section Soil/Site Evaluation *File 3 a 9 4 .7 For On-Site Wastewater System PIN EHPR-1-10-3636 *Owner Marvin & Elaine Pope Proposed Facility SINGLE FAMILY Proposed Design Flow (.1949) 3 6 0 Location of Site 1259 Sand Pit Rd. Property Size 45.88 Water Supply EXISTING WELL Evaluation Method Auger 1,940 Horizon SOIL MORPHOLOGY Profile# Lan scape Depth .1941 Other Profile POS Slope oo (IN) Mineralogy Matrix Mottle Factors Texture Structure Consistence Color Color 1 L 0-30 C 2-Modr sbk fr ss sp .1942 stet. ob 30-45 1-Wea abk fr ss sp .1943 Depth 4 S PS GPS Saprohte: (in) .1944 Rest. Horizon EHS .1947 Class ps Megen McBd( IProfile 0 3 LTAR _ .1942 Wet. °.o .1943 Depth GPS Saprotrte:(rn`, .1944 Rest. Horizon EHS • 19947 47 Class Copy ro61e L~ogp .19482 17 et. ~b .1943 Depth GPS Saprolite:(in) .1944 Rest. Horizon .1947 Class EHS Copy rot le IProfile LTAR - . .1942 Wet. .1943 Depth GPS Saprolde:pn; .1944 Rest. Horizon EHS 1947 Class Copy Profile Profile LTAR .1942 Stet. 0o .1943 Depth GPS Saprolite:(in) .1944 Rest. Horizon EMS 1947 Class Copy roh a Profile LTAR Available Space (.1945) PS Other Factors(. 1946) PS Site Classification (.1948)Ps Initial LTAR: Repair LTAR: 0 . 3 Others Present: Boyd. Jason Comments: 30.40 inches was SAP mixed with some BC (clay f SAP). It was frM Evaluated By: Megen McBride 14%.vt`rvrX Division of Environmental Health On-Site Wastewater Section Date: a ;z / o s / -1e i o Soil/Site Evaluation File 3 8 9 4 For On-Site Wastewater System PIN 1940 Horizon SOIL MORPHOLOGY Landscape .1941 Other Profile Profile# POS Depth Factors Mineralogy Matrix Mottle Slope Qo (IN) Texture Structure Consistence Color Color 1942 Wet. Qb 1943 Depth GPS Saprolite:(m) .1944 Rest. Horizon 1947 Class EHS COpyCStofil Profile LTAR ,J .1942 Wet. Qo .1943 Depth GPS Saprolite:pny .1944 Rest. Horizon EHS .1947 Class ~ Copv-Protile Profile U LTAR .1942 VV et. % .1943 Depth GPS Saprolde:Qn`, .194 icon t. .1947 Class EHS Copy tofu LTAR _ .1942 Wet. Qb .1943 Depth GPS Saprolite:(in; .1944 Rest Horizon EHS 1947 Class Copy Profile Pror LTAR .1942 V et. o'o .1943 Depth GPS Saprolite:(m) .1944 Rest. Horizon EHS .1947 Class CopiC roh? Profile- LTAR Comments: ^tLU%.Ii u~~ua~o 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 a~Ycs Pro cry i s q54 ~k"t his 7300 ~4. Nowt eitih; Profile: 1 X Y Z Profile: X Y Z Profile: (j X Y Z Profile: X Y Z Profile: X Y Z Profile: X Y Z Profile: X Y Z Profile: X Y Z Profile: X Y Z Profile: X Y Z CATAWBA COUNTY Case # Subdivision 2 Public Health Department Environmental Health Division Section/B1/Ph/Lot# PO Box 389, 100A Southwest Blvd, Newton NC 28658 PIN# j~ 4 L Ski (828) 465-8270 Fax (828) 465-8276 TDD (828) 465-8200 Applicant/Owner ( i , Site Address: 5d., , Property Size: Directions: 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. As the property owner or authorized representative, I have received the above referenced permit(s) as requested in the application for service, by the following method(s): Received in Person Facsimile Transmittal (Return form with signature required) Electronic Image Transmittal/ E-mail (Return receipt required) _ 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 c=,) I1 D l i D Received Date Catawba County Public Health Environmental Health Section Owner/Authorized Representative Signature Date Documentation of Permit(s) Transmittal _(permit transmitted by electronic or other means) Permit transmitted by J ult ei Cn(~Ash (name ofperson ending permit) Signature Date/Time 11/10 Method: Fax Email US Mail Other Owner's request to send by the above indicated method of transmittal in lieu of signature acknowledges the conditions and statements above. C~m~ lid IIo~,~AC.f~ ~hc~~~r,}.esn e~F. ~Cw1