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HomeMy WebLinkAboutEOP-02-2022-166412.tif Alternative Septic Services, LLC 803-242-2639 AlternativeSepticServices.com October 27,2023 Alternative Septic Services, LLC Re: 8474 Monbo Point Drive,Catawba,NC Alternative Onsite Wastewater Treatment System As-Built PIN: 4710-0343-7601 Gentlemen: Enclosed is the As-built plan for 8474 Monbo Point Drive, Catawba, North Carolina as installed by Alternative Septic Services, LLC (NC Certification: 6821) on October 23, 2023. This system was installed as designed. The drain field was observed to be in the general location as originally designed and using all components from the original design on the south side of the four(4) bedroom residence. The drainfield components meet all horizontal (minimum 10 feet from property lines) and vertical (minimum 12 inches above a restrictive horizon) setbacks as designated by NCDEQ regulations 15A NCAC 18A, Sanitation, Section .1900, Sewage Treatment and Disposal Systems. Please note that the as-built location and/or orientation of the wastewater treatment system tanks may vary from the proposed location and/or orientation during construction due to site conditions and building placement. The tanks also adhere to the setbacks (minimum 5 feet from the property line and building) provided by NCDEQ regulations 15A NCAC 18A, Sanitation, Section .1900, Sewage Treatment and Disposal Systems, regardless of tank orientation. The as-built plan has been completely analyzed and should function as intended. I recommend final approval. Sincerely, Brett G. Schaefer, IN, ``�111111111/// Cr... Ess,o ,,i�, SEAL - 036114 '1/F G.SCHP'v" CO V a Co 0 o n, o n o \ — \ a \ \ a, \ 47 CD . \=. % / I \ N �. F 1 / 1 I \ �.\'\ j / \\ \\ I \• / �; \ \ f'''''Nc)... / / it / \ t \\\ 6 I • \ is Ao I i \\\ /�� I 1 \ I /_, / I n ; \\ 7 / t m �i $ \\'1\ /// / m \\` \ i.' [If Q2 o opi y + , .. haa a PPPP_ b (— 202Z—)qyz( 1`' RICHARD 0, BRAJER Secretary • DANIEL STALEY Davao'',ANOlv(sfortofPuTALEY PublicHDHUMAN HealthS r HEALTH AHD SERVICES � t/�� lk-Hoaffh 1p �-bL -Z� L— COMMON FORM FOR ENGINEERED OPTION PERMIT See Instructions for Use in Appendix A Except for"Date received",this Section to be completed by the Professional Engineer licensed In accordance with G.S.89C i LHD USE ONLY: Initial submittal of this NOI received; 2-—1 0— '2_2 by g(c Vote initials PART 1:Notice of Intent to Construct(NOI) 1, Facility Owner's name:(Owner,Company Name,Utility,Partnership,Individual,etc.): d 1a-vQ N a3a U014.0(14�c_.ti r City: State: Zip:t4-1}5F� Mailing address: +� id r � 1 .enm Telephone number: q3_-' 3� 0138 E-mail Address: 2, Professional Engineer(PE)name: Brett G. Schaefer License number: 036114 Mailing address: 6945 Curlee Ct. City: Charlotte State: NC Zip: 28277 Telephone number: 631-7 8 6-4 6t)1 E-mail Address: 3. Licensed Soil Scientist(LSS)name: Steven J. Melin License number: 1254 Mailing address: 15 Lone Co ate Ride City: Fletcher State: NC Zip: 28732 828-551-9903 E-mail Address: SJMelin@gmail.corn Telephone number; License Number: 4. Licensed Geologist(LG)(if applicable)name: City:_____.r__.— State: Zip: Mailing address: E-mail Address: Telephone number: Gr License number: 6821 isso S, On-site Wastewater Contractor name: Brian m Lake Wylie State: SC Zip; 29710 Mallingaddress: 168 Hwy 274, Ste 155 City: Telephone number: 8a3-627-4917 E-mail Address: brian rlssom alternativese ticservices.com 6, Proof of Errors and Omissions or other appropriate liability Insurance for the following persons is attached that includes the!AO oft urer,name of the Irn-site Wastewater Contractor coverage:and the effective dates of Eli ' E LSSS 0 LG" number of the property to address,tax parcel identification number r subdivision lot,block� M �� p o 7. Property location(physicalg�_____ _ al"" � be permitted): 'lam @39---43 7 01 County Name: awb a—— "Nothing Compares"-, V,.,,ulmoNolllrallllt`I'Scrtrur Ill ftrac•uI'ILillllgh''l`Iortahlf1rtu�blic He'I(9}11il: EHS131 I(IS Six IorF%R":u1 j 16111 1U,,o,i I 11'1 tie,i0111 `ll`71 • Ili i pi State of NC EOP LI-ID Reference: FO/ —L-�-c zC-- l U 0"if L_ 8. Type of facility: ?Place of residence No. Bedrooms: 4 _ No. Occupants: 8 n Place of business Basis for flow calculation: ❑ Place of public assembly Basis for flow calculation: 9, Factors that would affect the wastewater load: N/A (Domes Liu Wastewater) 10. Type and location of wastewater system: Engineered Waste Water Treatment. System (Type Vc) located south of house location (Figure 1) . _ 11.. Design wastewater flow: 480 gpd (For flow>3,000gpd,duplicate plans shall be sent to the State.) Design wastewater strength: domestic n high strength [1] Industrial process(oupilcote plans shall be senttotie State.) 12, A plat as defined in G.S. 130A 334(7a) is attached: E Yes [eNo 13. Owner meets requirements of ownership or control of the system per 15A NCAC 18A .1938(j): fetes III No 14. Easement or encroachment agreement required per 15A NCAC 18A,1938(j): n Yes eNo If yes,documentation filed in County Register of Deeds in Deed book Page 15. Multi-party agreements required,as applicable,pursuant to 15A NCAC 18A.1937(h): E Yes o If yes,agreements filed in— County Register of Deeds in Deed book Page 16, Location of proposed or existing wells (drinking water,irrigation,geothermal,groundwater monitoring, sampling, etc.) and any pot e and non-potable water conveyance lines Is indicated on attached plans and complies with 15A NCAC 18A .1950: Yes ElNo This is a saprolite system. I'►I Yes ❑ No 17. Soils and site evaluation as defined In 130A-335(a1)signed and sealed by either a LSS or LG is attached: Yes n No 18. Proposed landscape,site,drainage,or soil modifications are attached: ❑Yes 14A Attestation by Professional Engineer licensed in North Carolina pursuant to G.S.89C I,_Brett G G. Schaefer hereby attest that the information required to be included with this Registered Professional Engineer(Print Name) Notice of Intent to Construct is accurate and complete to the best of my knowledge and that the proposed system shall meet applicable federal,State,and local laws,regulations,rules and ordinances in accordance with G.S. 130A-336- .1(e)(6). '/4? ' 12/21/20 Signature of Licensed Professional Engineer Date Page 2 of 6 DHHS/EHS/OSWPB—COMMON FORM Effective November 1, 2016 EHS131 11/2/2016 State ofNCEOP LIIDlteference: E0f9_ Z-2b ( L1(2 This section is for owner use to either designate PE as their legal representative or to self submit the NC% Deslgnatlon.of Registered Professional Engineer as legal representative:of Owner for this:Notice of intent: I, )14 140 /1140.ve`1 .y Hereby deign te; .. .ate: r cx :tot Fc,2 Pilnt Noi4 of Owne Print.Nome.o/Registered Pr%sslottal Engineer as my'legal representative for purposes:of this Notice of Intent pursuantto:G,S. 130A.336;•1, sfgnotoe of P vner` Dote Owner self-sub'mlttal of NOI: I, hereby submit.this NOI prepared by Print Nemo ojOwnet 'Print'Nome of Licensed PE p u rs:u a n t.to'G.S: 130A-33 6.1, $laRattJls;of Owner Date NOTES:. LIABILITY; The Department,,the Department`s authorized agents,or local health departments shall have no lrabilityfol. wastewater systems designed,constructed a;nd.Installed pursuant to an Engineered Option permit.((NC General Statute 130A-336,1(f)) RIGHT OF ENTRY: The submitta!of thls::N:otite cif Intent to Construct grants right of entry.to the Local Health Department. and the State to,the referenced property.. ISSUANCE OF BUIWING PERMIT Once the LHD deems that the Notice of I;ntentto Construct is complete.via signature in the section above,the owner may apply to the local permitting agency for a permit for electrical,plumbing,heating,air conditioning orother construction, location or relocation activity under any provision of general or special law pursuant to G.S.130A•338. Page 3 of G. DHHS/EHS/OSWPB—COMMON FORM Effective November 7; 2016. eNsial 11/2/2016 State of NC POP LHD Reference: !—'9,— 2-- Z()2 —// �(l2 This section for Local Health Department use only. PART 2: LHD Completeness Review of the Notice of intent to Construct "(c)Completeness Review for Notice of Intent to Construct.—The local health department shall determine whether a notice of intent to construct,as required pursuant subsection(b)of this section,is complete within 15 business days after the local health department receives the notice of Intent to construct. A determination of completeness means that the notice of intent to construct includes all of the required components. if the local health department determines that the notice of intent to construct is incomplete,the department shall notify the owner or the professional engineer of the components needed to complete the notice. The owner or professional engineer may submit additional information to the department to cure the deficiencies in the notice. The local health department shall make a final determination as to whether the notice of intent to construct is complete within 10 business days after the department receives the additional information from the owner or professional engineer. If the department fails to act within any time period set out in this subsection,the owner or professional engineer may treat the failure to act as a determination of completeness." The review for completeness of this Notice of Intent was conducted in accordance with G.S. 130A-336.1(c). This NOI is determined to be: INCOMPLETE (If box is checked, Information in this section is required.) Based upon review of information submitted by the PE in Part 1,the following items are missing: Copies of this form listing missing items were sent to the design PE and the Owner on Date via with directions to re-submit missing items using Page 5 of this form. Email,FAX,USPS,hand-delivered dCOMPLETE(If box is checked,information in this section is required.) Based upon review of information submitted by the PE in Part 1 of this form,this NOI is deemed�COMPrLETE. Copies of this signed form were sent to the design PE and the Owner on 2 L via f=��11( Date Email,FAX,USPS,hand-delivered A copy of this NOI and tracking information was sent to the State on __via l� Date Email,FAX,USPS,hand U 6 ; /,,� nr 4(144 �l!t(/Ij 2-_211( Print Name of Authorized Agent�f the LHD Signature of Authorized Agent of the LHD Dote Page 4 of 6 DHHS/EHS/OSWPB- COMMON FORM Effective November 1, 2016 EHS131 11/2/2016 Lu 2- State of NC EOP LHD Reference: Re-submittal of NOI with missing items included This Section Is for use by PE to submit Items noted as missing during LHD Completeness Review above. Resubmlttals must he arcomponled by a rover letter from the PE. LHD USE ONLY: This NOI resubmittal received: by Dote loll lots Item 41 from Initial NOI Resubmittal description Attestation by Professional Engineer licensed in North Carolina pursuant to G.S. 89C hereby attest that the information re-submitted for this Notice of Licensed Professional Engineer(Print Name) Intent to Construct is accurate and complete to the best of my knowledge and that the proposed system shall meet applicable federal,State, and local laws,regulations, rules and ordinances in accordance with G.S. 130A-336-.1(e)(6). Signature of Licensed Professional Engineer Date The section below is for local Health Deportment use often submittal of items noted as missing above. LHD Follow-up Completeness Review of Notice of Intent to Construct This follow-up review for completeness of this Notice and Intent was conducted in accordance with G.S. 130A-336.1(c). This NOI is determined to be: [] INCOMPLETE Based upon review of information submitted by the PE in the RESUBMITTAL above,this Notice of Intent remains INCOMPETE because the following items from Part 1 of this form remain missing: Copies of this signed form were sent to the design PE and the Owner on via Date Ernoll,FAX,LISPS,hand n COMPLETE Based upon review of information submitted by the PE in the RESUBMITTAL above in addition to information provided in Part 1 of this form,this NOI is deemed complete. Copies of this signed form were sent to the PE and the Owner on via Date Email,FAX,USPS,I-land A complete copy of this form with tracking information was sent to the State: via Date Email,FAX,LISPS,hand Print name of authorized Agent of the LHD Signature of authorized Agent of the LHD Date. Page 5 of 6 DHHS/EHS/OSWPB—COMMON FORM Effective November 1, 2016 EHS131 11 l2/2016 State of NC EOP LHD Reference: D, UL ZUL2� PART 3: Authorization to Operate(ATO) Except for date received,the Section below is to be completed by the Owner or by the PE designated to act as their legal representative for the EOP, LHD USE ONLY: Initial submittal of request for ATO received: _by note Initials Date of Post-construction Conference: The following items are included in this submittal for an Authorization to Operate under an EOP: 1. Signed and sealed copy of the Engineer's report that includes: a. Signed and sealed evaluation of soil conditions and site features es n No b. Drawings, specifications, plans '"i es C No c. Reports on special inspections and final inspection ;r/ es n No d. Management Program manual i% es n No e. On-site Wastewater Contractor's signed statement ,^es No f. Signed and sealed statement pursuant to 15A NCAC 18A.1938(h) :I s U No 2. Fee (as applicable) ►i •s n No 3. Notarized letter documenting Owner's acceptance of the system from the PE in Yes n No Attestation by the Owner or the PE for Authorization to Operate Brett G. Schaefer hereby attest that all items indicated above have been provided to the Print name of Owner or Professional Engineer Catawba County LHD and the system shall meet applicable federal,State, and local laws, regulations, rules and ordinances in accordance with G.S. 130A-336-.1(e)(6). 4: Aef.5,4/. & 10/27/23 Signature of Owner or rofessional Engineer Dote This section for LHD Use Only. LHD Review of required information for the ATO r INCOMPLETE Based upon review of information submitted by the Owner or PE in the Section above,the following items are missing from the information required for an Authorization to Operate for an EOP: Copies of this signed form were sent to the design PE and the Owner on via Dote Email,FAX,USPS,hand 17 COMPLETE Based upon review of information submitted by the Owner or PE in the Section above,this Authorization to Operate is hereby issued in accordance with G.S. 130A-336.1(m). A copy of this complete NOl/ATO with tracking information was sent to the State on _via Dote Email,FAX,USPS,hand Print Name of Authorized Agent of the LHD Signature of Authorized Agent of the LHD Date ISSUANCE OF CERTIFICATE OF OCCUPANCY; Once the LHD determines completeness based upon the PE submission,the owner may apply to the local permitting agency for permanent electrical service to a residence, place of business or place of public assembly pursuant to G.S. 130A-339. Page 6 of 6 DHHS/EHS/OSWPB—COMMON FORM Effective November 1, 2016 EHS131 I1/2/2016 ACORD® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 11/01/2023 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Holly Parrish NAME: Correll Insurance Group-Rock Hill PHONE (803)324-2984 FAX (A/C,No,Ext): (A/C,No): 319 Oakland Ave E-MAIL h arrish correllinsurance.com ADDRESS: p INSURER(S)AFFORDING COVERAGE NAIC N Rock Hill SC 29730 INSURER A: Pennsylvania National Mutual Casualty Ins Co 14990 INSURED INSURER B: Accident Fund 12304 Alternative Septic Services LLC INSURER C: National Fire&Marine Insurance Company 20079 168 Highway 274 Suite 155 INSURER D: INSURER E: Clover SC 29710 INSURER F: COVERAGES CERTIFICATE NUMBER: 23-24 Master Dist REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTR NSD yWVD POLICY NUMBER MMIODIYYYY PMIDOIYOLICY EXP LIMITS TYPE OF INSURANCE ( ) (MMIDDlYYYY) X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S 1,000,000 DAMAGET0 RENT ED 100,000 CLAIMS-MADE X OCCUR PREMISES(Ea occurrence) $ _ MED EXP(Any one person) $ 5,000 A Y GL9 0727799 03/09/2023 03/09/2024 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 PRO- 2,000,000 POLICY X JECT LOC PRODUCTS-COMPrOPAGG 5 OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT s 1,000.000 (Ea accident) X ANY AUTO BODILY INJURY(Per person) $ A OWNED SCHEDULED AU90757292 07/24/2023 07/24/2024 BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY (Per accident) X 19 Underinsured motorist s 1,000,000 X UMBRELLA LIAB _ OCCUR EACH OCCURRENCE S 1,000,000 A EXCESS LIAB CLAIMS-MADE UL9 0727799 03/09/2023 03/09/2024_ � AGGREGATE $ 1000,000 , DED RETENTION $ WORKERS COMPENSATION STAPTUTE—TTCT - AND EMPLOYERS'LIABILITY Y I N ANY PROPRIETOR/PARTNER/EXECUTIVE E L EACH ACCIDENT 5 1,000,000 B OFFICER/MEMBER EXCLUDED? Y NIA Y AF WCP 100019726 02 04/04/2023 04/04/2024 (Mandatory in NH) E L DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under 1,000,000 _ DESCRIPTION OF OPERATIONS below EL,DISEASE-POLICY LIMIT $ _ Each Occurrence $1,000,000 Professional Liability C F85108232AEM 07/09/2023 07/09/2024 Aggregate $2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Covered under above listed policies are: Brett Schaefer-Professional Engineer,Steven Melin-Licensed Soil Scientist,Brian Grissom-On-site Wastewater Contractor CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN NC Department of Health and Human Services ACCORDANCE WITH THE POLICY PROVISIONS. Division of Public Health AUTHORIZED REPRESENTATIVE 1642 Mail Service Center Raleigh NC 27699-1642 I _ OOhh ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Alternative Septic Services, LLC October 27,2023 Mr. Brett Schaefer, PE 6945 Curlee et Charlotte,NC 28277 Mr. Schaefer, An EOP was obtained from the Catawba County Depart e, t of PublicThe se i Health sy for as set proposed septic system at 8474 Monbo Pointn D (Brian Grissom forth in the EOP was installed by Alternative Septic Services, LLC #6821) and inspected by Steve Melin. ereb accept the engineered septic system as installed by Alterative Septic Services, WEh Y LLC as being completed in accordance with specifications set forth in the EOP documents. Sincerely, 40i4 Notro v or State of County of kl a Notary for County, State of do hereby certify that personally appeared before me this day and acknowledge the due execution of the foregoing instrument. Witnessed my hand an official seal, this day of riOl/e 1 bt , 2023. „.,,,,,,tt , ooD O r''9 414ta(OtiLd 1-06 a� = � = -cnao � t_ y y 00 - R \ 4FXP:Fee A� \ \0 % 1 "I 7e OF C Seal Alternative Septic Services, LLC 168 HWY 274#155 Lake Wylie, SC, 29710 October 27, 2023 Re: 8474 Monbo Point Drive,Catawba,NC Alternative Onsite Wastewater Treatment System Dear Environmental Health, This letter is intended satisfy the requirement that the system at Arlington Estates was installed according to recommendations in the Engineering and Soil Scientist Report. I hereby certify that the system was installed consistent with the Engineering and Soil Scientist Report. This included installing a pretreatment (Clear Stream)tank that feeds a total of 600 linear feet of GeoFlow drip irrigation tubing for the 4-bedroom residence. I greatly appreciate your time. Please feel free to contact me if additional information is required. Kind Regards, r n Grissom, Certified Septic Installer(Level IV)—Certification #6821 Alternative Septic Services 803-627-4917 1 Alternative Septic Services, LLC 15 lONE COYOTE RIl(TL:11.ETCI1ER,NC 28732 EMAIL: SJMEI.IN@GMAII.COM C11.1.:(828)551-9903 October 27, 2023 Re: 8474 Monbo Point Drive, Catawba,NC Alternative Onsite Wastewater Treatment System Parcel ID #:47 1 0-0343-7601 To whom it may concern, This letter is intended satisfy the requirement that the system at 8474 Monbo Point Drive,Catawba,NC was designed and installed according to recommendations in the Soils Report. I hereby certify that the system was installed consistent with the Soils Report. This included installing a Clearstream treatment unit that feeds 600 linear feet of drip irrigation tubing for the 4-bedroom residence. Please note that the 0.40 LTAR and 36"drip depth were utilized as specified in the Soils Report. I greatly appreciate your time. Please feel free to contact me if additional information is required. Kind Regards, 9,. Steven J. Melin, LSS Alternative Septic Services, LLC 1