HomeMy WebLinkAboutAUTH-11-2019-125094.tif Airr 14 -p 50] 4
MAINTENANCE REPORT FORM
A:),
to iv 1 • -- ii ii• .._ ,„, , Name and Location of System Date of Inspection
I Ili 1 ‘10 , 2.1.'I'vt in iiii3 Mark Shue 16 Nov 2022
1285 Saunders Drive Permit Number
FPPNFRnIr?r1TPI►ifri, '�_ r
r li"r'�c Catawba, NC 28609 471003401001
Operators Responsible for Care (O.R.C.'s): System Classification
Jack Moore - Certified Operator #985357 Phone (828) 850-5660 Iv-a
David Lynch - Certified Operator #996383 Phone (828) 850-5661
Alternate Mailing Address 1
J.C. Moore Phone (704) 873-2171 Subdivision
1227 Troutman Drive Fax (704) 873-9928 Saunders Property
Statesville, NC 28625 Mobile(704) 902-1122 County
Phone
Catawba Phone
SEPTIC TANK AND PUMP TANK LOW PRESSURE PIPE SYSTEM
Risers accessible? [S] Satisfactory Turnups,cleanouts,valves
Signs of infiltration? [S] Satisfactory located and protected? [S] Satisfactory
Structurally sound? [S] Satisfactory Laterals free of excess solids? [5] Satisfactory
Landscape position? [5] Satisfactory Laterals flushed? YES
Septic tank filter cleaned?
Pump tank filter cleaned? PRESSURE HEADS
SOLIDS ACCUMULATION DESIGN HEAD ADJUSTED HEAD
Line 1 2 2
Approximate Quantity of Solid Waste in Septic Tank Line 2 2 2
Line 3 2 2
INLET Scum: — 4 in. Sludge: - 8 in. Line 4 2 2
OUTLET Scum: - 0 in. Sludge: - 8 in. Line 5 2 2
Line 6 2 2
Approximate Percentage of Solids to Liquid Waste in Tank
- 25 %
DRAIN FIELD
No effluent surfacing? ES] Satisfactory
Surface water diverted? [S] Satisfactory
Line cover maintained properly? [S] Satisfactory
Protected from traffic? [S] Satisfactory COMMENTS
Distribution devices operating properly? [5] Satisfactory
Repair area reserved? [S] Satisfactory The paper in the septic tank is not breaking down.
suggest a more biodegradable brand.
PUMP
Pump present and operating?
Design GPM 33 REC JED
Actual GPM 33
Efficiency 100%
High water alarm operating properly? [S] Satisfactory
Pipework in good condition? [S] Satisfactory I'
Control panel in good condition? [S] Satisfactory
Control floats operating properly? [5] Satisfactory
Straps/float tree in good condition? [S] Satisfactory Environmental Health
Effluent free and clear of solids? [S] Satisfactory
/ - I ) 5/fiq
MAINTENANCE REPORT FORM
Name and Location of System Date of Inspection
M /: 1q Mark Shue 11 May 2023
1285 Saunders Drive Permit Number
FrrNPreilIMPinfinl``. SrrvirPf Catawba, NC 28609 471003401001
Operators Responsible for Care (O.R.C.'s): System Classification
Jack Moore - Certified Operator #985357 Phone (828) 850-5660 IV-A
David Lynch - Certified Operator #996383 Phone (828) 850-5661
Alternate Mailing Address
J.C. Moore Phone (704) 873-2171 Subdivision
1227 Troutman Drive Fax (704) 873-9928 Saunders Property
Statesville, NC 28625 Mobile(704) 902-1122 County Phone
Catawba Phone
SEPTIC TANK AND PUMP TANK LOW PRESSURE PIPE SYSTEM
Risers accessible? [5] Satisfactory Turnups,cleanouts,valves
Signs of infiltration? [5] Satisfactory located and protected?
[SI Satisfactory
Structurally sound? [5] Satisfactory Laterals free of excess solids? [5] Satisfactory
Landscape position? [S] Satisfactory Laterals flushed? YES
Septic tank filter cleaned?
Pump tank filter cleaned?
PRESSURE HEADS
SOLIDS ACCUMULATION DESIGN HEAD ADJUSTED HEAD
Line 1 2 2
Approximate Quantity of Solid Waste in Septic Tank Line 2 2 2
Line 3 2 2
INLET Scum: — 2 in. Sludge: — 12 in. Line 4 2 2
OUTLET Scum: — 0 in. Sludge: — 12 in. Line 5 2 2
Line 6 2 2
Approximate Percentage of Solids to Liquid Waste in Tank
- 29 °%
DRAIN FIELD
No effluent surfacing? [5] Satisfactory
Surface water diverted? [5] Satisfactory
Line cover maintained properly? [5] Satisfactory
Protected from traffic? [5] Satisfactory COMMENTS
Distribution devices operating properly? [5] Satisfactory
Repair area reserved? [S] Satisfactory The paper in the septic tank is not breaking down. I
suggest a more biodegradable brand.
PUMP
Pump present and operating?
Design GPM 33w1�;�cD
Actual GPM 33
Efficiency 100%
High water alarm operating properly? [S] Satisfactory MAY 2 d 2023
Pipework in good condition? [5] Satisfactory
Control panel in good condition? [5] Satisfactory
Control floats operating properly? [5] Satisfactory n. i �,� Health
r�.� mental
Straps/float tree in good condition? [S] Satisfactory
Effluent free and clear of solids? [5] Satisfactory
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... MAINTENANCE REPORT FORM
t , , _ ..,...M ?''y'� 'S
Name and Location of System Date of Inspection
J Mark Shue 16 May 2024
1285 Saunders Drive
Environmental " , Services Permit Number
Catawba, NC 28609 471003401001
Operators Responsible for Care (O.R.C.'s): System Classification
Jack Moore - Certified Operator #985357 Phone (828) 850-5660 IV-A
David Lynch - Certified Operator #996383 Phone (828) 850-5661
y p Alternate Mailing Address
J.C. Moore Phone (704)873-2171 Subdivision
1227 Troutman Drive Fax (704)873-9928 Saunders Property
Statesville,NC 28625 Mobile(704)902-1122 County Phone
Catawba Phone
SEPTIC TANK AND PUMP TANK LOW PRESSURE PIPE SYSTEM
Risers accessible? [S] Satisfactory Turnups,cleanouts,valves
Signs of infiltration? [S] Satisfactory located and protected? [5] Satisfactory
Structurally sound? [S] Satisfactory Laterals free of excess solids? [S] Satisfactory
Landscape position? [S] Satisfactory Laterals flushed? YES
Septic tank filter cleaned?
Pump tank filter cleaned?
PRESSURE HEADS
SOLIDS ACCUMULATION DESIGN HEAD ADJUSTED HEAD
Line 1 2 2
Approximate Quantity of Solid Waste in Septic Tank Line 2 2 2
Line 3 2 2
INLET Scum: — 1 in. Sludge: ^' 4 in. Line 4 2 2
OUTLET Scum: ^' 0 in. Sludge: — 4 in. Line 5 2 2
Line 6 2 2
Approximate Percentage of Solids to Liquid Waste in Tank
= 1 0 %
DRAIN FIELD
No effluent surfacing? [S] Satisfactory
Surface water diverted? [S] Satisfactory
Line cover maintained properly? [S] Satisfactory
Protected from traffic? [S] Satisfactory COMMENTS
Distribution devices operating properly? [5] Satisfactory
Repair area reserved? [S] Satisfactory
PUMP
Pump present and operating?
Design GPM 33 RECEIVED
Actual GPM 33
Efficiency 100%
High water alarm operating properly? Es] Satisfactory S E P 5 2024
Pipework in good condition? [5] Satisfactory
Control panel in good condition? [S] Satisfactory
Control floats operating properly? [S] Satisfactory
Straps/float tree in good condition? [S] Satisfactory Environmental Health
Effluent free and clear of solids? [5] Satisfactory
Ctdik- II- jtl - fD q(di
,,----,,, MAINTENANCE REPORT FORM
!( x `ti i ,, 1S
Name and Location of System Date of Inspection
I / Mark Shue 16 May 2024
1 " 1285 Saunders Drive
Environmental Services Permit Number
Catawba, NC 28609 471003401001
Operators Responsible for Care (O.R.C.'s): System Classification
Jack Moore - Certified Operator #985357 Phone (828) 850-5660 IV-A
David Lynch - Certified Operator #996383 Phone (828) 850-5661
Alternate Mailing Address
J.C. Moore Phone (704)873-2171 Subdivision
1227 Troutman Drive Fax (704)873-9928 Saunders Property
Statesville, NC 28625 Mobile(704)902-1122 County Phone
Catawba Phone
SEPTIC TANK AND PUMP TANK LOW PRESSURE PIPE SYSTEM
Risers accessible? [5] Satisfactory Turnups,cleanouts,valves
Signs of infiltration? [S] Satisfactory located and protected? [S] Satisfactory
Structurally sound? [S] Satisfactory Laterals free of excess solids? [S] Satisfactory
Landscape position? [S] Satisfactory Laterals flushed? YES
Septic tank filter cleaned?
Pump tank filter cleaned? PRESSURE HEADS
SOLIDS ACCUMULATION DESIGN HEAD ADJUSTED HEAD
Line 1 2 2
Approximate Quantity of Solid Waste in Septic Tank Line 2 2 2
Line 3 2 2
INLET Scum: ^' 5 in. Sludge: ^' 15 in. Line 4 2 2
OUTLET Scum: ^' 0 in. Sludge: ^' 13 in. Line 5 2 2
Line 6 2 2
Approximate Percentage of Solids to Liquid Waste in Tank
40+
DRAIN FIELD
No effluent surfacing? [S] Satisfactory
Surface water diverted? [S] Satisfactory
Line cover maintained properly? [S] Satisfactory
Protected from traffic? [S] Satisfactory COMMENTS
Distribution devices operating properly? [S] Satisfactory
Repair area reserved? [S] Satisfactory The paper in the septic tank is not breaking down. I
suggest a more biodegradable brand.
PUMP The septic stank needs to be pumped as soon as
Pump present and operating? possible.
Design GPM 33
Actual GPM 33
Efficiency 100% RECEIVED
High water alarm operating properly? [S] Satisfactory
Pipework in good condition? [S] Satisfactory
Control panel in good condition? [5] Satisfactory
Control floats operating properly? [5] Satisfactory S E P 5 2024
Straps/float tree in good condition? [5] Satisfactory
Effluent free and clear of solids? [S] Satisfactory
Environmental Health
I
o Quk- tOiI3O$ (.i MAINTENANCE REPORT FORM
\ 4 -4 64 i Name and Location of System Date of Inspection
' Mark Shue 22 Nov 2024
1285 Saunders Drive Permit Number
iffnvironmentar Services
Catawba, NC 28609 471003401001
Operators Responsible for Care (O.R.C.'s): System Classification
Jack Moore - Certified Operator #985357 Phone 1828) 850-5660 Iv-A
David Lynch - Certified Operator #996383 Phone (828) 850-5661
Y p Alternate Mailing Address
J.C. Moore Phone (704)873-2171 Subdivision
1227 Troutman Drive Fax (704)873-9928 Saunders Property
Statesville, NC 28625 Mobile(704)902-1122 County Phone
Catawba Phone
SEPTIC TANK AND PUMP TANK LOW PRESSURE PIPE SYSTEM
Risers accessible? [S] Satisfactory Turnups,cleanouts,valves
Signs of infiltration? [S] Satisfactory located and protected? [S] Satisfactory
Structurally sound? [S] Satisfactory Laterals free of excess solids? [S] Satisfactory
Landscape position? [S] Satisfactory Laterals flushed? YES
Septic tank filter cleaned?
Pump tank filter cleaned?
PRESSURE HEADS
SOLIDS ACCUMULATION DESIGN HEAD ADJUSTED HEAD
Line 1 2 2
Approximate Quantity of Solid Waste in Septic Tank Line 2 2 2
I
Line 3 2 2
INLET Scum: ^' 2 in. Sludge: "' 9 in. Line 4 2 2
OUTLET Scum: ^' 0 in. Sludge: "' 12 in. Line 5 2 2
Line 6 2 2
Approximate Percentage of Solids to Liquid Waste in Tank
at25 %
i DRAIN FIELD
INo effluent surfacing? [5] Satisfactory
Surface water diverted? [S] Satisfactory
Line cover maintained properly? [5] Satisfactory
Protected from traffic? [5] Satisfactory COMMENTS
Distribution devices operating properly? [S] Satisfactory
Repair area reserved? [S] Satisfactory ,
PUMP RI� L.D
Pump present and operating?
Design GPM 33
Actual GPM 33 DEC - 2 2024
Efficiency 100%
High water alarm operating properly? Es] Satisfactory
Pipework in good condition? [5] Satisfactory Environmental Health
Control panel in good condition? [S] Satisfactory
Control floats operating properly? [S] Satisfactory
Straps/float tree in good condition? [S] Satisfactory
Effluent free and clear of solids? [5] Satisfactory
GL - Oi9 t 5O9 f
MAINTENANCE REPORT FORM
r M; Name and Location ofSystem
Date ofInspection
_ ( ` ))
p
Mark Shue 21 May 2025
' AA - 1 S
iirb
1285 Saunders Drive
Environmental „�. Services Permit Number
Catawba, NC 28609 471003401001
Operators Responsible for Care(O.R.C.'s): System Classification
Jack Moore - Certified Operator #985357 Phone (828) 850-5660 IV-A
David Lynch - Certified Operator #996383 Phone (828) 850-5661
Alternate Mailing Address
J.C. Moore Phone (704)873-2171 Subdivision
1227 Troutman Drive Fax (704)873-9928 Saunders Property
Statesville, NC 28625 Mobile(704)902-1122 County Phone
Catawba Phone
SEPTIC TANK AND PUMP TANK LOW PRESSURE PIPE SYSTEM
Risers accessible? [S] Satisfactory Turnups,cleanouts,valves
Signs of infiltration? [S] Satisfactory located and protected? [S] Satisfactory
Structurally sound? [S] Satisfactory Laterals free of excess solids? [S] Satisfactory
Landscape position? [S] Satisfactory Laterals flushed? YES
Septic tank filter cleaned?
Pump tank filter cleaned?
PRESSURE HEADS
SOLIDS ACCUMULATION DESIGN HEAD ADJUSTED HEAD
Line I. 2 2
Approximate Quantity of Solid Waste in Septic Tank Line 2 2 2
Line 3 2 2
INLET Scum: "' 3 in. Sludge: ^' 12 in. Line 4 2 2
OUTLET Scum: ^' 0 in. Sludge: ^' 12 in. Line 5 2 2
Line 6 2 2
Approximate Percentage of Solids to Liquid Waste in Tank
= 31
DRAIN FIELD
No effluent surfacing? [S] Satisfactory
Surface water diverted? [S] Satisfactory
Line cover maintained properly? [S] Satisfactory
Protected from traffic? [S] Satisfactory COMMENTS
Distribution devices operating properly? [5] Satisfactory
Repair area reserved? [S] Satisfactory
REC
PUMP IV
ED
Pump present and operating?
Design GPM 33 JUN 2 2025
Actual GPM 33
1 Efficiency 100%
High water alarm operating properly? [S] Satisfactory
Pipework in good condition? [S] Satisfactory Environmental Health
Control panel in good condition? [S] Satisfactory
Control floats operating properly? [S] Satisfactory
Straps/float tree in good condition? [S] Satisfactory
Effluent free and clear of solids? [S] Satisfactory