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HomeMy WebLinkAboutLSSP-08-2022-176796.tif 3102 Jennys Lane State of NC LSS Permit Option COVID 19 LHD Reference: LSsp `60o —202i.. —t76 7qt PART 3: Authorization to Operate(ATO) A6Pg -0 7->oa) Ali 7)) Except for dote received,the Section below is to be completed by the Owner.LHD USE ONLY: Initial submittal of request for ATO received: I =7 -23 by 1I-y� A _ ate Initials Date of Post-construction Conference: Iiri 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 LSS's report that includes: a. Signed and sealed evaluation of soil conditions and site features ❑X Yes ❑ No b. Drawings,specifications,plans ['Yes ❑ No c. Reports on special inspections and final inspection ❑X Yes ❑ No 1 d. Management Program manual ®Yes ❑ No 1 e. On-site Wastewater Contractor's signed statement ❑X Yes ❑ No •4.1 2. Fee (as applicable) ®Yes ❑ No --.....- 3. Notarized letter documenting Owner's acceptance of the system from the LSS 0Yes ❑ No W 4. On-site Wastewater Contractor name: Dewey Grant License number: 2607 Mailing address: 214 S. Main Street City: Maiden State: NC Zip: 28650 Telephone number: 828-291-0569 E-mail Address: dewey@maidengrading.com 5. 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 Four Corners of Charlotte LLC hereby attest that all items indicated above have been provided to the Print name of Owner Catawba County LHD and the system shall meet applicable federal,State,and local laws, regulations, rules and ordinances. RECEIVED Atlic2. 06-30-23 -, 1 gonzalez(Jun 30,2023 21:24 EDT( Signature of Owner Date ft This section for LHD Use Only. J111. I 0 2U23 LHD Review of required information for the ATO ❑ INCOMPLETE Environmental Health Based upon review of information submitted by the Owner 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 LHD Signature of authorized Agent of the LHD Date [Z.-COMPLETE Based upon review of information submitted by the Owner 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 7/ P_0L i).i 6 7 23 via £M bi l' 1 . Dote Email,FAX,LISPS,Hood-delivered —1� 2 3 Print name of authorized A ent 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 to a residence,place of business or place of public assembly pursuant to G.S.130A-339. DHHS/EHS/OSWPB—LSS COVID-19 COMMON FORM Effective September S,2020 Page 6 of 6 LSS COVID-19 Permit Option Tracking information The LHD completes this form for each NOI/ATO submitted to their offices. The LHD updates this information and re- sends it throughout the process as appropriate. The Department will use this data to answer any questions on the implementation of the LSS COVID-19 permitting process. Tracking information for LSS COVID-19 permits (Required) County I(Mair41M LHD Reference Number L55P- Og_ 2022 -I7b7q/6 Permitting backlog as of date of NOI submittal(#days) 35 d s Number of days to process the NOI(#days) I do Number of days to process re-submitted NOI(#days or p(} ) I� Facility type 3 job louse. Domestic,High Strength or IPWW PUrlalleShc- Design Daily Flow ? Oq�d_, Residential or Commercial PfSid i System type(per Rule.1961) —I L Date of Post-construction conference N I Date Authorization to Operate issued 7 (Z/23 Fee charged for LSS COVID-19 le r 5 7v. cc Is fee sufficient to cover LHD costs? 16 Date LHD notified of LSS COVID-19 malfunction Date LHD notified of Owner complaint DHHS/EHS/OSWP—COVID-19 Appendix A Updated February 2021 Page 4 of 4 ATO Closeout Form - Dewey Grant Final Audit Report 2023-07-01 Created: 2023-06-30 By: Larry Thompson(tarry@thompsonenv.com) Status: Signed Transaction ID: CBJCHBCAABAAoPEJYBMUdwz2oXrMkIyZT79M5YAV-S4i "ATO Closeout Form - Dewey Grant" History n Document created by Larry Thompson (larry@thompsonenv.com) 2023-06-30-10:45:43 PM GMT-IP address: 108.70.197.25 C'-. Document emailed to ramon gonzalez (romelle03@yahoo.com)for signature 2023-06-30-10:46:03 PM GMT n Email viewed by ramon gonzalez (romelle03@yahoo.com) 2023-06-30-11:39:14 PM GMT-IP address:69.147.95.11 6o Document e-signed by ramon gonzalez (romelle03@yahoo.com) Signature Date:2023-07-01 -1:24:29 AM GMT-Time Source:server-IP address: 172.73.176.49 0 Agreement completed. 2023-07-01 - 1:24:29 AM GMT nwmpipvconnnn mg Powered dY stun Acrobat Sign Four Corners of Charlotte LLC 1612 Seattle Slew Court Waxhaw, NC 28173 Subject: Septic System Installation Lot 19—Heaven Sent 3102 Jenny's Lane Newton, NC 28658 The septic system installed on the above-referenced property was specified by Larry Thompson, LSS,and installed by Dewey Grant. We do hereby accept the septic system installation for 3102 Jenny's Lane, Newton, NC 28658. ,7 1/31 VS Owner igTf&Eu re Date NORTH CAROLINA NOTARY ACKNOWLEDGMENT THE STATE OF NORTH CAROLINA COUNTY OF MIX��Coyl�l.LB�� I, arit SiP.V lGi , Notary Public,do hereby certify that gOY✓l►1 CAA ". a 9",5i1 (name of individual(s)whose acknowledgment is being taken)personally appeared before me this day and acknowledged the due execution of the foregoing instrument. Witness my hand and official seal this A,3'd day of %T' 20 , 7r3. VkikOYLtik Notary Public Signature Print ivVV I# ' &1a-v`1 My commission expires: (Official Seal) \\\\`\\vtiA�B E6, `//// Notary Public Q Mecklenburg County My Comm. Exp. �l� 10-19-2024 June 30, 2023 RE: Septic System Installations 3102 Jenny's Lane Newton, NC 28658 The purpose of this letter is to confirm that the septic system installation for the above referenced property was installed in general accordance with the proposal submitted to your office by Larry Thompson, LSS. Sincerely, Dewey" L Grant(Jun 30,2023 19:22 EDT) Dewey Grant Maiden Grading and Septic Tank A�� DATE(MMIDDIYYYY) CERTIFICATE OF LIABILITY INSURANCE 07r07r2023 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER NAME:CONTACT Lisa Lynch Davis Mauney Insurance Agency,Inc (A/C,NE,EXq: (828)428-8231 IAA/c.Not: (828)428-8237 1205 E Main Street E-MAIL ADDRESS: � ymaune Idavis insurance.com INSURER(S)AFFORDING COVERAGE NAIC# Maiden NC 28650 INSURERA: Erie Insurance Exchange 26271 INSURED INSURERB: Maiden Grading and Septic Tank INSURERC: 214 S Main Ave INSURER D: INSURER E: Maiden NC 28650 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 TYPE OF INSURANCE ADDLISUBR POLICY EFF POLICY EXP LIMITS LTRINSD WVD POLICY NUMBER IMMIDDIYYYYI IMM(DD/YYYYI X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1000000 DAMAGE TO RENED CLAIMS-MADE X OCCUR PREMISES(Ea occurrence) $ 1000000 MED EXP(Any one person) $ 5000 A Q30-0621570 06/06/2023 06/06/2024 PERSONAL&ADV INJURY $ 1000000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2000000 POLICY JEC7 LOC PRODUCTS-COMP/OP AGG $ 2000000 OTHER: $ AUTOMOBILE LIABILITY (EOMMdED SINGLE LIMIT $ 1,000,000 ANY AUTO BODILY INJURY(Per person) $ A AWNED SCHEDULED AUTOS ONLY AUTOS Q06-0530679 06/05/2023 06/05/2024 BODILY INJURY(Per accident) $ HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY (Per accident) UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER A OFFICER/MEMBER EXCLUDED?ANY PROPRIETOR/PARTNER/EXECUTIVE Yn N IA I Q91-5900316 07/09/2023 07/09/2024 E.L EACH ACCIDENT $ $1,000,000 (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ $1,000,000 It yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ $1,000,000 DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES ACORD 101,Additional Remarks Schedule,maybe attached If more space Is required) ( Pa 4 ) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Thompson Enviromental Consulting, Inc ACCORDANCE WITH THE POLICY PROVISIONS. Post Office Box 541 AUTHORIZED REPRESENTATIVE Midland NC 28107 Fax: Email:larry@thompsonenv.com ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD THOMPSON ENVIRONMENTAL CONSULTING, INC . WATER • WASTEWATER • WETLANDS June 30, 2023 RE: Septic System Installation Lot 19— Heaven Sent 3102 Jenny's Lane Newton, NC 28658 The purpose of this letter is to confirm that the septic system installation for 3102 Jenny's Lane, Newton, NC 28658 was installed in general accordance with the permit package submitted to your office. The system has been inspected for the LSS COVID-19 permit closeout process. Sincerely, Larry B.Thompson, Jr. PO BOX 541 • MIDLAND, NC • 28107 PHONE: 704-301-4881 • EMAIL: LARRY@THOMPSONRNV.COM WEB: WWW.THOMPSONENV.COM t, 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: � �D SOiL s,��� ti 0 1 OM,os j. Four Corners of Charlotte LLC � , ''~ ° � 1612 Seattle Slew Court .. . *Waxhaw, NC 28173 �� tr.+ 704-713-2602 • J} "�7. 1287 Prepared by: oomm„l,,,4,���,, N Roy -, Larry Thompson, REHS, LSS .�` pQ,.•'��NsTEq. �,,e'�, Thompson Environmental Consulting, Inc. • •••':? PO Box 541 = SEAL Midland, NC 28107-0541 =y :�o 1208 (1 : Z Phone: 704-301-4881 =,� • �j �,�;O� larry@thompsonenv.com .�1-�• ...... •P�,,,.�� 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 (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. III NC Subsurface Septic System Operator No. 22199 NC Grade IV Wastewater System Installer/Inspector No. 1762/17621 2 7 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 fi 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 1% 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 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 PB. 49 PG 45 4yo PID# 3648-2081-5749 ZONE: R-40 • IMF #6 LOT 20 \ i , ...; ° /I/ 06, �s /f S ���1 /(G3 �iti D� IRF #6 0? r! C .^ \ .57�� cqs a ' ,4, / 5 , \ >, ,'P,L, IPS #4 .0 ,bo ' \ J' // /rif N N 17N%( ° 'S'57°'CI ...c • IN/ ---- 3 --- THE d:' #6 7 NATHALIE 'dy �qs i 7 IRF air by Lip t 4 6 . ,• •W \ l`' �p , 4.26,01 \ �.'� �' �•►!Si IRF f • . 9 Zi? S 2 d,o B 2�� • SO / � � '� , 0, 1--\ t),c . SB/-1Q Li./ _,.., LEGEND \ � �� �� ,. ii-) ,o, - -- GIS 2-ft Contour Lines j/ 6' Q / o o c` \ • Existing Wells % / 4 L9 \ S B 3 G.� j4e I/ ^ CT�y 50-ft Existing Well Buffer ;` COift • Proposed Well Location t�0 S` Sao ' o��', v / .., 0 „.‘4_, 50-ft Well Buffer / , VZ , iii House Box LU 660� co tu4J g v Septic Tank Z 39 4 co 2 Supply Line h_' c 1 3/ = PPBPS Drainlines IRF #6 •••+ PPBPS Repair Lines - 1-1RF #4 Soil Boring Locations z N/F Date: Proposed Septic Layout March 2022 Figure Thompson Prepared For: Environments Lot 19- Heaven Sent Scale: immiemsuiting Four Corners of 3102 Jennys Lane 0 15 30 n Charlotte LLC Newton, NC 28658 TEC Job #: Catawba county 22-66 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