HomeMy WebLinkAboutAUTH-10-2020-139675.tif SUBSURFACE WASTEWATER INSPECTION FORM it —i3(1(75
System Manager: Date of Inspection _Initial _6 month "12 month
TCW Wastewater Management, LLC - ! Follow-up Service call _Other
5600 Lakeview Road,Charlotte,NC 28269 County System Type Drainfield
Tele.704.776.4443 -r ' On site Off-site
infoi tcwwastewater.com Time I Initials C
Location of System/Drainfield(off-site)
John McCormick
4990 Kiser Island Rd
Terrell, NC 28682
'Lot# (I/ Phase Subdivision MA dl .4-44,ri
Compliance Status: - = Compliant , Non-Compliant —
Malfunctioning
Copies: '�Homeowner DEH -Builder Owner's Association Developer
'J=Satisfactory N1=Marginal X = Unsatisfactory N=Not Evaluated NA=Not Applicable
Septic Tank: size: e 0 gallons 1000= 53' LL 1500=43"LI 2000=49"LL
Tank risers are accessigie • mama
Riser Type /N'r- • ( _ Height_____- -_..` Dam aer-?.f[_J Inlet End of Tank
No odors present Scum Level Sludge Level
There are no Infiltration problems __ ► Surface _ Subsurface _ " Q"
Surface water Is being diverted away _-__. Scum plus Sludge level ____" (SST)
Tanks and accesses are structurally sound Filter End of Tank SST "/liquid Depth "x 100= %
Inlet pipe at proper angle yes Can't observe.__� Sul:i;,as.:, sludge vet Tank Needs Pumping: yes No -
Intel lee Is in good condition -- N/A - > —ems <30 9tr=No >30%=Yes
Inlet "eu is cleaned today —,- N'4.. •
_ _
Effluent Filter dogging percental l'10.25,50,75,1ae1 _) C°% NIA_ rype r Sample of total r column
Effluent Filter was cleaned No Yes i— N/A_-_._ _ Three distinct zones: good medium -. murky__
Effluent Filter is in good condition - N/A__,.__
Effluent Filter Canister Is in good condition NIA- ___ __
Effluent Filter is snapped in place — NIA. Bacteria Added at In action Left wiz homeowner
Effluent Pipe at proper angle _ Pulp pis Pulp _pis
a ,'' Regular pis Regular_,l__pks
Water level is at proper level in Yes, Freeboaw �_ 9
F'fflaent Dosing Station:size: JC r gallons 1000=50"=20 GPI 1500=52"=28 GPI 2000=59"=34 G Scum Level Sludge Leval
11
Tank Riser is at proper hei�t -__-- " pius C„ •
Riser Type a)-+ Height ` Diameter Total Scum+Sludge
No odors present _____ >4' es
No Infiltration issues: Surface Subsurface__. - Tank Needs Pumping: yes ___ No_ _ ( ' Y )
Required pumps are present&operating properly ___- - Amp Draw ____-_ _
High water alarm is operating properly -- Can't Observe Filter Cleaned today No Yes__ N/A!
Floats,pipes,valves, disconnects are in good condition --'Pump make and mode Filter Is In good condition N/A /'
Pump Is Installed on block or raised platform(min.6 inches) N!R -_ Root Killer Added 1LB 2LBS_
Pump float is not resting on top of pump NsA
Control panel enclosureicomponents are in good condition Elapsed Time Readings:
TCW sticker is placed on front door of Panel Pump#1-C_ -P =Usage nrs
Duct Seal Is present in all conduit openings j Usage /days = se Per Day = hrs
Effluent appears clear and free of solids ____
His_ _ x 60= m .x GPM GPD
Telemetry/Dialer Is working properly N/A-__LI Average_(<2T5) Above av ge (>275) -Very high__(>350)
Pressure Bell settings: Off 4',On 10"-12",Tele 16", Alarm 22" Pump#1-CC /' PC Useage _
Grinder Lift Station: Authorized to Inspect Not Authorized to Inspect
Tank Riser Is at proper neigh! ► Buried_____ , _____ /
No odors present
No Inftdratian issues: 'v Surface _ Subsurface /
Required pumps are present&operating properly _ •
High water alarm is operating properly ___ Can't Observe _ /
Floats,pipes,valves, disconnects areln good condition
Pump float is not resting on top of pump
Control panel enclosureicomponents are in good condition .____
Grease Trap Section N/A size: gallons 1000=52"LL 1500=4,34LL Scum Level
P. tturied_ _ " Inlet " Outlet
Tnnk risers are accessible -. -_
No odors present --
There are no Infiltration problems _ ► Surface,_. _. Subsurface .__ Tank Needs Pumping: yes_ Ne___, (>3"yes)
Surface water is being diverted away -----
Tanks and accesses are structurally sound -- p f olumn
Inlet pipe at proper angle _._._
Infer toe is in good condition l Three distinct zones ../Ldi'Yea--
Inlet Tee Is cleaned today 44
Effluent Filter clogging percentage ___ 1c Filter type
Effluent Filter was cleaned No __.- Yes
Effluent Filler is in good condition ')
Effluent Filter Canister Is in good condition
Effluent Filter Is snapped in place .._._..
Effluent Pipe at proper angle
Water level Is at proper level No` Yes_____ Freeboard _ _ Ci)41 f O i1 f<I e1' ir ('
revise°r!zurtutu ea[th
Ground Absorption Fields:
No cdars present
There is no evidence of effluent surfacir Drop boxes used In Ilev of Distribution box No_ Yes
Vegetative cover Is maintained property • Distribution box(es)in good condition I
Reid Protected from traffic/destructive t / Distribution box(es)In proper adiuslment
Surface water is being diverted away
Lines are not pending or holding water ▪ ) If ponding Is occuring,how much?
No low areas or settling occurring /line cover cover(soli)Is adequate — Repair area is properly reserved,maintainer _
Pressure Manifold Systen #of 1/2"taps = GPM (Formula. @ 3 feet head-Taps X 6.71 GPM; f1 2 feet head-Taps X 5.46)
Manifold vault,valves,piping are In good condition Replacement needed. lid____ Valves ! qly; Repair needed: Box
No evidence of leakage,blockage In discharge linen : Deep cleaning needed Corrected Today
No evidence of effluent backing up Into box Pressure heed Is properly adlusled Corrected'lode
Low Pressu'e Pipe System:
Limn are Intact and accessible Corrected lode Need extensions? Yes 1 Later es are free of excess solids /" letting necesser
Laterals were flushed this Inspection No ' Yes —- CPDR= GPM; Efficiency= c�
Zone valves are operating properly ��/ Corrected Tod* Need replacing? Yes ! _qty
Pressure head Is properly adjusted f'� Corrected Tod*Turn-up Turn•up buckets are dry Inside --
Valvo box or buckets are dry Inside •
Buckets needs replacing? Yes_. !_qty
Buckets needs replacing? Yes _ ! qty
Pump Tank Size (Gallons): 1000 1500 200n I Design Pump Delivery Rate GPM Design Dose ' Gallons
1000 Gallon=50"=20 GPI 1500 Galion=52"=28 GPI 2000 Galion=59"=34 GPI
Level End Dose Level Begin Dose =Difference_ Inches X GPI = Curre ose Gall s
Level End(large f)) Lee - D evel Begin(smell#) v_ _ ✓ 1
x GPI VA, + _ 7 Min.Run Time = �
GPM(Co OR)
Current GPM(CPDR) + Design GPM(DPW) = )( 100 = %
---_—�_ Efficiency
Valves Lines Design Observe Adjusted Valves Lines Design Observe
Adjusted
Recomm:: -to?tions to Owner: 7 /
Signature of"ORC"
Revised 6(24r01
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January 12,2023 CO / D
N
V ^ 0 223
Mr. John McCormith
4990 Kilter Island Rd •r�,,,,rental Het
Terrell, NC 28682
4j3' L )S"
NOTICE OF CANCELLATION
Effective January 31, 2023 your septic system maintenance contract will cancel
without further notice for non-payment. If you would likze to continue your
contract, please pay the invoice by that date. A copy of this cancellation notice
will be sent to the Department of Environmental Health as required by law.
TCW Wastewater values your business and would likze to continue to serve you
as a customer. The loss of your business will be missed.
There is a$50.00 reinstatement fee
TCW Wastewater Management, Inc.
Cc: Catawba County DEH
5600 Lakeview Road • Charlotte NC 28269 • Email:infnghcwwashewater.rom