Loading...
HomeMy WebLinkAboutRBPR-07-2022-41722.TIF t trfp- 68-zoz2-17 7qt STATE a<:, se ,r tia<,. ROY COOPER•Governor • : s NC DEPARTMENT OF KODY H. KINSLEY• Secretary wl = HEALTH AND HUMAN SERVICES HELEN WOLSTENHOLME •Interim Deputy Secretary for Health .4/ . . MARK T.BENTON•Assistant Secretary for Public Health .00 Division of Public Health COMMON FORM FOR LICENSED SOIL SCIENTIST COVID-19 PERMIT OPTION FOR NON-ENGINEERED SYSTEMS See Instructions for Use in Appendix A Except for"Date received",this Section to be completed by the LSS in accordance with S.L.2010-97,Section 3.19 and G.S. 130A-336.2 LHD USE ONLY: Initial submittal of this NOl received: 1_21 - 1- Date Initials PART 1:Notice of Intent to Construct(NOI)-Please check all that apply ❑■ Single System or ❑ Multiple Systems AND ❑■ New ❑Expansion ❑Relocation of all or part of the Existing System ❑Relocation of Repair Area ❑ Repair—LHD Permit Number ❑ Repair—EOP/LSS COVID 19/AOWE Permit Number 1. Facility Owner's name:(Owner,Company Name, Utility, Partnership, Individual,etc.): Four Corners of Charlotte, LLC Mailing address: 1612 Seattle Slew Court City: Waxhaw State: NC Zip: 28173 Telephone number: 704-713-2602 E-mail Address: romelle03@yahoo.com 2, Licensed Soil Scientist(LSS) name: Larry Thompson, LSS LSS License number: 1287 Mailing address: PO Box 541 City: Midland State: NC Zip: 28107 Telephone number: 704-301-4881 E-mail Address: larry@thompsonenv.com 3. Licensed Geologist(LG)(if applicable)name: N/A License Number: Mailing address: City: State: Zip: Telephone number: E-mail Address: 4. Proof of Errors and Omissions or other appropriate liability insurance for the following persons is attached that includes the name of the insurer,name of the insured and the effective dates of coverage: ❑� LSS ❑ LG 5. Property location(physical address, tax parcel identification number or subdivision lot, block number of the property to be permitted): 3102 Jenny's Lane, Newton, NC 28658 (Parcel: 364820816846) County Name: Catawba 6. Type of facility: ❑■ Place of residence No. Bedrooms: No.Occupants:6 ❑ Place of business Basis for flow calculation: ❑ Place of public assembly Basis for flow calculation: NC DEPARTMENT OF HEALTH AND HUMAN SERVICES • DIVISION OF PUBLIC HEALTH LOCATION:5605 Six Forks Road,Raleigh,NC 27609 MAILING ADDRESS:1642 Mail Service Center,Raleigh, NC 27699-1642 www.ncdhhs.gov • TEL:919-707-5874 • FAX.919-845-3972 AN EQUAL OPPORTUNITY/AFrIRMATIVE ACTION EMPLOYER COVID-19 Permit Option Common Form LHD Reference: LS.1 fi- og-7042,—( 47,7t 7. Factors that would affect the wastewater load: Design is for domestic strength wastewater only. 8. Type and located of proposed wastewater system: Gravity flow PPBPS bed located behind the proposed house site. System type Ille. 9. Design wastewater flow: 360 gpd Design wastewater strength: ❑■ domestic ❑ high strength E industrial process(For industrial process wastewater,a Professional Engineer licensed in accordance with G.S.89C shall design the on-site wastewater system.) 10. A plat as defined in G.S. 130A-334(7a) is attached: ❑■ Yes ❑No A site plan as defined in G.S. 130A-334(13a)is attached: ❑■ Yes ❑No 11. Location of proposed or existing wells(drinking water, irrigation,geothermal,groundwater monitoring, sampling,etc.) and any potable and non-potable water conveyance lines is indicated on attached plans and complies with 15A NCAC 18A.1950: ❑■ Yes ❑ No This is a saprolite system. ❑Yes ❑■ No 12. Evaluation(s)of soil conditions and site features in accordance with G.S. 130A-335(a1)signed and sealed by a LS5 is attached: E Yes ❑ No 13. Evaluation of geologic and hydrogeologic conditions signed and sealed by a LG is attached ❑Yes ❑j NA 14. Proposed landscape,site,drainage,or soil modifications are attached: ❑Yes 0 NA Attestation by LSS pursuant to S.L.2020-97,Section 3.19 and G.S.130A-336.2 Larry Thompson, LSS _hereby attest that the information required to be included with Licensed Soil Scientist(Print Name) this 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,and that the proposed system does not require a Professional Engineer, licensed in accordance with G.S.89C,and in accordance with 15A NCAC 18A.19,_ .ti ities determined to be engineering as determined by the North Carolina Board of Examiners for n an rveyors. 07-28-22 Signature of Lie oil3 ipntist Dote O►4 ief self-submittal of NO1: I, hereby submit this NOI prepared by Print Name of Owner Print Name of Licensed PE pursuant to G.S. 130A-336.1. Signature of Owner Date DHNS/EHS/OSWP-LSS C-19 COMMON FORM Updated April 2022 Page 2 of 6 COVID-19 Permit Option Common Form LHD Reference: Lsrp r `2a 22447(b NOTES: LIABILITY: The Department, the Department's authorized agents, or local health departments shall have no liability for wastewater systems designed, constructed, and installed pursuant to an LSS COVID-19 Permit Option fS.L.2020- 97,Section 3,19(d)and G.S. 130A-336.2(f)] RIGHT OF ENTRY: The submittal of this Notice of Intent to Construct grants right of entry to the Local Health Department and the State to the referenced property. ISSUANCE OF BUILDING PERMIT: Once the LHD deems that the Notice of Intent to Construct is complete via signature in the section below, the owner may apply to the local permitting agency for a permit for electrical, plumbing, heating,air conditioning or other construction,location,or relocation activity under any provision of general or special law pursuant to G.S. 130A-338. DHHS/EHS/OSWP-LSS C-19 COMMON FORM Updated April 2022 Page 3 of 6 COVID-19 Permit Option Common Form LHD Reference: l -1767f6 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 the notice of intent to construct required pursuant to subsection(b)of this section is complete within five business days after receiving 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 deportment determines that the notice of intent to construct is incomplete, the local health department shall notify the owner and list the information needed to complete the notice-The owner may then submit additional information to the local health deportment to cure the deficiencies in the initial notice. The local health department shall make a final determination as to whether the notice of intent to construct is complete within five business days after the department receives the additional information.If the local health department fails to act within any time period set out in this subsection,the owner may treat the failure to act as a determination of completeness. The owner shall be able to apply for the building permit for the project upon the decision of completeness of the notice of intent by the local health deportment or if the local health department fails to act within the five business day time period." The review for completeness of this Notice of Intent was conducted in accordance with G.S. 130A-336.2(c). This NOI is determined to be: ❑ INCOMPLETE(If box is checked,Information in this section is required.) Based upon review of information submitted in Part 1,the following items are missing: Copies of this form listing missing items were sent to the LSS and the Owner on Date via with directions to re-submit missing items using Page 5 of this form. Email,FAX,LISPS,hand-delivered Print Nome of Authorized Agent of the LHD Signature of Authorized Agent of the LHD Date Er COMPLETE(If box is checked, information in this section is required.) Based upon review of information submitted in Part 1 of this form,this NOI is deemed COMPLETE. p Z Copies of this signed form were sent to the LSS and the Owner on 4 via �H' Date Email,FAX,LISPS,hand-delivered A copy of this NOI and tracking information was sent to the State on via Date Email,FAX,LISPS,hand-delivered 20 IDLE 447 ( r /141114 Y-r'-22 Print Name of Authorized Agent of the LHD Signature of Authorized Agent of the LHD Date DHHS/EH5/OSWP—L55 C-19 COMMON FORM Updated April2022 Page 4 of 6 COVID-19 Permit Option Common Form LHD Reference: LI V`d b~t 0Z2— /76 MI Re-submittal of NOI with missing items included This Section is for use by owner to submit items noted as missing during LHD Completeness Review above. Resubmittals must be accompanied by a cover letter from the LSS. LHD USE ONLY: This NOI resubmittal received: by Dote Initials Item St from initial NOI Resubmittal description Attestation by LSS pursuant to S.L.2020-97,Section 3.19 hereby attest that the information required to be included with Licensed Soil Scientist{Print Name) this 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. Signature of Licensed Soil Scientist Date The section below is for Local Health Department use after 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- 336.2(c). This NOI is determined to be: ❑ INCOMPLETE Based upon review of information submitted 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 LSS and the Owner on via Date Email,FAX,LISPS,Hand-delivered Print name of authorized Agent of the LHD Signature of authorized Agent of the LHD Date ❑ COMPLETE Based upon review of information submitted 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 LSS and the Owner on via Dote Email,FAX,LISPS,Hand-delivered A complete copy of this form with tracking information was sent to the State: via Date Email,FAX,LISPS,hand-delivered Print name of authorized Agent of the LHD Signature of authorized Agent of the LHD Dote DHHS/EH5/0SWP—L55 C-19 COMMON FORM Updated April 2022 Page 5 of 6 COVID-19 Permit Option Common Form LHD Reference: YIP 2022"174 7V8 PART 3: Authorization to Operate(ATO) Except for date received,the Section below is to be completed by the Owner. LHD USE ONLY: Initial submittal of request for ATO received: by Dote Initials Date of Post-construction Conference: The following items are included in this submittal for an Authorization to Operate under an LSS COVID-19 permit: 1. Signed and sealed copy of the L55's report that includes the information in G.S. 130A-336.2(k) ❑Yes ❑ No 2. Operation and management program ❑Yes ❑No 3. Fee (as applicable) ❑Yes ❑No 4. Notarized letter documenting Owner's acceptance of the system from the LSS ❑Yes ❑ No 5. On-site Wastewater Contractor name: License number: Mailing address: City: State: Zip: Telephone number: E-mail Address: 6. Proof of Errors and Omissions or other appropriate liability insurance for the On-site Wastewater Contractor is attached and includes the name of the insurer,name of the insured,and the effective dates of coverage. ❑Yes ❑ No Attestation by the Owner for Authorization to Operate I, hereby attest that all items indicated above have been provided to the Print name of Owner County LHD and the system shall meet applicable federal,State,and local laws, regulations, rules,and ordinances. Signatureof Owner Date This section for LHD Use Only. LHD Review of required information for the ATO ❑ INCOMPLETE Based upon review of information submitted in the Section above,the following items are missing from the information required for an Authorization to Operate for an LSS COVID-19 permit: Copies of this signed form were sent to the LSS and the Owner on via Date Email,FAX,USPS,Hand-delivered Print name of authorized Agent of the!HD Signature of authorized Agent of the.!HD Dote ❑ COMPLETE Based upon review of information submitted in the Section above,this Authorization to Operate is hereby issued in accordance with G.S. 130A-336.2(m). A copy of this complete NOI/ATO with tracking information was sent to the State on via Date Email,FAX,USPS,Hand-delivered 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 ATO submission,the owner may apply to the local permitting agency for permanent electrical service too residence,place of business or place of public assembly pursuant to G.S.130A-339. DHHS/EHS/05WP—LSS C-19 COMMON FORM Updated April 2022 Page 6 of 6 ��1 THOMP-0 OP ID:D2 ACOROp CERTIFICATE OF LIABILITY INSURANCE D09/28/202 ATE IMM1DDNYYY) fir" o9r2sr2o21 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 endorsemenL A statement on this certificate does not confer rights to the certificate holder In Ileu of such endorsement(s). PRODUCER 918-779-7880 ACT David Vaughan Vaughan Insurance Group, LLC PHONE 918 779-76130 I FAX 918-779-7885 PO Box 52534 No,E:t1: (A/C,No): Tulsa, OK 74152-0534 wiess:dIvjr@higginbotham-net David Vaughan INSURER(S)AFFORDING COVERAGE NAIC* INSURER A:Mid Continent Casualty Company 23418 INSURED Thompson Environmental INSURER B:Hartford Underwriters Ins Co 30104 Consulting, Inc. INSURER C: PO Box 541 Midland, NC 28107-0541 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 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. INSR cm OF INSURANCE ADS SUER POLICY NUMBER POLICY EFF POLICY EXP LIMITS L INSD WVp (MM100lYYYY1 ININN O1b'VM1 A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE ITC OCCUR 04-GL-001067648 09/25/2021 09125/2022DAMA'E TO RENTED 100,000 PREMISES fEa necurreneel $ MED EXP(Any one won) $ EXCLUDED A X Professional Llab 04-GL-001067648 09/25/2021 09/25/2022 PERSONAL&AOV IruuRY $ 1,000,000 GENL AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 3,000,000 X POLICY P LOC PRODUCTS-cce cP AGG $ 3,000,000 OTHER $ AUTOMOBILECOMBINED SINGLE LIMIT LIABILITY (Ea accident) $ ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOSpN p pBRODILY INJURY(Per eccadenf}1 uTOS ONLY _-AllrO�Y (Per accmenll GE $ _ $ UMBRELLA LIAB — OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ OEO RETENTION $ $ B'AND EMPLOYERS'LIABILITY WORKERS COMPENSATION X STATUTETH- O ANYPROPRIETORIPARTNERIEXECUTIVE YIN 38WECNW6175 10/17/2021 10/17/2022 E.L.EACH ACCIDENT $ 1,000,000 QpFFFICER BER EXCLUDED? N N I A - (Mend ory NH) E L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes.descnbe under 1,000,000 DESCRIPTION OF OPERATIONS below E L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS f VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached IT more space Is required) CERTIFICATE HOLDER CANCELLATION FORIN-1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN For Informational Purposes ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25(2018/03) O 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Residential Subsurface Wastewater Treatment and Disposal System COVID-19 Proposal for Lot 19 — Heaven Sent 3102 Jenny's Lane Newton, NC 28658 Tax Parcel Number: 364820816846 July 28, 2022 Prepared for: t,D SOIL sc`� OcNo „� ��ys Four Corners of Charlotte LLC .ti° - 1612 Seattle Slew Court � ol Waxhaw, NC 28173 ��. ,�•;, '` � 704-713-2602 187 2a7 Prepared by: �``<<�ti��uiin,i.++++1f '`` 0tCAR Larry Thompson, REHS, LSS p •• ISASTFge0• Thompson Environmental Consulting, Inc. �. PO Box 541 = SEAL i Midland, NC 28107-0541 = 'o 1208 Phone: 704-301-4881 Larry@thompsonenv.com %�-'••.;�[H.�A�-•..• ,��.•`� 1 3102 Jenny's Lane Details The following wastewater treatment and disposal system proposal is submitted to Catawba County Environmental Health (CCEII) at the request of Four Corners of Charlotte, LLC. This proposal is to construct a new 3-bedroom single family residence on Lot 19 — Heaven Sent, 3102 Jenny's Lane, Newton, North Carolina. The residence will be served by a private well. Based upon a soil and site investigation performed by Thompson Environmental Consulting, Inc. (TEC), as well as a separate evaluation performed by TEC, it has been determined that there is a sufficient amount of"Suitable"Group IV soils available for the installation and repair of a Gravity-Flow Prefabricated Permeable Block Panel System (PPBPS) at a 0.25 GPD/sq. ft. long-term acceptance rate (LTAR) for the 3- bedroom residence. The enclosed Licensed Soil Scientist Evaluation is being submitted pursuant to and meets the requirements of SL 2020-97 Section 3.19. Four Corners of Charlotte, LLC would like to request that Catawba County Environmental Health(CCEH) issue the appropriate permits for a subsurface wastewater treatment and disposal system based upon the enclosed LSS COVID-19 permit option. Location From Newton, take St. James Church Road to Kathy Street. Turn right onto Kathy Street and left onto Jenny's Lane. Lot is located on the left in the cul-de-sac. References Laws and Rules for Sewage Treatment and Disposal Systems, 15A NCAC 18A, Section .1900, Department of Environment and Natural Resources, Division of Environmental Health, On-Site Wastewater Section, April 1, 2017. Design, Installation and Maintenance of the T&J Panel Wastewater Treatment System; Sixth Edition, published by T& J Panel. Primary Investigator's Credentials NC Registered Sanitarian No. 1208 NC Licensed Soil Scientist No. 1287 SC Professional Soil Classifier No. 11 I NC Subsurface Septic System Operator No. 22199 NC Grade IV Wastewater System Installer/Inspector No. 1762/17621 2 3102 Jenny's Lane This proposal is for a gravity flow pre-fabricated permeable block panel system meeting the minimum setbacks for this lot. Exceptional care should be taken to protect the drainfield area from all forms of encroachment throughout the life of the project. TEC recommends protecting the system area with orange barrier fencing. Plumbing from the house must be held high to prevent the need for a pump. Plans and Specifications A. Septic Tank 1. The septic tank shall be State approved (Section .1953 of 15A NCAC 18A), watertight, structurally sound, and 1,000 gallons in capacity(minimum). 2. The septic tank will be fitted with an approved effluent filter and riser for easy access and periodic maintenance. 3. It is the responsibility of the septic contractor to thoroughly inspect the septic tank prior to accepting delivery to assure that the tank has had time to properly cure and is free of cracks or other structural deficiencies. B. Pipes and Fittings 1. All discharge piping, connectors and supply lines should be made of SCH 40 PVC. 2. All joints must be properly "welded" utilizing the appropriate PVC cement for each application. C. Distribution Method 1, Individual drainlines shall be evenly fed via a distribution box. 2. Distribution box shall be water tested for equal flow at the time of the final inspection. D. Backfill 1. Backfill sand shall be clean, washed, medium sand that is naturally occurring and falls within the gradation of ASTM C-33 specification (used in the ready-mix industry and is readily available). Properly compact backfill to provide the intended subgrade support. E. Drainfield Installation 1. The drainfield and the proposed septic tank location have been marked on-site utilizing metal stemmed flags. Once this area has been approved by the county, the property owner/builder should mark this area and isolate it as much as possible from construction traffic. Prior to the system installation, the septic contractor shall contact the designer for a preconstruction conference at which time the drainfield area will be re-verified. 3 3102 Jenny's Lane 2. Under no circumstances shall any construction take place within the drainfield area while the soil is in a wet condition. If the installer has doubts as to whether or not the drainfield area is dry enough to begin construction, the environmental health specialist for this area should be contacted for permission to proceed with the installation. 3. The specified system is a Type V(e) pre-fabricated permeable block panel system — specifically the horizontal prefabricated permeable block panel system manufactured by T&J Panel Wastewater Treatment System, Patent No. 4013559; telephone: 1-800-222-2577. The installer must follow the manufacturer's guidelines for installing the T&J Panel System and should request an installation manual from the manufacturer prior to beginning construction. 4. The initial drainfield consists of four (4) laterals constructed 2-feet wide by 67- feet in length. 5. It is essential that the lateral trenches be constructed on contour with the land, with each trench being excavated level from beginning to end. The use of a tripod mounted engineer's level is essential to assure that each trench is constructed as level as possible. 6. The maximum trench depth for this system shall be 28-inches (high-side). Each trench shall be placed on a minimum of 8-foot on centers. 7. Once trenches are dug, the side walls shall be raked, and a light dusting of lime applied. 8. Backfill the trench with 7-inches of sand and level to grade properly compacted to intended subgrade support. Once leveled, place 1 x 4 or 6-inch boards on top of the sand the entire length of each trench. Once the grade boards have been set, the panels may be set into the trench. The panels should be placed 6 inches apart. 9. Once the panels have been set, line the top portion of each chamber with the T&J supplied sand alternative product(SAP —geotextile fabric). GE Foam Sealer or tar seal rope should be placed in the bottom of the"U"outs to form seals around the pipe as shown in earlier drawings. 10. Tar seal rope, or approved foam, should be placed in the "U" outs of each end of the panel to form seals. Once the tar rope is in place, the l'/4 inch Schedule 40 PVC connectors can be added, and the seal completed by the addition of more tar rope on the top and sides of the pipe. Now that the connection and seals are complete, a block cap is placed on each end of the panel so that all openings are covered. 1 1. Once the lateral has been installed and the panels closed, the trench is ready to be backfilled to the top with the sand used in the trench bottom. At this point, the trenches should be left open for the final inspection by the LSS. F. Final Landscaping 1. The drainfield shall be shaped to shed rainwater and be free from low spots. 2. Minimum cover requirement over the drainfield area is 6-inches. 3. The entire area of the drainfield should be planted with grass as soon as possible to prevent erosion. The soil should be properly tilled, limed (if necessary) and 4 3102 Jenny's Lane fertilized prior to planting. After applying grass seed, the area should be heavily mulched with straw or other suitable material. G. Utility/Drive Conflicts 1. The builder and property owner must take special care in planning for utilities (water, power, gas, telephone, cable lines, etc.). All utilities shall be kept clear of the septic system and its proposed repair area. Improper planning for underground utilities can negatively impact the installation and, in some cases, cause irreparable damage and permit revocation. 2. Water lines must be kept at least ten (10) feet from any portion of the septic system. 3. Irrigation systems should not be placed in the drainfield area. 4. The builder must also take special care in planning for a drive into the property. The driveway must be installed along the property sideline to allow enough clearance for the proposed repair drainlines. The driveway must be constructed at- grade without cuts or excavations. 5. The entire drainfield area shall be delineated with orange barrier fencing throughout the construction process to protect it from unnecessary encroachment. Maintenance H. In General 1. The homeowner must maintain the drainfield area through periodic mowing. The drainfield must not be allowed to become overgrown. 2. The septic tank should be pumped every 4 years or when the solids within the septic tank reach an elevation that is equivalent to 25 percent of the volume of the tank. In some situations, the tanks may need to be pumped more frequently. If using a garbage disposal, it is recommended that the homeowner has the septic and pump tanks cleaned out annually. 3. Use of a garbage disposal is not recommended. Solids added through the garbage disposal tend to degrade at a very slow rate. 4. Grease, cooking oils, coffee grounds and non-degradable solids (disposable diapers, cigarettes, and solid paper wastes) should never be put into a septic tank. 5. Used motor oil or any oily liquids should not be disposed of in a septic tank. 6. Be aware of the amount of water that you are using in your home. Water saving fixtures and devices can be installed on sinks, toilets, and showers to reduce the volume of wastewater that you are sending to your drainfield. 7. Run dishwashers and washing machines only when you have a full load. 8. Repair leaky faucets and toilets. Small drips equal large volumes of water over time and can over burden your drainfield. 9. Do not use chemical additives in your system. Studies have indicated that they do not increase the biological activity that naturally occurs in the septic system and in some cases certain additives have been found to be detrimental to the life of a system. 5 3102 Jenny's Lane Design Specifics Daily Design Flow: 360 GPD Septic Tank Size: 1,000 Gallons Effluent Loading Rate: Design =0.25 GPD sq. ft. (50 %reduction - PPBPS) Drainfield Type: PPBPS Number and Size of Drainlines: (6) 2' Wide x 40' Long Maximum Trench Depth: 28 Inches (high-side) Drainline Spacing: 8 Foot on Centers Total Length of Drainline: 240 Feet Total Number of Panels: 54 Repair Specifics Effluent Loading Rate: Design = 0.25 GPD sq. ft. (50 % reduction -PPBPS) Drainfield Type: PPBPS Distribution Method: Pressure Distribution Required Linear Footage: 240 Feet Available Linear Footage: 240 Feet Maximum Trench Depth: 28 Inches (high-side) *See septic layout for site locations and additional details. 6 `"� PS_d9 PG 45 PID#364$-20$1-5749 co ZONE: R-40 IA .,./ •RF #6 LOT 20 -cli e/,/ 76''. --N ---__ \ 0 / ill0' // - /1.Gk.,' bt2 y IRF #6 riss tx w .,, / / ::, 421i, Nxi. SO- N4/4,,t. IPS #4 AW, 0 G' ,� `Pei , c., s S ` 7/ G ea / dd. 4y O, \ T • Nks, 0 * Ic, Gi / / 4R #6 $, NATHALIE 'ZL s� IRF . tx7 49 4._ 1 I $. 4 liP W Q ` �• lie• 0� 4..6i\ ='r, IRE 4,/ 1/4 s4r / t� ` '• S di ` � DcQ , s6 w�'� I LEGEND ct, �% c� h Z. GIS 2-ft Contour Lines lSPO �Q I o • Existing Wells ��� fB3 .�50-ft Existing Well Buffer , . . a ,' • Proposed Well Location0 I 7 . � 50-ft Well Buffer �` U a v House Box lip66 01 �tv � 11111 Septic Tank 39'rssi " so so° A 3 . Supply Line / ri) ii PPBPS Drainlines •••• PPBPS Repair Lines IRF #6 L_ 1RF #4 • Soil Boring Locations NT Date: Proposed Septic Layout March 2022 Figure Thompson Prepared For: Environmcnt� Lot 19- Heaven Sent Scale: suiting Four Corners of 3102 Jennys Lane o 15 30 ft Charlotte LLC Newton, NC 28658 TEC Job#: Catawba County 22-66 f �..�r . ' 1 Thompson Environmental Consulting, Inc. -..+.' ; sheet 1 of I PO Box 541 ,+ PROPERTY ID 1: 4 2-2-,Z,I Ltzgla Midland,NC 28107 •�'; 'qk; COUNTY: [ f..rtt L Ydc� .''r .t.: .!SITE EVALUATION j, • for ON-SITE WASTEWATER SYSTEM OWNED ). ADDRESS: i( e 'Sic:.( /\Ar�.L1F> ,il)C 2 Z c DATE EVALUATED: ' i PROPOSED FACILIT r� PROPOSL`9.QESIGN FLOW(.1949): PROPERTY SIZE: Can. LOCATION OF SITE: (cj \.fx,, -�...P e_( •kpn, PROPERTY RECORD D: WATER SUPPLY: Private Public i- +ell 0 Spring 0 Other EVALUATION METHOD: Auer Boring ❑Pit 0 Cut TYPE OF WASTEWATER: ,Sewage 0 Industrial Process 0 Mixed r R SOIL MORPHOLOGY OTHER F (.1941) PROFILE FACTORS I. .1940 I: LANDSCAPE HORIZON POSITION/ DEPTH 1942 PROFILE H SLOPF.% (11`44 .1941 .1941 SOIL .I943 .1956 .1944 CLASS STRUCTURE/ CONSISTENCE/ WETNESS/ SOIL SAPRO RESTR &LTAR f �T�EfXTURE MINERALOGY COLOR DEPTII CLASS NORIZ eje 1 / G /� 6,2 T5 D . 1 z c rr7/4-1/ i --e5 t 52 -� ctl r . ' 3 ' l L , r (iT)4 .-,i.J 1,-._. . ,.., _ e_ „,, pV ....''''...-' •*".-- CL, f 4 DESCRIPTION INITIAL SYS'I1:M REPAIR SYSTEM OTHER FACTORS(.1946): / ' O SO+I S SITE CLASSIFICATION(.1948): .,•,., _ ''fig. ¶14• . _ Availabk Specs(.1945) � _ / , • S+ Y Type(s) � a0 EVALUATED BY: ,- r - a t.."`,':•:YikrAi;`` 1. System T s ,> OTHER(S)PRESENT: �.� f ": , . • a Site LTAR r h- 2, ��•' D•�zs r7 2�� � ;�_. 1 COMMENTS: Updated February 2014 ' •a LEGEND —- -- -- -- - use the following standard abbreviations SOIL CONVENTIONAL LPP MINERALOGY/ LANDSCAPE POSITION GROUP TEXTURE ,1455 LTAR" ,1457 LIAR* CONSISTENCE ,STRUCTURE CC(Concave Slope) I S(Sandl 12-0 R 0.6-0.4 SIiXP(Sleghlly Expansive) G(Single Grain) CV(Convex Slope) I.S(Loamy Sand) fiXP(Expansive) M(Massive) D(Drainage Way) CR(Crumb) DS(Dcbns Slump) II SL(Sandy Loam i 0 S-0.6 0.4-0.3 . GR(Granular) FP(Flood Plain) L(Loam) SBK(Subanguler Blocky) FS(Foot Slopel ABK(Angular Blocky) H(Head Slope) III Si(Silt) 0 a-o.3 0.3-0.15 PL(Platy) I.(Linear Slope) SiCI.(Silty Clay Loam) PR(Pnsmatle) N(Nose Slope) CL(Clay Loam) R(Ridge) SCL(Sandy Clay Loam) MOIST W.LI S(Shoulder Slope) SiL(Silt Loam) T(Terrace) VFR(Very Friable) NS(No..rrickyl IV SC(Sandy Clay) 0.4-0 I 0 2-0.05 FR(Friable) SS(Sliandy Sticky) SIC(Silty Clay) Fl(Fin) S iSnelry) C(Clay) VI1(Very Finn v Very Sticky) VS(Very Sticky O(Organic) None None EFl(Extremely Flm) NP(Non-plaulc) SP(Shahtly Plastic I *Adjust LTAR due to depth,consistence.structure.soil wetness.landscape,position.wastewater flow and quality P Mastic) dgnil VP(Very Mum) HORIZON DEPTH In inches below natural soil surface DEPTH OF FILL In inches from land surface RESTRICTIVE HORIZON Thickness and depth from land surface SAPROLITE S(suitable)or INunsuttable) SOIL WETNESS Inches from land surface to free water or inches from land surface in soil colors with chrome 2 or less-record Munsell color chip dcstgnanon CLASSIFICATION S(Suitable),PS(Provisionally Suitable),or II(Unsuitable) Evaluation of saprolite shall be by pits Long-term Acceptance Rate(LIAR):gal/day/IV Show profile locations and other site features(dimensions,reference or benchmark and North). L'6 - -ca t l Ipdated February 20I4 NOTES: LEGEND s, I.APPARENT SOURCE OF TITLE: NJ LOT 19.RECORDED IN PLAT BOOK 49 PAGE 45.(CATAWBA COUNTY REGISTER a .•HG OF DEEDS)PARCEL IO/36415-2061-6846(3102 JENNY'S IN) QIRF IRONRODFOU14p {• 2.AREA CALCULATED BY COORDINATE GEOMETRY METHOD. IPS IRON PIPE SET CO TOTAL LOT AREA 22,210 sg11/0.510 acre.. A UTILITY POLE 3.SUBJECT TO R-441 ZONING REGULATIONS. PROPERTY USE 4. MINIMUM SETBACK 30' — — LINES NOT SURVEYED MINIMUM SIDE YARD 15' SETBACKS 44Or —— MINIMUM REAR YARD 30" '� —NW-- RICH'OF WAY 'a 5. THIS PARCEL MAY BE SUBJECT TO EASEMENTS AND/CR R/NTS g SITE EITHER RECORDED OR IMPLIED. A COMPLETE AND FULL TITLE SEARCH WAS —0— UNDERGROUND GAS LINE NOT PERFORMED FOR THIS SURVEY, 6.NO PORTION OF THIS PARCEL UES THIN A COMMUNITY OR FEMA FLOOD — — s7ONr3DRUSUNe WI VICINITY MAP LONE PER FIRM#3710364600.1 GATED SEPTEMBER 5.2007. —DRIP— OVERHEAD WIRES MO,To SCAM N.G.S.'ROWDY' ••••SUPERINTENDANT TO 4 STATE PLANE COORDINATES VERIFY ALL DIMENSIONS N-668561.97 PRIOR TO CONSTRUCTION•••• E-1349155.07 N.A.D. CURVE TABLE COMBINED FACTOR:0.99885528(71EI CURVE LENGTH RADIUS DELTA TANGENT CHORD BEARNG CIAug50.00 M'31y7• 21AY 39.4w KU'IADL'E C`AugI INI C2 20.91' 25.00 47.58'46 ,1,11' 21.31' 130.5.5172 IF C3 58.24' 172.50' I cH2D37' 29.40' 57.98' WS-1 45T ry p I� '� Nrr In JROBERT C ALLEN / OB.3630 PG.1209 +, PB.49 PG 45 / PIDM 364&2061.5749 a• ZONE:R 40 IRF#6 LOT 20 1/4.• L : • ' rs`C9 (rti\ ¢Qi 4' ,yyce�y IRF#6 �••. G � 25Q\ / C\ sy,, ¢, IPS#4 N. / EJ,' O a pA/ a•D,,,.., „. �yd '50- tie ' l qd /1 1. IRF#6 Np$ NAT ALIETHE 9� b\ IRE#6 N20°46'43"E a tiF A 4j 20.23(TIE) IRF#4 ` 6 '� . \ 4;26,/ 1 -..., /V4"S LOTTO22.210 SO.FT \ ~ ` `a1, ". 0.5,0 AC. 3wi nco C 4 iF ROB eR3aC.�EF ,a \ i. /1iJt PIDM 9.49 G ST4B ,�89 \ t ` ZONE.R-O0 40 / LOT 18 t� `70 1 A,.. h r � , oT, e A�3414.1 i' 1.�am ' IRF#6 IRE#4 / ' Nil MALINOA HART DAY DD JOBS PG.862 PH 182 PIDM 10 3 ZONE: 200NE:R-405 R-40 GRAPHIC SCALE ' 50 0 25 50 — / ( IN FEET ) II THIS PLOT PLAN DOES NOT REPRESENT A 1 in - 50 ft. LAND SURVEY,WAS NOT PREPARED FOR RECORDATION, AND IS NOT SEEABLE FOR DEEDING OF PROPERTY. 3 PLOT PLAN AT REQUEST OF FOUR /¢ CORNERS OF CHARLOTTE LLC: 3102 Jenny's Lane CLAREMONT TOWNSHIP.CATAWBA COUNTY.NC THIS IS AN EXISTING PARCEL OF LAND WITHIN A MUNICIPALITY DATE: JUNE 18, 2022 THAT REGULATES PARCELS OF LAND. SCALE./5050' PROJECTS:1091-0002 I CERTIFY THAT THIS MAP DRAWN UNDER MY SUPERVISION FROM AN ACTUAL SURVEY MADE UNDER MY SUPERVISION (DESCRIPTION RECORDED IN DEED BOOK 2913 PACE 676); THAT THE BOUNDARIES NOT SURVEYED ARE PROPERTY OWNER: INDICATED AS DRAWN FROM INFORMATION IN PUT BOOK 49, PACE 45: DANIEL McREE AND SANDRA McREE THAT THE RATIO OF PRECISION OR POSmONAL ACCURACY IS 1:10,000; AND DB.2913 PG.676 PB.49 PG.45 THAT THIS MAP MEETS THE REQUIREMENTS OF THE STANDARDS OF PRACTICE FOR LAND SURVEYING IN NORTH CAROLINA (21 NCAC 50.1600). SUBJECT TRACT PID#3648-2081-6846 THIS I6TH DAY OF JUNE, 2022. PRELIMINARYSURVEY PROVIDED BY! — (rnodv!A,�cr JUUA A. McDONALO REGISTRATION (I L-3617 3556-A CENTRE CIRCLE •e,•• ,• FORT MILL. SC 29715 844-865-5263 C-4291 A# THIS IS NOTA PERMIT Case# RBPR-07-2022-41722 CATAWBA COUNTY HEALTH DEPARTMENT PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES 8 SIJ Residential Building Plan Review- Building New I IMPROVEMENT- AUTH CONST- NEW WELL �I1 �ZZ Rsed — - Contractor 'VICTORY BUILDERS,LLC (DANIEL HAMILTON),3281 KEADY MILL LOOP,KANNAPOLIS NC 28081 B:70470104I8 C:7047013189 VICTORYBUILDERSLLC a GMAIL_COM Owner FOUR CORNERS OF CHARLOTTE LLC, 1612 SEATTLE SLEW CT, WAXHAW NC 28173 C:704-713-2602 ROMELLE03(i-YAHOO,COM NAME TO APPEAR ON PERMIT *Victory Builders, LLC (Daniel Hamilton) SITE ADDRESS: 3102 JENNYS EN,NEWTON NC 28658 PIN# 364820816846 NAME of SUBDIVISION: HEAVEN SENT Lot a_ 19 Section/Block PROPERTY SIZE: Square Feet Acres 0.5 DIRECTIONS: Right off of St James Church Rd onto Kathy St.Left onto Jennys Ln.5th lot on left. PRIMARY CONTACT: Contractor SEWER TYPE: Septic Tank GALLONS PER DAY: 360 WATER SUPPLY: Private Well C BE WORK: 8/1/2022 REVISED TO COVID 19 SUBMITTAL REFUND AC BACK TO COVID FEE(-$60). PREVIOUS DESCRIPTION: DENIED**SESSION LAW 2022-11**IP/AC/New Septic/New well/360 GPD---New 58x34, 3 bedroom single family dwelling I no basement SITE INFORMATION Do any of the following apply to the property for which this application is applied? If the answer to any of the questions below is"YES",then supporting documentation is required: Does this site contain any jurisdictional wetlands? No Does this site contain any existing wastewater systems? No Is any of the wastewater going to be generated on the site other than domestic sewage? No Is the site subject to approval by any other public agency? Yes Are there any easements or right-of-ways on this property? No APPLICATION FOR: New Structure STRUCTURE TYPE: PRIMARY RESIDENCE FACILITY TYPE: Single Family Residence OTHER DESCRIPTION: DESCRIPTION OF EXISTING STRUCTURES ON SITE(IF ANY) DIM EXISTING STRUCTURE: NUMBER OF EXISTING BEDROOMS: #OF OCCUPANTS: 4 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 58x34 sfd #OF NEW BEDROOMS:: 3 Desired system types(Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: CONVENTIONAL: OTHER: INNOVATIVE: ANY: YES Other described: APPLICATION FOR WELL CONSTRUCTION PROPOSED WELL TYPE: Individual Well REPLACE WELL?: NO r,i...: 08/01/2022 15:32 Page I of 3 Catawba county public health AUTHORIZATION OF REFUND Date: 8/1/2022 Case#: RBPR-07-2022-41722 Applicant: Daniel Hamilton - Victory Builders LLC Refund Amount: S60.00 Refund Reason: Revised to COVID 19 submittal. Authorizing Signature: . 11/W` ��'y✓� Received By Staff: LtllL Date: <611 7L catawbacountync.gov Environmental Health Catawba County Government Center 25 Government Olive I PO Box 389 I Newton NC 28658 1828.465.8270 MAKING. LIVING. BETTER. Catawba County, North Carolina - Disbursement Voucher Vendor No. Date: 8/1/2022 Make Payment To: G Voucher No(s) Daniel Hamilton �'11�,x Victory Builders LLC d �.►� y 3281 Keady Mill Loop v Kannapolis, NC 28081 1$4� ATTACHMENT Prepared by: Julia English Description Amount Application revised to COVID 19 submittal $60.00 Sub-Total Food Tax Sales Tax Total $ 60,00 For Accounting Use Fund Cost Center Object Project Amount Only 110 580200 663000 Iota' • The undersigned hereby certifies that the goods or services specified above have been received or performed. Payment has not been previously authorized and this expenditure is a proper charge to the appropriation indicated. The above charge is certified to you for payment. (SIGNATURE-APPROPRIATE OFFICIAL) �$A CATAWBA COUNTY �" "}� 100A SOUTHWEST BLVD �' + NEWTON,NORTH CAROLINA 28658 RECEIPT U Cr* ,.., PHONE:828.465.8399 JMonday,August 1, 2022 1$t}Z sM www.catawbacountync.gov PAYOR: `Victory Builders, LLC *Victory Builders,LLC(IlamiIton,Daniel) PAYMEN'I'S TRANSACTION NUMBER: TRC-44506637-01-08-2022 PAYMENT DATE: 08/01/2022 PAYMENT TYPE: DV INVOICE NUMBER ACCOUNT FEE NAME FEE AMOUNT 07-22-409401 110-580200-663000 Authorization to Construct Fee(N (S60,00) ew/Expansion)Fee TOTAL PAYMENTS: ($60.00) RBPR-07-2022-4 1722 CASE TYPE: Residential Building Plan Review WORK CLASS: Building New SITE ADDRESS: 3102 JENNYS LN,NEWTON NC 28658 Owner FOUR CORNERS OF CHARLOTTE LLC, 1612 SEATTLE SLEW CT,WAXHAW NC 28173 C:704-713-2602 ROMELLE03@YAHOO.COM Contractor *VICTORY BUILDERS,LLC,3281 KEADY MILL LOOP,KANNAPOLIS NC 28081 B:7047010418C:7047013189 VICTORYBUILDERSLLC@GMAIL.COM **NO PEOPLESOFT ACCOUNT ASSIGNED** receipt 08/01/2022 15:24 Pagc 1 of 1 catawba county public health 7/28/2022 Four Corners of Charlotte LLC 1612 Seattle Slew Ct Waxhaw, NC 28173-6642 Re: Application for Improvement Permit and Authorization to Construct for 3102 Jennys Ln, Newton,NC Health Department file number RBPR-07-2022-41722 Dear Sir: The Catawba County Health Department, Environmental Health Division on 2/7/2019, evaluated the above referenced property at the site designated on the plat/site plan that accompanied your Improvement Permit application. According to your application the site is to serve a 3-bedroom home with a design wastewater flow of 360 gallons per day. The evaluation was done in accordance with the laws and rules governing wastewater systems in North Carolina General Statute 130A-333 including related statutes and Title 15A, Subchapter 18A,of the North Carolina Administrative Code, Rule.1900 and related rules. Based on the criteria set out in Title 15A, Subchapter 18A, of the North Carolina Administrative Code, Rule.1940 through .1948,the evaluation indicated that the site is UNSUITABLE for a sanitary system of sewage treatment and disposal. Therefore, we must deny your request for an Improvement Permit. A copy of the site evaluation is enclosed. The site is unsuitable based on the following: Unsuitable soil topography and/or landscape position (Rule.1940) X Unsuitable soil characteristics(structure or clay mineralogy) (Rule .1941) Unsuitable soil wetness condition (Rule.1942) Unsuitable soil depth(Rule.1943) Presence of restrictive horizon (Rule.1944) X Insufficient space for septic system and repair area (Rule.1945) X Unsuitable for meeting required setbacks(Rule.1950) Other(Rule.1946) These severe soil or site limitations could cause premature system failure, leading to the discharge of untreated sewage on the ground surface, into surface waters,directly to ground water or inside your structure. The site evaluation included consideration of possible site modifications, as well as use of modified, innovative,or alternative systems. However,the Health Department has determined that none of the above options will overcome the severe conditions on this site. A possible option might be a system designed to dispose of sewage to another area of suitable soil or off-site to additional property. catawbacountync.gov Environmental Health Cc.tcwhc County Government Center 25 Government Drive ( PO Box 389 I Newton NC 28658 1828.465.8270 MAKING. LIVING. BETTER. Page 2 For the reasons set out above, the property is currently classified UNSUITABLE,and no improvement permit shall be issued for this site in accordance with Rule.1948(c). Note that a site classified as UNSUITABLE may be classified as PROVISIONALLY SUITABLE if written documentation is provided that meets the requirements of Rule.1948(d). A copy of this rule is enclosed. You may hire a consultant to assist you if you wish to try to develop a plan under which your site could be reclassified as PROVISIONALLY SUITABLE. You have a right to an informal review of this decision. You may request an informal review by the soil scientist or environmental health supervisor at the local health department. You may also request an informal review by the North Carolina Department of Health and Human Services regional soil scientist. A request for informal review must be made in writing to the local health department. You also have a right to a formal appeal of this decision. To pursue a formal appeal,you must file a petition for a contested case hearing with the Office of Administrative Hearings, 1711 New Hope Church Rd, Raleigh, NC 27609. To get a copy of a petition form, you may write the Office of Administrative Hearings or call the office at 984-236- 1850 or download it from the OAH web site at http://www.oah.nc.gov. The petition for a contested case hearing must be filed in accordance with the provision of North Carolina General Statutes 130A-24 and 150E-23 and all other applicable provisions of Chapter 150B. N.C. General Statute 130A-335 (g) provides that your hearing would be held in the county where your property is located. Please note: If you wish to pursue a formal appeal,you must file the petition form with the Office of Administrative Hearings WITHIN 30 DAYS OF THE DATE OF THIS LETTER. The date of this letter is 7/28/2022. Meeting the 30 day deadline is critical to your formal appeal. If you file a petition for a contested case hearing with the Office of Administrative Hearings,you are required by law(N.C.General Statute 150B-23)to serve a copy of your petition on the Office of General Counsel, N.C. Department of Health and Human Services, 2001 Mail Service Center, Raleigh, N.C. 27699-2001. Do not serve the petition on your local health department. Sending a copy of your petition to the local health department will not satisfy the legal requirement in N.C. General Statute 150E-23 that you send a copy to the Office of General Counsel, N. C. Department of Health and Human Services. You may call or write the local health department if you need any additional information or assistance. Sincerely, 44.,(4/- Robert Phelps, REHS Environmental Health Supervisor Enclosures: Site evaluation Rule.1941, .1945, .1948, .1950 DEPARTMENT OF HEALTH AND HUMAN SERVICES Slieti of DIVISION OF PUBLIC HEALTH,ENVIRONMENTAL HEALTH SECTION PROPERTY ID IP ON-SITE WATER PROTECTION BRANCH COUNTY: Catawba SOIIJSTFE EVALUATION for ON-SITE WASTEWATER SYSTEM (Complcte in&kis in full) OWNER: _ APPUCATION DATE ADDRESS: DATE EVALUATED:a;9411 PROPOSED A : PRO ESION W(.1949): PROPERTY SIZE: - LOCATION OF STTE: • PROPERTY RECORDED: WATER SUPPLY: 0 Prime D Public 0 Spring 0 Other EVALUATION METHOD: 0 A ,- Emilia 824(ft 1 Cut TYPE OF WASTEWATER: ILloviagc Li Industrial Pros 0 Mimi t•; .:.;:Ik.T..7::1'.!rr' Z1.17717Afi ,''"Nc'''n ;5V4r2:-W.;-i71T:47Ff44t4,47A1W'fV'..'v• -:--FNER4:1"'77-KA.11•N v ...z.„ei,....,i-it,,it ;Ti,,;,-, -,, -.1N/; .‘ *ct.t'r,vi1/414;,,A-,•,..leMr ,"• -•;.J. :., '..,.%ls-11-14?-,.. Itrw,-`,4 i_`.,•''' r' V'• p f-11 ' 0'I: "*I:1,': '•• .•*'-i,TP•I'''0 •7)•Cis Y ,... , ' /I'.'.1:3)47,-* •,, L't,.. ..' -,.i.;'5'17ip, !r=1. ; .,. ..i= .',)-ix• f‘ '-',,v'' n.._.. .. - ,,*.. ., „..,,v,..T., ..., ?- 4,i.'41 '-.11',:-.,i,Ar .4,744_1 1 '2:;,14Eti.41;,• ;k:1, iy. • !rt,A,`7, ,,,,xt'e 1.-Ir''1 r 4 4 1121. . If-itt-6it ..!, -,.....re.17.4..c...,/,I,..:,45.4. ..m,b.,. ',1.):i.4 •:"'4.! r_:";4...' 1%.:Yi,*,' is',,' ,',.p.., '••-• hi v. .'14- irg,,,ri le,',--lc ,, .1 10-,,,,' '''t3t4-',5"-: +;17,-1," . ‘^i'V•k$131±44-:04 d 'ii.:F.^..i. 1. l'f,,f'1;'31';,f1 '•,..1C..,14 ..:1__..___ V :il"f•..es t. .__'‘FN:1-, .2.--AVLIA.,44-11AL:'1,-. .E`,'IO5A "It 0..!, 'c41,5iA.,144.„:,24-;ipsi ,) )1 :,:: ;Ill...J..4,• riP',7-' :-,--:,9; ,,,,IF-,-Tiree7--zil,•::- ,-7,. 1-1, :41.•41,.c„.1- riur4j,r,.77.,;"4"-Fr-:-''ii,it :11,7 c i 1,tri)'::: !,.:;(,,,:,,4114,!:,.,,ei.4., z-,k ‘: • „ , g• klj i A -.::., ,,.,,,, .,1••• r•V • ..t."-N: m't r-it. .w.. - ,-•Frqs,) -11 t ..,,-. 7.'.•••-11''ft k ...,..,.....,1,... -xis' ln-17,-r, f04- i,k44. 1,04)-,,.-' :``Znsol. teN: ,i. t4-• -IV.:J 44a - -,..:.:.•.• c•• 0:ytA i •&1•4,‘'it f..-A4 --• • .!• - ;V_ `:',n, ' c?..it'•ik„,•1,.,;inz:i'=:•,47:1 .f.,...):i.,4‘1.t;.12,•,,,14.1.q,-ed,-/... ..,,-.,,:..,..:4,a. _,-. . .:10.-:•A'.' '.!,:el,.: 1 '•: Ili :..a* 14 1.1 .‘4kW::1.111'. e...*'11.2. 4.1V.tri;.1';11:-e-4 'ilt?:QAPe;r4 P.:4 iiile..P.r•16!..- --e'r.04211,1-tiil,....rfs!! 4(.... 4 ;.---, , ...= ‘,14; I.' ,. 0-3 MEilli=6MI xfli A , -,,, , NMI WiMPAINM riiik") IA , I 36 =awn/1mM! Min A4v4e,- 6 c Peri • .—16 PIIIIENIME211 .#416 /0 5iii MILINEMPJ111M 2 Li/LTA M I M.1 ia _ef.- :1 I I #. 2 lo 169 Eggirtievi-e-r- ifb- - dy 0-)6 PAM. - bE • 15 la it ninirdirraMirAll # 9--+o lerf . 3 MaireZ21 ft' - Ai f-b-e- gtp '11,-6 raiMinMil II rligrallEIRIMPRAI 6115 '16 I/ PAM PARM:MEPAI . - .-c)) 7 4 ;rlin Jr4IMMILMFAII 1-dc OFSII L-0•‘-r an,ip. IIIIM DESETUETION NATAL SYSTEM RENUI SYSTEM OTHER FACTORS(.1946): Monads L SPeor(194 5) i5 (.1,5 SITE CLASSIFICATION(.1948): 1J 5 EVALUATED BY: ke- 1L----4--iii .ell. Atine1:7• System Type(s) OTHER(S)PRESENT: Sits LTAR i iS 1 I • _ COMMENTS - upthicrifictwum7 2014 .. . . . • • . .. . DEPARTMENT OF HEALTH AND HUMAN SERVICES Sheet of DIVISION OF PUBLIC HEALTH,ENVIRONMENTAL HEALTH SECTION PROPERTY[Di: ON-SITE WATER PROTECTION BRANCH COUNTY:_Catawba SOIL/SITE EVALUATION for ON-SITE WASTEWATER SYSTEM (Cortpleat all fields in full) OWNER: )14 VI"r_i in c is-e.-e--- APPLICATION DATE ADDRESS: DATE EVALUATED- //, PROPOSED FACILITY: PROPOSE9 DESIGNK49): PROPERTY SIZE: .evri LOCATION OF SITE: y,/,,,„i 1---P1 AV 1., - f4;;; ' — PROPERTY RECORDED: , s WATER SUPPLY: D Privato D Public F ell C Spring D Ma EVALUATION METHOD: D A .- Boring 411-K' 0 Cut TYPE OF WASTEWATER: TErfcwage CI industrial Process U Mixed ..-7,,, ... ' ,:.t''71117,5 •1if137,1.i.'i:--7..47d.i'Krrw4:..,,!..i,:,.4i:..14.,•...;pr_e7:,l74' ,.-i4'l iPi:4t:7..,ii...ii1..0-:4-.•*4,::•:';.N:,,,.„,.-\4..;LI4- .',;•1.;7..._7•.t1..„r,5-w7v0-t-, Wa.,-v,-,7.,-,'1f:,,,‘T*'.T-,:l idF-.-.jtr 1..,e124.-1-kc;4:4sct,e,741.;s1,z4.,.a.;i`47rrk:.i'•7t.,11r.5..p,1,.2,%„,-cI,%olk1!:-r:,-,,e,•,,;&:t-,i.P.c.F.,-4p 4 q Ii 04, .. . ,, , ?T oiF . , t t'4,,-' .;,:,...1„,;:w 0.•F,. ' ,.Z14i1i,,1.71A.,.-WgF.,Lt4-.1?. 1 i 1;! ;:i,..vr ,oi_.:4,,,:ii.,,i0J,t,i,ir,,, :,1 -,17.-ge.f.:,illS5.;•41.f :tt.:-.311 !'.._.wwt-1,176-7V4E..e.4-11E.;,..-yr,:. :4.43 tr,. .lt,,,- 4,14 !r.isii0; ,,,KiiliWIT,I:Ii..- .1;,, Ar^:1 V 1 qtril *4 1 iict ( ,''Ili\ 4, ,,,,,k,;:, ,o., ,,it.-,,,; N 1: t, 'it ,'._ , ,.. ,:ro: -m;.--4.4... 1 II.-.1F.4 :- !,! "31,;.,,,, ,.- . ,..1,-;;:y7lh'-,i- .70:t -:47-r-1...ii.,..l't V' 4 4':::,''..:,., 1..ti.L2 gri'llj:-/V. t II:z11:71tr.flYji, .t.-a.1.74,e., ,..- : w-470--5,-..NW IMP:4 W52.3 TITO,M1442,11V":14441 ik5u,:lalLX."10ik.ti..;M!TLIZbA..V...40...,:sX'ay.:211 .ma kr...7.4 .. ..:-.1 . L.. . •a_...-- , r.• ...3.1f c.4.....1•4.,- r •...4.....:. • $ ..r•-..1..J a ragril MEM EOM i 0, /3 Ito i orilLowszermwro uifmwPBnitmwsiH ? ii . ,c rimic amin71 • 2 MEM . 3 • 4 - . DEsournoN INI]IAL SYSTEM REPAIR SYSTEM OTHER FACTORS(.I946): _ SITE CLASSIFICATION(.1948). Amiable Space(.1945) Li ti 5 EVALUATED BY: - ____tf---Ine—dy . System Type(s) OTHER(S)PRESENT: . ' Site LTAR ' 4'‹ , /3 COMMENTS Updated Febirrxrry 2014 . • ... . . • • •: , •.t l• -0 :• • ' •1...::. • ....• ....." ..•.:... •, .. e( il D D7 ‘i,y. da / . if 1\-rd 14 .1) • . • -....s. v . •-,. . cr • .... ' s \ • 4, 4P 4 , cr -e#$ q?. '....k...0 ... - : • to • -.‘ . i V ty ki----7---.7------: f-",' . • • • I - k , .• . - Oa / Y . N.)`•%1 . .. . •• /Vs. vi, 1• - ' - i .ttl -1. . \ (\t/ NI) k • • -,, ge'`°e' ' • .Po vi-A_.. - , 1 '1.5 • .. ,r‘ . , . , ,.., .,.: . • kr:e • / .60x - A cl; • . . 41 ._,7„ ii • A 41 SA• . ./ fr) 4 SZI . S" .: ..'•- 1" '- . .. •. . . . . • 4,,iri).- Jape . . ....:() . • • . loLik" ..r.er: em,..sy., .. . . -...... IP ‘5 ' • IV 0/. ..V.!-.T'.. 1/4P.A2.0.• \P V\ t .\, r-••"' / \ i b . ..: . -.. : . a •,. .. , .•..1 0 CI / . .., .4• %'..... ' -t • 7.. 1 lei. - ' #• . `; • 9. /..).kk %.',. • ' .‘ ill' ./ ,; tff •..':.. ;• - -45:4)e 44,- leN (le) ' -' :! . .1' •• - • sok-4 ,. 64 . . .. ..- .. S -CP 74sa ' 1Sr•P ..agkle• ., P-cli U4__IIP\.41.. • -.•• .-... ...-. ,. . •. . ... ..-„.. • -" • ''-'4fe# - .._ 4.. •. -•.V•' • V 4• . .0 „,s,lt.) t\j ;V" #X(/W'i -,4)...- .-:-.0 t).- ' $ -• i`Nb \Y VV ) 3 0 ,.,. . .. .. • . -- , 41 7 -• 4. - . fv`, .-•. . 24,\•1,• ,4 NI. ..tt \4,0 .. . • . s' /°z- -r-e"/""y`.5 tf /.1 e.,...attevii 2-4045"-ff i . PA reel 36q21Z01(6 81746 - j 0 —/6 t_- . 6,1 ' woxil • 0. ' ii-( c z__ m„ - ,..,,A p-,- --,,-,_ ,, ‘4I I .. • . 7 ‘-5-I- - :214--- 1 .. . . . , is 0 ,. . • .., . 0 • ., ..--., c.‘. 00 . , • I, , R.. orb •-. --•:. A . . la .09 " 'Ailli - 0 . . • : . . • . as •./.- - •. ..Aie... • . ,.;. ,..- ' .. . . ._ ...., . . .• • . • ri . .. IV. — 63 . . • 4 , \ • . . ,. • , .., . . •. .Nts.,. ..,-..I. -r • .... • .jr ",,,, r ',4,? -: . 'y !. 11 • 6% :.; / . . . .. .. ;. .....:',. vra -. . : -...., . :. . . 1 . . • . • • 0 7 :/ C . s • - \ . . . ...... . . ... - . .41 / • leil ' ?Air::::,.-.....• cr. . ',1 • • . : .--.6 % .6 X , 0 • - . - • .......„. .., . .c.,4\ - --...., . . •,....... ,... _. ,,.. -75,... , .....,:,.... '9 •4 ,.• IQ .20 I_ L 6, J . .. : ..:a ,ig i L Id)- 3.2 C le4fir • : , b-n e__Ltvo wis 1 . -' lLi. _/._ iii.j i. ' . 3.7-i:Lit .C_ ivid4d,, Mc'.1 , 5A4s- . ct—33..c wsis tA +- iv(044-k- ;,III /11 —36 c_ klil 47-7--r2 -a 7 36 4 1,(,),,t &P.' . "3?-- bdtki,31f- -4?) 35 " 34 • 1 .. 1S 10 /1 . 1- 14'14 blt btc • kctif- :._ , -6tAit vitiktf 1 ..- (-6,274sitv. / ,-' /.4.). 1. i • • 1;14;--kci vi.------ . 1 7tIt' 02\ W\ . . 0 1( ' . -7/ ,- ,. _ R , -. - . . • _ 15A NCAC 18A.1941 SOIL CHARACTERISTICS(MORPHOLOGY) (a)The soil characteristics which shall be evaluated by the local health department arc as follows: (1) Texture-The relative proportions of sand,silt,and clay sized mineral particles in the fine-earth fraction of the soil are referred to as soil texture. The texture of the different horizons of soils shall be classified into four general groups and 12 soil textural classes based upon the relative proportions of sand, silt, and clay sized mineral particles. (A) SOIL GROUP I-SANDY TEXTURE SOILS.The sandy group includes the sand and loamy sand soil textural classes and shall be considered SUITABLE with respect to texture. (B) SOIL GROUP II-COARSE LOAMY TEXTURE SOILS.The coarse loamy group includes sandy loam and loam soil textural classes and shall be considered SUITABLE with respect to texture. (C) SOIL GROUP III - FINE LOAMY TEXTURE SOILS. The fine loamy group includes silt, silt loam, sandy clay loam, clay loam, and silty clay loam textural classes and shall be considered PROVISIONALLY SUITABLE with respect to texture. (D) SOIL GROUP IV-CLAYEY TEXTURE SOILS.The clayey group includes sandy clay, silty clay,and clay textural classes and shall be considered PROVISIONALLY SUITABLE with respect to texture. (E) The soil textural class shall be determined in the field by hand texturing samples of each soil horizon in the soil profile using the following criteria: (i) Sand: Sand has a gritty feel,does not stain the fingers,and does not form a ribbon or ball when wet or moist. (ii) Loamy Sand:Loamy sand has a gritty feel,stains the forgers(silt and clay),forms a weak ball, and cannot be handled without breaking. (iii) Sandy Loam:Sandy loam has a gritty feel and forms a ball that can be picked up with the forgers and handled with care without breaking. (iv) Loam: Loam may have a slightly gritty feel but does not show a fingerprint and forms only short ribbons of from 0.25 inch to 0.50 inch in length.Loam will forma ball that can be handled without breaking. (v) Silt Loam:Silt loam has a floury feel when moist and will show a fingerprint but will not ribbon and forms only a weak ball. (vi) Silt: Silt has a floury feel when moist and sticky when wet but will not ribbon and forms a ball that will tolerate some handling. (vii) Sandy Clay Loam: Sandy clay loam has a gritty feel but contains enough clay to form a firm ball and may ribbon to form 0.75-inch to one-inch long pieces. (viii) Silty Clay Loam: Silty clay loam is sticky when moist and will ribbon from one to two inches. Rubbing silty clay loam with the thumbnail produces a moderate sheen. Silty clay loam produces a distinct fingerprint. 'L89L-119LZ DN` !aieul`L89LZ x0g'0'd `tmeoli ieivauntonnug 3o UOIS!n!Q `saomOS3)1 lemWWN pue `tpleaH `luaanloa!Aug jo luauuaedaU aq1 'wag paulelgo saldoo pue `u! paloadsu! aq Amu saldoD •(o)b1-SOS I 'SD ti1IM aauepioaae u! aouaaalaa Xq poldope Xgaaoq s!gowm I x!puoddy`Auuouoxej i!os Su!sn paleniena oq IIems amiotu1S (A) •amlof 1 S of se 3ZSy.LIfIStsIf1 paaappuoo aq ileus aoe,Ims llos Sulun000 Allemleu aq1 jo satpu! 9E mifliM spad temptuls ou itgnixa pue anIsseut aan goyim sI!oS •aanlon IS 01 se 3'1SVL[f1S paaaplsuoo aq !legs so:53122e leamotuls ou 1!q!gxa pue powea ai8u!S a.te go!gM silos - 32If1.L3f1II.LS 1IOS 30 3DN3SSy (3) •amlonalS of se g-ISy.LIfSI'If1 paaaplsuoo aq Hugs aaeims itos Suuanoao JCileanleu at{1 3o Sagau! 9E upptm amlonals !!os otleIusud aneg golgM silos -32If113111IJS 'IIOS JIIVI"ISRId (a) •amloniis of se g'gy,LIf1SNf1 paaaptsuoo aq Hugs aoe3ms llos;ltn.unaao Aptunteu oqi jo satlatn 91;u!gl!M aanlonals ilos Aleid aneg go!gM silos-alln LJrnas'IIOS uv'Id (a) •amlonais of se 3'ISvirishin paaaplsuoo aq[legs aonjms 1!os 2tn.un000 iiieanleu aq)Jo sallow!9E Timm azis u!(gout l)uia S•Z uetp lomat?spad qv" amlonus HOS alli-loo(g•a 11o1u1S 0)Se g'lHVZIf1S ATIVNOISIAO !d Paaap!suoa oq Hugs OZIS u! ssal io Now I)ulo S Z spad tpuu amlotu1S i!oS WWI-1301g -3Nf IlDf lUIS 'IIOS aNI-I-)IDO'IS (S) •amlonals o1 se 3lSyLU1S paaaplsuoo aq llegs amlonals mini mS ao qumao aneg goyim sli0S -31If1ianuS 'IIOS 1iy'If1Nb'2ID QNy S[If1ua (v) :paleniena aq Ilegs amlonals l!os Jo sadr(1 2UMollo3 0tjJ -amlonaIS P.oS (Z) 'L89L-i[9LZ eu!loalD t!JJON`1!alu)1`L89LZ xoS•O•d`tilleaH leluautuoatnu3 Jo uols!n!Q `saomosag InmleM pue`tpieaH luaunzoa!nug Jo luaunaeda(alp uuoa3 pau!elgo sa!doo pue to paloadsu! aq Amu saldo3 .smog Z[ of paseaaow oq Hugs own uolsaadstp alp `(AI Pun III sdnoa0) silos AoAela pue Ameol amij 1o3'(o)bi-SOS l •S•D 1 IM aouepa000e u!aouaaaJaa Aq paidope rtgaaotl am tlo!gn+sasdleue .ialauuoapAq pue anal5 aoj saanpoaoad ZZp-Q (sleua nj pue Supsa,L aoj ic1O!30S ueouauty) IALLSv tpiM aouepa000e u! palonpuoa uagM Su!isai piag ao3 saing asatp u! paugap se saz!s appaed Aeio pue `ills `puns aq1 Su!sn(azls u!tutu 0'Z uegi ssai)uopaea3 quea-aug alp Jo s!s,C[eue az!s-appaed Aq sa11I asatp to paugap se ssep lemlxa! i!os otp 3o uopemuualap £iouuogel alnlpsgns Amu luaugaedou ouj (d) •Supleaaq o1 1uelslsaa ileq Suoals a suuoj pue`i!eugumgl atll g11M poggtu uagM uaatls tlSlq a soonpoad`glSuol u! sallow oM1 aano uoqqu um] e soonpoid `1SIOUi UagM opseld pun A)pl1s tpoq sl ICeDD :AIIJ (!!x) 'g1Suo!u!sagau!oMi aano of suogqu Appeal pue Hug uug a suuoJ 'felo dclt!S 'Ou!iaai A11uS!Cue sloe!pue ls!OUi uagM /clops pue opseld wog s! Aep 1(1I!S :Aeo A'IiS (!x) •llgual to sagau!OM)JOAO of uoqqu upp a saonpoad pun ling uui1 a suuoj pun tsioui uat(M d?fa!is pun •AniuS 'opseid s! Aelo pun :Amp ApueS (x) •luudanStnij lomis!puou e saonpoad tueo!Aei3 •i!eugtunglotp 1UM poggna uagM uaags 112!ls a saonpoad pun tpSua! u! sagou!oM101 auo Jo uoqqu unp a suuoj utno!AeiD•1slom uagM tipps s!uleol dell:tueol,(elD (x!) (3) Clay Mineralogy- Along with soil texture,the mineralogy of the clay-sized fraction determines the degree to which some soils swell when wetted and thereby affects the size and number of pores available for movement of sewage effluent through the soil. There arc two major types of clays, including the 1:1 clays, such as Kaolinite,which do not shrink or swell extensively when dried or wetted;and the 2:1 clays,including mixed mineralogy clays, such as clays containing both Kaolinite and Montmorillonite that will shrink and swell when dried and wetted. The type of clay minerals in the clay-sized fraction shall be determined by a field evaluation of moist soil consistence or of wet soil consistence using Soil Taxonomy,Appendix 1,which is hereby adopted by reference in accordance with G.S. 150B-14(c). The Department may substitute laboratory determination of the expansive clay mineralogy as defined in these Rules for field testing when conducted in accordance with ASTM D-4318, procedures A and B, for the detennination of liquid limit, plastic limit,and plasticity index of soils.These procedures are hereby adopted by reference in accordance with G.S. 150B-14(c).If the liquid limit exceeds 50 percent and the plasticity index exceeds 30,the soil shall be considered as having an expansive clay mineralogy. Copies may be inspected in, and copies obtained from, the Department of Environment, Health, and Natural Resources, Division of Environmental Health, P.O.Box 27687,Raleigh,NC 27611-7687. (A) SLIGHTLY EXPANSIVE CLAY MINERALOGY - Soils which have loose, very friable, friable or firth moist soil consistence,or have slightly sticky to sticky or nonplastic,slightly plastic to plastic wet soil consistence,are considered to have predominantly 1:1 clay minerals and shall be considered SUITABLE as to clay mineralogy. (B) EXPANSIVE CLAY MINERALOGY-Soils which have either very firm or extremely firm moist soil consistence,or have either very sticky or very plastic wet soil consistence, are considered to have predominantly 2:1 clay minerals(including mixed mineralogy clays)and shall be considered UNSUITABLE as to clay mineralogy. (4) Organic Soils-Organic soils shall be considered UNSUITABLE. (b)Where the site is UNSUITABLE with respect to structure or clay mineralogy, it may be reclassified PROVISIONALLY SUITABLE after an investigation indicates that a modified or alternative system may be installed in accordance with Rule.1956 or Rule.1957 of this Section. History Note: Authority G.S. 130A-335(e); Eff July 1, 1982; Amended Eff.January 1, 1990. 15A NCAC 18A.1945 AVAILABLE SPACE (a) Sites shall have sufficient available space to permit the installation and proper functioning of ground absorption sewage treatment and disposal systems,based upon the square footage of nitrification field required for the long-term acceptance rate determined in accordance with these Rules. (b) Sites shall have sufficient available space for a repair area separate from the area determined in Paragraph(a)of this Rule.The repair area shall be based upon the area of the nitrification field required to accommodate the installation of a replacement system as specified in Rule .1955, .1956, or .1957 of this Section. Prior to issuance of the initial Improvement Permit for a site, the local health department shall designate on the permit the original system layout, the repair area,and the type of replacement system. (c)The repair area requirement of Paragraph(b)of this Rule shall not apply to a lot or tract of land: (1) which is specifically described in a document on file with the local health department on July 1, 1982,or which is specifically described in a recorded deed or a recorded plat on January I. 1983;and (2) which is of insufficient size to satisfy the repair area requirement of Paragraph(b)of this Rule,as determined by the local health department;and (3) on which a ground absorption sewage treatment and disposal system with a design daily flow of: (A) no more than 480 gallons is to be installed;or (B) more than 480 gallons is to be installed if application for an improvement permit which meets the requirements of Rule .1937(c)of this Subchapter is received by the local health department on or before April 1, 1983. (d)Although a lot or tract of land is exempted under Paragraph(c)from the repair area requirement of Paragraph(b), the maximum feasible area,as determined by the local health department,shall be allocated for a repair area. History Note: Authority G.S. 130A-335(e)and(J}; Eff.July 1, 1982; Amended Eff. February I, 1992;July 1, 1983;January 1, 1983. 15A NCAC 18A.1948 SITE CLASSIFICATION (a) Sites classified as SUITABLE may be utilized for a ground absorption sewage treatment and disposal system consistent with these Rules. A suitable classification generally indicates soil and site conditions favorable for the operation of a ground absorption sewage treatment and disposal system or have slight limitations that are readily overcome by proper design and installation. (b)Sites classified as PROVISIONALLY SUITABLE may be utilized for a ground absorption sewage treatment and disposal system consistent with these Rules but have moderate limitations. Sites classified Provisionally Suitable require some modifications and careful planning, design, and installation in order for a ground absorption sewage treatment and disposal system to function satisfactorily. (c)Sites classified UNSUITABLE have severe limitations for the installation and use of a properly functioning ground absorption sewage treatment and disposal system. An improvement permit shall not be issued for a site which is classified as UNSUITABLE. However, where a site is UNSUITABLE, it may be reclassified PROVISIONALLY SUITABLE if a special investigation indicates that a modified or alternative system can be installed in accordance with Rules.1956 or.1957 of this Section. (d)A site classified as UNSUITABLE may be used for a ground absorption sewage treatment and disposal system specifically identified in Rules.1955,.1956,or.1957 of this Section or a system approved under Rule.1969 if written documentation,including engineering,hydrogeologic,geologic or soil studies,indicates to the local health department that the proposed system can be expected to function satisfactorily. Such sites shall be reclassified as PROVISIONALLY SUITABLE if the local health department determines that the substantiating data indicate that: (1) a ground absorption system can be installed so that the effluent will be non-pathogenic, noninfectious,non-toxic,and non-hazardous; (2) the effluent will not contaminate groundwater or surface water;and (3) the effluent will not be exposed on the ground surface or be discharged to surface waters where it could come in contact with people,animals,or vectors. The State shall review the substantiating data if requested by the local health department. Ilistorw Note: Authority G.S. 130A-335(e); Ef July 1, 1982; Amended Eff April 1, 1993;January 1, 1990. ISA NCAC 18A.1950 LOCATION OF SANITARY SEWAGE SYSTEMS (a) livery sanitary sewage treatment and disposal system shall be located at least the minimum horizontal distance from the following: (I) Any private water supply source. including any well or spring 100 feet; (2) Any public water supply source 100 feet: (3) Streams classified as WS-I 100 feet; (4) Waters classified as S.A. 100 feet,from mean high water mark: (5) Other coastal waters 50 feet,from mean high water mark: (6) Any other stream,canal,marsh,or other surface waters 50 feet: (7) Any Class I or Class II reservoir 100 feet.from normal pool elevation; (8) Any permanent storm water retention pond 50 feet,from flood pool elevation: (9) Any other lake or pond 50 feet.from normal pool elevation; (10) Any building foundation 5 feet; (II) Any basement 15 feet; (12) Any property line 10 feet; (13) lop of slope of embankments or cuts of 2 feet or more vertical height 15 feet; (14) Any water line 10 feet; (15) Drainage Systems: (A) Interceptor drains,foundation drains,and storm water diversions (i) upslope 10 feet, (ii) sideslope 15 feet,and (i i i) downslopc 25 feet; (II) Groundwater lowering ditches and devices 25 feet; (16) Any swimming pool 15 feet; (17) Any other nitrification field(except repair area) 20 feet; (h) Ground absorption sewage treatment and disposal systems may he located closer than 100 feet from a private water supply, except springs and uncascd wells located downslopc and used as a source of drinking water, for repairs, space limitations,and other site-planning considerations but shall be located the maximum feasible distance and in no case less than 50 feet. (c) Nitrification fields and repair areas shall not he located under paved areas or areas subject to vehicular traffic. Ifeflluent is to be conveyed tinder areas subject to vehicular traffic,ductile iron or its equivalent pipe shall he used. I lowever.pipe specified in Rule .1955(e)may be used if a minimum of 30 inches of compacted cover is provided over the pipe. (d) In addition to the requirements of Paragraph(a)of this Rule,sites to be used for subsurface disposal for design units with flows over 3.000 gallons per day, as determined in Rule .1949 (a) or (h) of this Section, which include one or more nitrification fields with individual capacities of greater than 1,500 gallons per day, shall be located at least the minimum horizontal distance from the following: (I) Any('lass I or II reservoir or any public water supply source utilizing a shallow(under 50 feet)groundwater aquifer 500 feet; (2) Any other public water supply source,unless determined to utilize a confined aquifer 200 feet; (3) Any private water supply source,unless determined to utilize a confined aquifer 100 feet; (4) Waters classified as SA 200 feet,from •1u!ssOJa agiJo apls J31pi)uo 1aaj 3ntl ism!lr JOJ 301 uoJI ;will)JO 313131103 ul poseaua Jo odid coal alllonp Jo Si JOMOS a111 (Z) ao'.pouttlulrw s1 aaurlslp uolleiedas JP3I3 sag3ul ZI (I) :Jl!quip mauls P SSOJ3 (ew saw11 Jamas (9) •9ulssoJO Jo 1u!od 3y1 w poJ3luoo adid Jo suOl133s IInJ 411m'9ulssoJO Jo mod aq) Jo apts yaea uo laaJ u31 weal to Jo aaurlslp P.JOJ spaepuels U!PUi JaleM of luOlenlnb3 slelJaleut snoJJol jo polanitsuoa aq ins au!!J31PM 3111 pur,lualrnlnba s11 Jo odld uOJ1 al!Onp Jo palanJtsuoa aq ins au!'lamas ay1'Jamas alp Japun SSOJa o1 au!!Jolum ayt JoJ kless3aau sl ll JanauaLM JO poulewleul gulag woij uopendas Je313 yowl-g! ue luanoJd suoglpuoa UayM aull Ja1em ayl Japun 1ufssed au!!JaM0S ayt yt1M'pau!RIU!PLL1 51 a7Ue1Slp UO!PJrdaS map Sayaul g l J1 au!1 JateM P.SS0J3,(P.W Saul!JaMas ()) •1331 S pl°J uolleOJullu Jayto ICuV (01) .133J 01 lood 9uLWWIMs 4uV (6) '1aaJ 01 SaOlnap pur sayallp 9uIJamol JaWM-punoJ9 (fl) :103J S suo!sJanip aaIPM mow pull'sullJp uuols'suleap Joldaaiatul (V) :swotsds 39euleUa (g) aaaJ 01 14glaq IE31UOn aaow Jo 13oj OM)Jo qua JO sluawyuugwa Jo odolsjo do.l. (L) 'aaaJ S au!!,C1J3doad&iv (9) :133J Ol luOwOSPq AuV (S) `1aaJ 0I SJaloM 33eJ111S Jayio a0•swatUpunodWi J3yl0 pUr S3)111'SJOWM Ielse03'ysaew'plum•um3J1S Jayto AIN (t) aaaJ 01 01 paanpaJ ay few llarglas wnwlulut ay1 3seo galym u1'spJepuels uteul J31PM of tualenlnba slulollloluey0alu 411m adld uOJ1 3ltlanp su Elam.'adld jooadyral Je11uu5 Jo pOlanJlsuOa ssolun'13a)OS fIS JO'VS'II'Ill-SM 'll-SM'1-SM se paulsselO SJa1PM Ai (£) aaaJ SZ o1 paanpOJ aq Sew'peglas wnwiulw ay1 3Sea ya14M u1 'SpJepuels u!eu1 J31em of 1u31enlnba snub!lealueyaaw llt!M adtd UOJ!3ltlanp sr. yons'MO JooJdral Je11wls10 pOlanatsuoO ssalun'loaj 05 s9uuds pur sIlOM 9wpnlaul'aaanos Alddns JalrM alenlad Any (Z) :laaJ OS 01 pa3npaa ay stew>IOeg13s wnwiulw 3y1 Oslo y314M ul'spaepuels Ulrw J31WM of wOlenlnb3 sluloC leOlue1433w y1!M 3dld uoal a111Onp se guns`od!d JOOJdyr3l Jo p31ona1suoa Ssalun'IOOJ 001 5J!Onaa531 11 MDJO I SSPI:)pun `sluuds's11am 9ulpnlaul'pantos i 1ddns J3tem allgnd XuV (I) :9ucMOIloJ ayl woJJ aOuetslp IewoziJoq wnwiulw 3y1 1se31 1r paleOo! aq Heys sOug Alddns pue 'sinew OOaoJ 'SJ3MDS UO11331f0j (3) '133J SZ au!! A1Jodoad i(uv (L) pull aaaJ 00I US 10'fl'I l l-SM'II-SM se pOJlssILO SJa11M aaejins Auy (9) :1333 OOZ I-SM se p3J!SSeI3 SJOW.M r(UV (S) !Intl]JaIPM ON MOW (h) Sewer lines may cross a stream if at least three feet of stable cover can be maintained or the sewer line is of ductile iron pipe or encased in concrete or ductile iron pipe for at least ten feet on either side of the crossing and protected against the normal range all igh and low water conditions,including the 100-year flood/wave action. Aerial crossings shall he by ductile iron pipe with mechanical joints or steel pipe. Pipe shall he anchored for at least ten feet on either side of the crossing. (i) Septic tanks,lift stations,wastewater treatment plants,sand filters,and other pretreatment systems shall not be located in areas subject to frequent flooding (areas inundated at a ten-year or less frequency) unless designed and installed to be watertight and to remain operable during a ten-year storm. Mechanical or electrical components of treatment systems shall be above the 100-year flood level or otherwise protected against a 100-year flood. History Now: Authority(IS. 130A-335(e)and(1). 1•:ff July 1, 1982; Amended .lwuurry 1, 1990; October 1, 1982. U.S. Postal ServiceTM CERTIFIED MAIL° RECEIPT rq Domestic Mail Only N D For delivery information,visit our website at www.usps.com®. O Certified Mail -- ►n $ tU Extra Services&Fees(check box,add fee as appropriate) 0 Return Receipt(hardcopy) $ Y r-a ❑Return Receipt(electronic) $ t.. D ❑Certified Mall Restricted Delivery $ r He D ❑Adult Signature Required $ l-� 1\11 ❑Adult Signature Restricted Delivery$ p)R c . O Postage J U- Total Postage and Fees fl $ RBPR-07-2022-41722 ,a Sent To Four Corners of Charlotte LLC Streetan6Apllit 7rStiittlif-STew Ct cvty,state,z, xhaw,NC 28173-6642 la.Yvr.T,T:T.L anima 64 :rm,c,:I;.,a1.r:,rnr..rr.,.r4 Certified Mail service provides the following benefits: •A receipt(this portion of the Certified Mail label). for an electronic return receipt,see a retail •A unique Identifier for your mailpiece. associate for assistance.To receive a duplicate •Electronic verification of delivery or attempted return receipt for no additional fee,present this delivery. USPS®-postmarked Certified Mail receipt to the •A record of delivery(including the recipient's retail associate. signature)that is retained by the Postal Service" -Restricted delivery service,which provides for a specified period. alive to the addressee specified by name,or E h E l authorized agent. Important Reminders: t Ice,which requires the •You may purchase Certified Mail service wit signee to a east 21 years of age(not First-Class Mail°,Rrst-Class Package Service0, available at retail). or Priority Mail°service. -Adult signature restricted delivery service,which •Certified Mail service Is not available for, r�e signee to be at least 21 years of age international mail. H u a es delivery to the addressee specified •Insurance coverage is not available for purchase by name,or to the addressee's authorized agent with Certified Mail service.However,the purchase (not available at retail). of Certified Mail service does not change the •To ensure that your Certified Mail receipt Is insurance coverage automa Ily included with acceptedas le I proof of mailing,It should bear a certain Priority Mail items. nyironmenl, t$F ou would like a postmark on •For an additional fee,and with a proper this Ce le eceipt,please present your endorsement on the mailpiece,you may request Certified Mall Item at a Post Office"'for the following services: postmarking.if you don't need a postmark on this -Return receipt service,which provides a record Certified Mail receipt,detach the barcoded portion of delivery(Including the recipient's signature). of this label,affix it to the mailpiece,apply You can request a hardcopy return receipt or an appropriate postage,and deposit the mailpiece. electronic version.For a hardcopy return receipt, complete PS Form 3811,Domestic Return Receiphattach PS Form 3811 to your mailpiece; IMPORTANT.Save this receipt for your records. PS Form 3800,April 2015(Reverse)PSN 7530-02-000.9047 County; (Gl 71 G. 11. 64 This Section for Local Health Deportment Use Only . - ,Initial submittal received: by Date Inrhals Permit Number: G.S. 130A-335(a4)states the following: 'If o local health department fails to act on an application for an improvement permit submitted pursuant to subsection(03)of the section within 10 business days of receipt of a complete application, the local health department shall issue the improvement permit.' In accordance with G.S. 130A-335(a3)the improvement permit application is: ❑ Incomplete(If box is checked, information in this sect on is reau`red.) The following items are missing: Copies of this were sent to the LSS and the Owner on _ Dote State Authorized Agent: Date: Denied(See attached report.) Copies of this were sent to the LSS and the Owner on 7,7 _ 2 Z Dote State Authorized Agent: v(1 Air__ Date: 7 , Z ❑ Complete State Authorized Agent: Date of Issuance: This Improvement Permit is issued pursuant to G.S. 130A-335(a2),(a3),and(a4)using the signed and sealed LSS/LG evaluation(s) attached here. The Issuance of this permit by the 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. This site Is subject to revocation if the site plan,plat,or the intended use changes,or if information submitted In the application was falsified, inaccurate or misleading. The Improvement Permit shall not be affected by a change in ownership of the site. This permit is subject to compliance with the provisions of the Laws and Rules for Sewage Treatment and Disposal and to conditions of this permit. The location and Identification of all property lines,easements,water lines,and other appropriate utilities shall be the responsibility of the owner. The Department,the Department's authorized agents,and the local health departments shall be discharged and released from any liabilities,duties,and responsibilities imposed by statute or In common law from any claim arising out of or attributed to evaluations,submittals,or actions from a licensed soil scientist or licensed geologist pursuant to GS 130A-335(a2). Improvement Permit Expiration Date: 'See attached site sketch' County: Catawba IMPROVEMENT PERMIT FOR G.S.130A-335(a2)/SL2022-11 PIN/Lot Identifier: 364820816846 Issued To: Four Corners of Charlotte, LLC Property Location: 3102 Jenny's Lane, Newton, NC 28658 Subdivision: Heaven Sent Lot#: 1 9 Block: Section: LSS Report Provided: Yes ✓❑ No❑ If yes,name and license number of LSS: Larry Thompson, NCLSS#1287 New E Repair❑ Expansion ❑ System Relocation ❑ Proposed Structure: Single-family residence Proposed Wastewater System Type: Gravity PPBPS (Initial) Gravity PPBPS (Repair) Fill System:❑Yes ✓❑No If yes,specify:❑New ❑Existing (when adding more than 6 inches of fill to system area please provide a fill plan) Proposed Design Daily Flow: 360 GPD Proposed LTAR(Initial): 0•3 Proposed LIAR(Repair): 0.3 Design Wastewater Strength: ✓❑domestic ❑high strength ❑industrial process Number of bedrooms: 3 Number of Occupants: 6 Other: Pump Required: ❑Yes ® No ❑May be required based upon final location and elevations of facilities Artificial Drainage Required: ❑Yes ❑✓ No If yes,please specify details: Type of Water Supply: ❑✓ Private well ❑Public well ❑Municipal Supply ❑Spring ❑Other: Drainfield location meets requirements of Rule.1945: Yes Q No❑ Drainfield location meets requirements of Rule.1950: Yes❑✓ No❑ Permit valid for:❑✓ Five years[site plan submitted pursuant to GS 130A-334(13a)] ❑ No expiration[plat submitted pursuant to GS 130A-334(7a)] Permit conditions: Licensed Soil Scientist Print Name: Larry Thompson, LSS Larry Thompson Digitally signed by Larry Thompson 7/19/22 Licensed Soil Scientist Signature: Date:2022.07.19 18'43:59-04'00' _ Date: The LS5 evaluation is being submitted pursuant to and meets the requirements of G.S.130A-335(a2). *See attached site sketch* The LSS/LG evaluation(s) attached to this application is to be used to issue an Improvement Permit in accordance with G.S. 130A-335(a2) and (a3). Residential Subsurface Wastewater Treatment and Disposal System Proposal for Lot 19 — Heaven Sent 3102 Jenny's Lane Newton, NC 28658 Tax Parcel Number: 364820816846 July 2, 2022 Prepared for: _Acc� .t� SOit so G� iHOM,, 0�ytak Four Comers of Charlotte LLC „ '` A s 1612 Seattle Slew Court fr`H i•+/9 Q. Waxhaw, NC 28173 +" a" • 704-713-2602 tk t2s7cP Atom Prepared by: ,ot+iim+n,% Larry Thompson, REHS, LSS OQ:••QtrtSTEqeo..: i Thompson Environmental Consulting, Inc. '�'; • •':�. PO Box 541 = : I J SEAL Midland, NC 28107-0541 ' q.• $ 1208 Phone: 704-301-4881 172•. larry@thompsonenv.com thompsonenv.com •• MQ71-.10 ��•, 3102 Jenny's Lane Details The following wastewater treatment and disposal system proposal is submitted to Catawba County Environmental Health (CCEH) at the request of Four Corners of Charlotte, LLC. This proposal is to construct a new 3-bedroom single family residence on Lot 19 — Heaven Sent, 3102 Jenny's Lane, Newton, North Carolina. The residence will be served by a private well. Based upon a soil and site investigation performed by Thompson Environmental Consulting, Inc. (TEC), as well as a separate evaluation performed by TEC, it has been determined that there is a sufficient amount of"Suitable" Group IV soils available for the installation and repair of a Gravity-Flow Prefabricated Permeable Block Panel System (PPBPS) at a 0.25 GPD/sq. ft. long-term acceptance rate (LIAR) for the 3- bedroom residence. The enclosed Licensed Soil Scientist Evaluation is being submitted pursuant to and meets the requirements of G.S. 130A-335(a2) and (a3). Location From Newton, take St. James Church Road to Kathy Street. Turn right onto Kathy Street and left onto Jenny's Lane. Lot is located on the left in the cul-de-sac. References Laws and Rules for Sewage Treatment and Disposal Systems, 15A NCAC 18A, Section .1900, Department of Environment and Natural Resources, Division of Environmental Health, On-Site Wastewater Section, April 1, 2017. Design, Installation and Maintenance of the T&J Panel Wastewater Treatment System; Sixth Edition,published by T&J Panel. Primary Investigator's Credentials NC Registered Sanitarian No. 1208 NC Licensed Soil Scientist No. 1287 SC Professional Soil Classifier No. 111 NC Subsurface Septic System Operator No. 22199 NC Grade IV Wastewater System Installer/Inspector No. 1762/17621 2 3102 Jenny's Lane This proposal is for a gravity flow pre-fabricated permeable block panel system meeting the minimum setbacks for this lot. Exceptional care should be taken to protect the drainfield area from all forms of encroachment throughout the life of the project. TEC recommends protecting the system area with orange barrier fencing. Plumbing from the house must be held high to prevent the need for a pump. Plans and Specifications A. Septic Tank 1. The septic tank shall be State approved (Section .1953 of 15A NCAC I 8A), watertight, structurally sound, and 1,000 gallons in capacity (minimum). 2. The septic tank will be fitted with an approved effluent filter and riser for easy access and periodic maintenance. 3. It is the responsibility of the septic contractor to thoroughly inspect the septic tank prior to accepting delivery to assure that the tank has had time to properly cure and is free of cracks or other structural deficiencies. B. Pipes and Fittings I. All discharge piping, connectors and supply lines should be made of SCH 40 PVC. 2. All joints must be properly "welded" utilizing the appropriate PVC cement for each application. C. Distribution Method 1. Individual drainlines shall be evenly fed via a distribution box. 2. Distribution box shall be water tested for equal flow at the time of the final inspection. D. Backfill 1. Backfill sand shall be clean, washed, medium sand that is naturally occurring and falls within the gradation of ASTM C-33 specification (used in the ready-mix industry and is readily available). Properly compact backfill to provide the intended subgrade support. E. Drainfield Installation 1. The drainfield and the proposed septic tank location have been marked on-site utilizing metal stemmed flags. Once this area has been approved by the county, the property owner/builder should mark this area and isolate it as much as possible from construction traffic. Prior to the system installation, the septic contractor shall contact the designer for a preconstruction conference at which time the drainfield area will be re-verified. 3 • • 3102 Jenny's Lane 2. Under no circumstances shall any construction take place within the drainfield area while the soil is in a wet condition. If the installer has doubts as to whether or not the drainfield area is dry enough to begin construction, the environmental health specialist for this area should be contacted for permission to proceed with the installation. 3. The specified system is a Type V(e) pre-fabricated permeable block panel system — specifically the horizontal prefabricated permeable block panel system manufactured by T&J Panel Wastewater Treatment System, Patent No. 4013559; telephone: 1-800-222-2577. The installer must follow the manufacturer's guidelines for installing the T&J Panel System and should request an installation manual from the manufacturer prior to beginning construction. 4. The initial drainfield consists of four (4) laterals constructed 2-feet wide by 67- feet in length. 5. It is essential that the lateral trenches be constructed on contour with the land, with each trench being excavated level from beginning to end. The use of a tripod mounted engineer's level is essential to assure that each trench is constructed as level as possible. 6. The maximum trench depth for this system shall be 28-inches (high-side). Each trench shall be placed on a minimum of 8-foot on centers. 7. Once trenches are dug, the side walls shall be raked, and a light dusting of lime applied. 8. Backfill the trench with 7-inches of sand and level to grade properly compacted to intended subgrade support. Once leveled, place 1 x 4 or 6-inch boards on top of the sand the entire length of each trench. Once the grade boards have been set, the panels may be set into the trench. The panels should be placed 6 inches apart. 9. Once the panels have been set, line the top portion of each chamber with the T&J supplied sand alternative product(SAP—geotextile fabric). GE Foam Sealer or tar seal rope should be placed in the bottom of the "U"outs to form seals around the pipe as shown in earlier drawings. 10. Tar seal rope, or approved foam, should be placed in the "U" outs of each end of the panel to form seals. Once the tar rope is in place, the 11/4 inch Schedule 40 PVC connectors can be added, and the seal completed by the addition of more tar rope on the top and sides of the pipe. Now that the connection and seals are complete, a block cap is placed on each end of the panel so that all openings are covered. 11. Once the lateral has been installed and the panels closed, the trench is ready to be backfilled to the top with the sand used in the trench bottom. At this point, the trenches should be left open for the final inspection by the local health department. F. Final Landscaping 1. The drainfield shall be shaped to shed rainwater and be free from low spots. 2. Minimum cover requirement over the drainfield area is 6-inches. 3. The entire area of the drainfield should be planted with grass as soon as possible to prevent erosion. The soil should be properly tilled, limed (if necessary) and 4 3102 Jenny's Lane fertilized prior to planting. After applying grass seed, the area should be heavily mulched with straw or other suitable material. G. Utility/Drive Conflicts 1. The builder and property owner must take special care in planning for utilities (water, power, gas, telephone, cable lines, etc.). All utilities shall be kept clear of the septic system and its proposed repair area. Improper planning for underground utilities can negatively impact the installation and, in some cases, cause irreparable damage and permit revocation. 2. Water lines must be kept at least ten (10) feet from any portion of the septic system. 3. Irrigation systems should not be placed in the drainfield area. 4. The builder must also take special care in planning for a drive into the property. The driveway must be installed along the property sideline to allow enough clearance for the proposed repair drainlines. The driveway must be constructed at- grade without cuts or excavations. 5. The entire drainfield area shall be delineated with orange barrier fencing throughout the construction process to protect it from unnecessary encroachment. Maintenance H. In General I. The homeowner must maintain the drainfield area through periodic mowing. The drainfield must not be allowed to become overgrown. 2. The septic tank should be pumped every 4 years or when the solids within the septic tank reach an elevation that is equivalent to 25 percent of the volume of the tank. In some situations, the tanks may need to be pumped more frequently. If using a garbage disposal, it is recommended that the homeowner has the septic and pump tanks cleaned out annually. 3. Use of a garbage disposal is not recommended. Solids added through the garbage disposal tend to degrade at a very slow rate. 4. Grease, cooking oils, coffee grounds and non-degradable solids (disposable diapers, cigarettes, and solid paper wastes)should never be put into a septic tank. 5. Used motor oil or any oily liquids should not be disposed of in a septic tank. 6. Be aware of the amount of water that you are using in your home. Water saving fixtures and devices can be installed on sinks, toilets, and showers to reduce the volume of wastewater that you are sending to your drainfield. 7. Run dishwashers and washing machines only when you have a full load. 8. Repair leaky faucets and toilets. Small drips equal large volumes of water over time and can over burden your drainfield. 9. Do not use chemical additives in your system. Studies have indicated that they do not increase the biological activity that naturally occurs in the septic system and in some cases certain additives have been found to be detrimental to the life of a system. 5 3102 Jenny's Lane Design Specifics Daily Design Flow: 360 GPD Septic Tank Size: 1,000 Gallons Effluent Loading Rate: Design= 0.25 GPD sq. ft. (50%reduction - PPBPS) Drainfield Type: PPBPS Number and Size of Drainlines: (6) 2' Wide x 40' Long Maximum Trench Depth: 28 Inches (high-side) Drain line Spacing: 8 Foot on Centers Total Length of Drainline: 240 Feet Total Number of Panels: 54 Repair Specifics Effluent Loading Rate: Design= 0.25 GPD sq. ft. (50%reduction - PPBPS) Drainfield Type: PPBPS Distribution Method: Pressure Distribution Required Linear Footage: 240 Feet Available Linear Footage: 240 Feet Maximum Trench Depth: 28 Inches (high-side) *See septic layout for site locations and additional details. 6 i' PEI.49 PG 45 PI©# 3648-2081•5749 A . , ZONE: R-40 j {�,F #6 �, LOT 20 t14 t • • 1 G1 !' f 1 f ;i ram, : s` �_C3 ;, 42. ti.r IRF #67_,- , , �''° s s ___.,,...---- 0 (,(,/„.,,s, 4b,i?.C.J - N , -- va, 7 ,- / IDe.1,, iltk / . .CON �J 4 ` Q () � \ * I .r 60 -7/1 .6 ".. (0 So.,NN \ -,,,N,$) sC, \d",ts,..(‘ ‘-f 7 .\\N / 31 #6 E .6,, F 44' HIALIE ''7y; s` \ _-- 3r , / IRF ti „„ f , I o, 141, \' / 1^ 4..6. IRE / .% a S 41-4/ \ / . o A S:/ ' % 0 % ‘• / AB-2 c0 0 �O ►, ♦� % TSB-1Q, tt� -... • ♦ V ,% tt/ 4 LEGEND c.,, 0 o 00 �: 3.k' cry GIS 2-ft Contour Lines ,',, • `% ;,Q,; O 6 N. s 9 `'3' ° • ExistingWells D % ` 'SB-3 : QQ ED 50-ft Existing Well Buffer '\♦ ,.'" ♦ / 30 ; co cr • Proposed Well Location \� :' l �+ ,.• U� __ 150-ft Well Buffer ` / ��' .� co NI House Box °j Septic Tank At '3 4 co - Supply Line ,. r: ° 11 mmi PPBPS Drainlines I I I I PPBPS Repair Lines IRF #6 ,--.., ,.! 1-1RF #4 e Soil Boring Locations -'` NIF Date: Proposed Septic Layout March 2022 Figure Thompson C .e Prepared For: F.nvironrnenta Lot 19- Heaven Sent scale: Ihng Four Corners of 3102 Jennys Lane 0 15 30 ft Charlotte LLC Newton, NC 28658 TEC)ob#: Catawba County 22-66 • Thompson Environmental Consulting,Iue-4e:,. Sheer_I of 1 PO Box 541 -7,14 0 PROPERTY ID ti: ,,i�('4 z--,`;I 1_ a Midland NC 28107 y;' /� . ' 'S..� COUNTY: ` C �'C.-_,")�� ' • USITE;EVALUATION for ON-SITE WASTEWATER SYSTEM OWNE) J{!1 14G IL .e, ADDRESS: t 1 c �"s/c._`j r,., Lc r;.? , C 7RZ.,(,c DATE EVALUATED: f.1- 2 V PROPOSED FACILITY: ,; PROPOSE�.I*SIGN FLOW(.1949): PROPERTY SIZE: O.� rzr� LOCATION OF SITE: 310- ,t, r\,,., _:,. .,..e ,LAIQ,;ti+Vn,t G PROPERTY RECORDED: WATER SUPPLY: Private Public ' ell l Spring 0 Other EVALUATION METHOD: Auer Boring L7 Pit 0Cut TYPE OF WASTEWATER: Sewage 0 Industrial Process 0 Mixed P R 0 SOIL MORPHOLOGY OTHER F (.1941) PROFILE FACTORS 1 .1940 E LANDSCAPE HORIZON PO5rr1ON/ DEPTH PROFILE (IN.) .1942 # SLOPE% .1941 .1941 SOILI943 .1956 .1944 CLASS STRUCTURE/ CONSISTENCE/ WETNESS/ SOIL SAPRO RESTR &LTAR TEXTURE MINERALOGY COLOR DEPTH CLASS HORIZ 1 /.-•' .:� ,r, ;,'C. ��ll 7,'� � q r � ( � 2 C ` i ° t t '' f i /'' r* y • / v w✓ ,_. ,. ,•,:,.. ;,,,i4......) c),_ • L - t 3 -- - oli.,,,,, r 4 DESCRIPTION INn1AL SYSTEM REPAIR SYSTEM OTHER FACTORS(.1946): 1 FCO SOIL S --) SITE CLASSIFICATION(.1948): ,•' J •.:2.`r •1.;1 H°AA. ,S,;. Available Space(.1945) (!J .4 r A 4rjSyr.- 4'0 tw System Type(s) sepc )....j ✓it� Y:EVALUATED B A. `+ .__ Le-1 0 r "�1'Z 01 I IER(S)PRESENT':_ MEW. .17i; w��.y `- Site LIAR 0'41 C f ) . ..✓ \ wh MY:'J ' - COMMENTS: 44" ✓ _ The LSS Evaluation is beingsubmittedpursuant to and / a' oaf Updated February 2014Qe H C meets the requirements of SL 2018-114 Section 11.(c). (..- LEGEND ___ use the following standard abbreviations SOIL CONVENTIONAL LPP MINERALOGY/ LANDSCAPE POSITION GROUP TEXTURE ,19$$LIAR' ,19$7 LIAR* coNslsr N('( SI'R17(TURE CC(Concave Slope) I S(Sand) I.2-0.8 0.6.0 4 SEXP(Slightly Expansive) C(Single Grain) CV(Convex Slope) I S(Loamy Sand) EXP I Expansive) M(Massive) D(Drainage Way) CR(Cnimb) DS(Debris Slump) Il SL(Sandy Loam) 0.8-0.6 04-0 3 . GR(Granular) FP(Flood Plain) I.(Loam) SHK(Subangular Blocky) FS(Foot Slope) ABK(Angular blocky) II(Head Slope) III Si(Silt) 0.6-0.3 0.3-0.15 PL(Platy) I.(Linear Slope) SiCL(Silty Clay Loam) PR(Prismatic) N(Nose Slope) CL(Clay Loam) R(Ridge) SCL(Sandy Clay Loam) MOIST WFT S(Shoulder Slope) Sit.(Silt Loam) T(Terrace) VFR(Very Friable) NS(Non-sticky) IV SC(Sandy Clay) 0.4-0 I 0 2-0 05 FR(Friable) SS(Slightly Sticky I SiC(Silty Clay) Fl(Finn) S(sticky) C(Clay) VFt(Very Finn v Very Sticky) VS(Very Sticky) 0(Organic) None None FFl(Fatremely Finn) NP(Non-plastic) SP(Slightly Plastic) *Adjust LIAR due to depth,consistence,structure,soil wetness,landscape.position,wastewater flow and quality. P t Plastic) vorf4 VP(Very Plastic) HORIZON DEPTH In inches below natural soil surface DEPTH OF FILL In inches from land surface RESTRICTIVE HORIZON Thickness and depth from land surface SAPROLITE S(suitable)or U(unsuitable) SOIL WETNESS Inches from land surface to free water or inches from land surface to soil colors with chrome 2 or less-record Mansell color chip designation CLASSIFICATION S(Suitable),PS(Provisionally Suitable),or U(Unsuitable) Evaluation of saprolite shall be by pits. Long-tens Acceptance Rate(LIAR):galIdayrt)t Shoss jrofik locations and other site features(dimensions,reference or benchmark,and North), 2 —. r--. �% -:( ., '��f._ lw L. Updated February 2014 AGENT AUTHORIZATION FORM PROPERTY LEGAL DESCRIPTION: LOT NO. 9 PHASE PARCEL ID: 364820816846 STREET ADDRESS: 3102 Jenny's Lane (Heaven Sent) Newton, NC 28658 Please print: Property Owner: Four Corners of Charlotte, LLC Property Owner: The undersigned, registered property owners of the above noted property, do hereby authorize Larry Thompson, LSS of Thompson Environmental Consulting, Inc. (Contractor/Agent) (Name of consulting firm) to act on my behalf and take all actions necessary for the processing, issuance and acceptance of this permit or certification and any and all standard and special conditions attached. Property Owner's Address (if different than property above): 1612 Seattle Slew Court, Waxhaw, NC 28173 Telephone: 704-713-2602 We hereby certify the above information submitted in this application is true and accurate to the best of our knowledge. The NC LSS evaluation attached to this application is to be used to produce design and construction features for permitting in accordance with Session Law 2018-114 Section 11. (c). OrL.Si ture: Owner Signature: racoon gonzal z((Jul 3,2022 07:00 EDT) Date: Jul 3, 2022 Date: P t , THIS IS NOT A PERMIT Case# RBPR-07-2022-41722 E-" _ ti CATAWBA COUNTY HEALTH DEPARTMENT PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES /8 2 5M Residential Building Plan Review-Building New IMPROVEMENT-AUTH CONST- NEW WELL Contractor *VICTORY BUILDERS,LLC (DANIEL HAMILTON),3281 KEADY MILL LOOP,KANNAPOLIS NC 28081 B:7047010418 C:7047013I 89 VICTORYBUILDERSLLC@GMAIL.COM Owner FOUR CORNERS OF CHARLOTTE LLC, 1612 SEATTLE SLEW CT,WAXHAW NC 28173 C:704-713-2602 ROMELLE03@YAHOO.COM NAME TO APPEAR ON PERMIT *Victory Builders, LLC (Daniel Hamilton) SITE ADDRESS: 3102 JENNYS LN,NEWTON NC 28658 PIN# 364820816846 NAME of SUBDIVISION: HEAVEN SENT Lot# 19 Section/Block PROPERTY SIZE: Square Feet Acres 0.5 DIRECTIONS: Right off of St James Church Rd onto Kathy St.Left onto Jennys Ln.5th lot on left. PRIMARY CONTACT: Contractor SEWER TYPE: Septic Tank GALLONS PER DAY: 360 WATER SUPPLY: Private Well DESCRIBE WORK: **SESSION LAW 2022-11**IP/AC/New Septic/New well/360 GPD--New 58x34, 3 bedroom single family dwelling/no basement SITE INFORMATION Do any of the following apply to the property for which this application is applied? If the answer to any of the questions below is"YES",then supporting documentation is required: Does this site contain any jurisdictional wetlands? No Does this site contain any existing wastewater systems? No Is any of the wastewater going to be generated on the site other than domestic sewage? No Is the site subject to approval by any other public agency? Yes Are there any easements or right-of-ways on this property? No APPLICATION FOR: New Structure STRUCTURE TYPE: PRIMARY RESIDENCE FACILITY TYPE: Single Family Residence OTHER DESCRIPTION: DESCRIPTION OF EXISTING STRUCTURES ON SITE(IF ANY) DIM EXISTING STRUCTURE: NUMBER OF EXISTING BEDROOMS: #OF OCCUPANTS: 4 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 58x34 sfd #OF NEW BEDROOMS:: 3 Desired system types(Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: CONVENTIONAL: OTHER: INNOVATIVE: ANY: YES Other described: APPLICATION FOR WELL CONSTRUCTION PROPOSED WELL TYPE: Individual Well REPLACE WELL?: NO ehapplication 07/20/2022 16:31 Page of 3 • • CATAWBA COUNTY Case# RBPR-07-2022-41722 t f Public Health Department Subdivision HEAVEN SENT Q __ H Environmental Health Division u ,.�,. *C PIN# 364820816846 Ig 5. PO Box 389, 100-A Southwest Blvd,Newton,NC 28658 NAME ON PERMIT: *VICTORY BUILDERS,LLC ( DANIEL HAMILTON),3281 KEADY MILL LOOP,KANNAPOLIS NC 28081 *Victory Builders, LLC ( Daniell- Site Address: 3102 JENNYS LN,NEWTON NC 28658 Property Size: Square Feet Acres 0.5 Directions: Right off of St James Church Rd onto Kathy St.Left onto Jennys Ln.5th lot on left. Completed applications are valid for a period of 2 years.Improvement Permits are valid:with complete site plan=SO months(5 years);with complete plat =without expiration. An Authorization to Construct will remain valid as long as the Improvement Permit is valid.An Authorization to Construct issued for septic repair is valid for 60 months(5 years).Permits may be revoked if the information on this application/site plan changes or if the intended use for the proposed facility changes. Permits may be revoked if site conditions are altered such that they effect permit conditions or installation requirements I have read this application and certify that the information provided herein is true,complete and correct. Authorized county and state officials are granted right of entry to conduct necessary inspections to determine compliance with applicable laws and rules. I understand that I am solely responsible for the proper identification and labeling of all property lines and corners and making the site accessible so that a complete site evaluation can be performed. The undersigned is the owner of the property or legal agent of the owner. Date: Signature of Applicant or Agent If you need further information or assistance please call 828-465-8270 AREA1 FEENAME DATE FEE AMOUNT Authorization to Construct Fee(New/Expansion) 07/20/2022 $150.00 Fee Improvement Permit Fee 07/20/2022 $150.00 Well Permit& Inspection Fee 07/20/2022 $300.00 TOTAL FEES $600i00 FEES ARE NON-REFUNDABLE ONCE A SITE VISIT IS MADE OR WORK ON A PLAN REVIEW HAS COMMENCED SYSTEM REDESIGN AND/OR RETRIP WILL INCUR AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) d iapplication 07/20/2022 16:31 Page 2 of 3 f t .. .:e�.r iED r1s,C p l ;; A :ri J1; ;? Catawba county public health Application for Environmental Health Services THIS IS NOT A PERMIT Application is for: 0 New Construction ❑ Existing Facility Offinprovement Permit [Authorization to Construct • le New Septic ❑ Septic Repair/Malfunction ❑Septic Relocation ❑Septic Expansion • ❑ Existing System Inspection or Reconnection ®New Well ❑Replacement Well ❑Well Abandonment ❑Well Repair • Property Address 3102 Jennys Lane Acres 0.50 Subdivision Heaven Sent Lot# 19 Driving Directions to Property From Newton, take St. James Church Road to Kathy Street. Turn right onto Kathy Street and left onto Jenny's Lane. Lot is located on the left in the cul-de-sac. Describe work New construction residential single family home.Design,manage and build all aspects of construction process. 1:On Applicant Name Victory Builders LLC Applicant Address 3281 Keady Mill Loop Kannapolis,NC 28081 Phone 7047010418 Cell Phone 7047010418 Owner Name Four Corners of Charlotte,LLC Owner Address 1612 Seattle Slew Ct Phone 7047010418 Cell Phone 7047010418 Contractor Name Victory Builders LLC License# Contractor Address 3281 Keady Mill Loop Kannapolis,NC 28081 Phone 7047010418 Cell Phone 7047010418 Name to Appear on Permit? ®Owner 0 Applicant [l Contractor Who will be the Primary Contact? ❑Owner 0 Applicant 2 Contractor Proposed New Construction-Residential Primary Residence 0 New Residence 0 Addition to Residence #of New Bedrooms*1- 3 #of Occupants Project Description New Construction Residential Home Structure Dimensions,also specify dimensions of decks&porches `r5)C.LI Basement 0 Yes g No Basement Plumbing ❑Yes 0 No Accessory Dwelling #of New Bedrooms*t #of Occupants Structure Dimensions Basement 0 Yes 0 No Basement Plumbing ❑Yes 0 No Accessory Structure(s)Describe Structure(s)Dimensions Plumbing 0 Yes 0 No Describe Plumbing Needed Multi-Family Residence #of Apartments #Bedrooms per Apartment*t Total#Bedrooms in Structure*t #of Occupants Structure Dimensions Basement 0 Yes 0 No Basement Plumbing 0 Yes ❑ No Well Construction/Abandonment/Repair Proposed Well Type ® Individual Well 0 Semi-Public Well 0 Community Well Abandonment Type ❑ Drilled 0 Bored 0 Dug ❑ Unknown Well Repair Requested ❑Yes 0 No Describe Will Certified Well Contractor Install Water Line or Electrical Line from Well I-lead to Pressure Tank'?0 Yes 0 No catawbacountync.gov Invironmentol Health Catawba County Government Center 25 Government Drive I PO Box 389 1 Newton NC 28658 1828.4b5.8210 MAKING. LIVING. BETTER, Existing Structures on Site Describe ma Structure Dimensions #of Bedrooms* #of Occupants Basement ❑Yes 0 No Basement Plumbing 0 Yes 0 No Existing'Water'Supply I 0 Individual Well 0 Shared Well—Number of Connections 0 Community Well ❑ County/City/Township Water Line IIs a public water supply available?** ❑ Yes 5 No Commercial ❑ Proposed New Construction 0 Existing/Change of Use 0 Repair Food Service Specify Type #Seats Dining Area(Sq.Ft.) #Employees per Shift #of Shifts Church #of Seats Daycare❑Yes 0 No #of Children #of Employees per Shift #of Shifts Commercial Kitchen ❑ Yes ❑No Residential Kitchen 0 Yes 0 No Daycare#of Children #of Employees per Shift #of Shifts Business/Other Specify Type Structure Dimensions Retail Floor Space #of Employees per Shift #of Shifts Other Information Calculated Design Flow,Commercial t (This value will be determined by EH staff) The Applicant shall notify the local health department upon submittal of this application if any of the following apply to the property in 7 question. If the answer to any question is"yes",applicant must attach supporting documentation. ❑Yes Q'No Does the site contain any jurisdictional wetlands? ❑Yes ®'No Does the site contain any existing wastewater systems? _❑ es No Is any wastewater going to be generated on the site other than domestic sewage? El Yes fit Is the site subject to approval by any other public agency? ❑Yes 21 No Arc there any easements or right of ways on this property? Describe If applying for an Improvement Permit or Authorization to Construct,Please Indicate Desired System Type(s): (systems can be ranked in order of your preference) ❑Accepted 0 Alternative 0 Conventional 0 Innovative 0 Other CS Any *Any room that will be intended for sleeping at the time of construction or for future consideration should be noted as a bedroom and counted on all applications.The number of bedrooms will be confirmed by rooms identified on floor plans as a bedroom at the time of building permit issuance. This may prevent the need for septic system expansion in the future. t If structure is plumbed but has no bedrooms,calculated design flow will be determined by EH Staff. ** If No,a well permit must be issued with the Authorization to Construct. RETRIP TO THE PROPERTY AND/OR SYSTEM REDESIGN WiLL INCUR AN ADDITIONAL CHARGE(SEE FEE SCHEDULE) Completed applications are valid for a period of 2 years. Improvement Permits are valid:with complete site plan=60 months(5 years); with complete plat=without expiration. An Authorization to Construct will remain valid as long as the Improvement Permit is valid.An Authorization to Construct, issued for septic repair is valid for 60 months(5 years).Permits may be revoked if the information on this application/site plan changes or if the intended use for the proposed facility changes.Permits may be revoked if site conditions are altered such that they effect permit conditions or installation requirements. I have read this application and certify that the information provided herein is true,complete and correct. Authorized county and state officials are granted right of entry to conduct necessary inspections to determine compliance with applicable laws and rules. I understand that I am solely responsible for the proper identification and labeling of all property lines and corners and making the site accessible so that a complete site evaluation can be performed. The undersigned is the owner of the property or legal agent of the owner. Signature of Owner or Legal Agent Pa4tiee7Vail rL Date 05 22 Printed Name of Owner or Legal Agent Daniel Hamilton Page 1 of 2 • Parcel Report - Catawba County NC Parcel Information: Owner Information: Parcel ID: 364820816846 Owner: FOUR CORNERS OF CHARLOTTE LLC Parcel Address: 3102 JENNYS LN Owner2: City: NEWTON, 28658 Address: 1612 SEATTLE SLEW CT LRK(REID): 902469 Address2: Deed Book/Page: 3741/1909 City: WAXHAW Subdivision: HEAVEN SENT State/Zip: NC 28173-6642 Lots/Block: 19/ Last Sale: $12,500 on 2022-05-02 School Information: Plat Book/Page: 49/45 School District: COUNTY Legal: LOT 19 19 PL 49-45 HEAVEN SENT PL Elementary School: MAIDEN 49-45 Middle School: MAIDEN Calculated Acreage: .500 High School: MAIDEN Tax Map: School Map Township: NEWTON State Road #: TaxNalue Information: Tax Rates(pdf) Zoning Information: City Tax District: All in County Zoning District: COUNTY County Fire District: MAIDEN RURAL Zoningl: R-40 Building(s) Value: $0 Zoning2: Land Value: $13,500 Zoning3: Assessed Total Value: $13,500 Zoning Overlay: Year Built/Remodeled: / Small Area: BALLS CREEK Current Tax Bill Split Zoning Districts: / Zoning Agency Phone Numbers Miscellaneous: Firm Panel Date: 2007-09-05 Building Permit Address Search for this parcel. Firm Panel #: 3710364800J If available, Building Permits for this parcel. 2010 Census Block: 1047 Septic links are not permits. 2010 Census Tract: 011601 Septic Final Permits prior to 08/2018, contact Agricultural District: PROXIMITY Environmental Health. Building Details I(-00(:_. N.0 Se-c`L _ WaterShed: b � + `�� J�'� Voter Precinct: P20/Voting Map Parcel Report Data Descriptions } List all Owners Deed History Report Assessment Report I 1 UDC +\ .C U This map/report product was prepared from the Catawba County,NC Geospatial Information Services.Catawba County has made substantial efforts to ensure the accuracy of location and labeling information contained on this map or data on this report.Catawba County promotes and recommends the independent verification of any data contained on this map/report product by the user.The County of Catawba,its employees,agents,and personnel,disclaim,and shall not be held liable for any and all damages,loss or liability,whether direct,indirect or consequential which arises or may arise from this map/report product or the use thereof by any person or entity. 7/18/2022