HomeMy WebLinkAboutAUTH-09-2022-180815.TIF SS a i. CATAWBA COt:NTY
Punt c Ilc.lib Department Sulxlivrsmn
< ��� Environmental Ileulth Division PIN# 368702970751
®� I'O Box 3R9,25 Govcmnicnt Drive,Nctston,NC IRht5 l,t)l p 24C&ADJ
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Stu?Address: 3555 MT BEULAH RD,SHERRILLS FORD NC 28673
Name on Permit: MARGARET PEMMARAJU
Property Size: Acres 2.17
Directions: N Bus Hwy 16,nght onto Mt. Beulah,property is about 2 miles down Mt. Beulah on left,property is before
Lineberger Rd Intersection,red barn
Owner/Authorized Representative Acknowledgement of Permit Receipt
1'" ri certify that I am the owner or authorized agent(owner's authorization required)representing the owner of
the property described above,
‘14 s the property owner or authorized representative, I have received the above referenced
permit(s)as requested in the application for service RBPR-07-2022-41544,by the following method(s):
_ Received in Person
Facsimile Transmittal(Return form with signature required)
I Electronic Image Transmittal/E-mail (Return receipt required)
pid As the property owner or authorized representative I have reviewed and understand the specific conditions
of the permit issued, and further understand that all applicable regulatory requirements specified under the
North Carolina Laws and Rules for Sewage Treatment and Disposal Systems(15A NCAC 18A.1900),
and/or Well Construction Standards(I SA NCAC 2C.0100), shall apply to the issuance of this permit and
the construction of the wastewater system and/or water supply well permitted.
Permit Issue Date:09/21/2022
r
Owner/AuthorizedAue Representative Signature
a
1 Date -r o (1{ --o) .
Documentation of Permit(s)Transmittal
(permit transmitted by electronic or other means)
Permit transmitted by (name of person sending permit)
Signature
nC Date/Time
Method: Fax Email _US Mail Other
Owner's request to send by the above indicated method of transmittal In lieu of signature
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Parcel: 368702970751, 3555 MT BEULAH RD 1in-60ft
SHERRILLS FORD, 28673
This map/report product was prepared from the Catawba County,NC Geosoatial Information Services. Catawba County has made substantial efforts
ca
to ensure the accuracy of lotion and labeling information contained on this map or data on this report.Catawba County promotes and recommends
the Independent vertficatlon of any data contained on this map/reportproduct
by the user. The County of Catawba,Its employees,agents,and
personnel,disclaim,and shall not be held liable for any and alldamages,loss or liability,whether direct,indirect or consequential which arises or may
arise from this map/roport product or the use thereof by any person or entity.
Copyright 2021 Catawba County NC
09/16/2022
INSPECTION AND MAINTENANCE AGREEMENT
STATE OF NORTH CAROLINA
COUNTY OF_ +G$,/Jo lta.
In
This agreement is made and entered intt,this 3 a day of \A.i AV ,20Q�
by and between Mai �_ P,e a r-C �a f (hereinafter referred to as
the"Owner")and u SSA 11 (hereinafter referred to
as the"Contractor"). bets f et,.a -t o, S�Gu. ds 5
WITNESSETH
WHEREAS,the Owner owns or controls the property upon which a ground absorption wage
treatment system(hereinafter"system")is installed,such system being designated a Type � system
under the Rules for Sanitary Sewage Collection,Treatment and Disposal found at 15A N.C.
Administrative Code um.- 11,01 seq.;and
WHEREAS, 15A N.C.Administrative Code 18A.1961 requires a contract to be executed between the
system owner and a management entity prior to the issuance of an Operation Permit for said system;and
WHEREAS,15A N.C.Administrative Code 18A.1961 requires that a condition of the Operation
Permit for said system be that a properly executed contract between the system owner and a management
entity,shall be in effect for as long as the system is in use;and
WHEREAS,the Contractor is a ent entity,of a type authorized by 15A N.C.Administrative
Code 1€E 1301 to manage a Type I system.
NOW THEREFORE,in consideration of the premises and of the mutual covenants and promises
contained in this Agreement,it is hereby agreed by and between the Owner and the Contractor as stipulated
below.
1. The Contractor's Obligations. The Contractor shall perform the following services on the Owner's
system located at R A .
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c'S 1 W Virg'G �.4_ A) 761 g-6 7
bowl fen Mai
a) The contractor shall inspect the system at least Cthe frequency,required in Table V(b)of 15A
N.C.Admin. Code 18A1961(b)fora Type 7 R. System.
b) The Contractor shall perform the following routine maintenance procedures in accordance with the
conditions of the Operation Permit
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2) Th5 r-f S s tvr.ca.ahtcd vot-t.rnc'15 c�v� ' v�•'Li •/1't�i1 �r4tJkt
3) TeS t`- Run Y �^p a. _m ec►vvrao 1 pcfm. l
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c) The Contractor shall report the results of its inspections to the local health department at the
el}}cy specified in Table V(b)of 15A N.C.Administrative Code 18 E 13n1(b)fora Type
/(tfr System.
d) If an inspection indicates the need for system repairs,the Contractor shall notify the local health
INSPECTION AND MAINTENANCE AGREEMENT
department within 48 hours of the inspection.
e) The Contractor shall notify the Owner of needed repairs,which are outside of the scope of routine
maintenance described in subparagraph(b)above. The Contractors shall perform necessary
repairs to the system at the request of the Owner and shall be entitled to payment therefor at the
Contractor's normal charge for services and materials.
f) The Contractors shall employ or shall contract with a certifie4 operator(s)if required by Table V
(b)of 15A N.C.Admin. Code 186 1301(b)fora Type - System.
g) The Contractor shall respond to a request for a nonscheduled service or maintenance call within
L fk hours after receipt of such request.
2. The Owner`s Obligations.
a) The Owner shall pay to the Contractor the sum of$ )O per year for periodic inspections,
routine maintenance procedures and periodic reports. The annual fee may be amended upon sixty
(60)days advance notice to the Owner but may not be increased more than S percent per
year. The Owner shall pay to the Contractor his normal and customary fees for any work
performed on the system as a result of nonscheduled service or maintenance calls. All fees are due
and payable within thirty(30)days of billing. Payments due to the Contractor and unpaid by the
Owner after thirty(30)days shall accrue interest from the due date until paid at a rate of l t 5
percent per month.
b) Within 15 days of receipt of notice of needed repairs pursuant to paragraph 1.e.above,the
Owner chat'request the Contractor to complete needed repairs or shall provide to the Contractor
evidence that the needed repairs were satisfactorily completed by another entity.
c) The Owner shall provide the Contractor with such access to the system as is reasonably necessary
for the Contractor to comply with the terms of this Agreement
3. Term. This Agreement shall remain in effect until terminated.
a) Automatic Termination.
This agreement shall automatically terminate if the Operation Permit for the system is revoked and
all appeals of the revocation are exhausted or the time for taking an appeal has passed.
b) Termination by Mutual Consent
The Parties may mnhnlly agree to terminate this Agreement by giving written notice of
termination by mutual consent to the local health department thirty(30)days in advance of the
date of termination.
c) Termination by the Owner.
The Owner may terminate this Agreement by giving notice to the Contractor and to the local
health department thirty(30)days in advance of the date of termination.
INSPECTION AND MAINTENANCE AGREEMENT
d) Termination by the Contractor.
I) The Contractor may terminate this Agreement for cause by giving written notice of intent
to terminate this Agreement to the Owner and to the local health department thirty(30)
days in advance of the date of termination. Cause shall be defined as:
a) failure to remit payment for any bill for services performed under and in accordance with
this Agreement if said bill is not paid within thirty(30)days of receipt by the Owner of
the bill. If said bill is paid after notice of termination of this Agreement,the Agreement
shall continue in effect;or
b) failure of the Owner to provide to the Contractor authorization to complete needed repairs
or satisfactory evidence that needed repairs to the system were completed by another
entity within 1 S days of receipt of notice of needed repairs pursuant to paragraph 1.e.
above. If said authorization to complete needed repairs or evidence of completion of said
repairs is provided after notice of termination is given but prior to the date of termination
of this Agrreement,this Agreement chall continue in eft or
c) failure of the Owner to allow the Contractor such access to the system as is reasonably
necessary in order for the Contractor to comply with the terms of this Agreement
2) The Contractor may not terminate this Agreement without cause,but may assign its rights
and duties under this Agreement as provided in paragraph 4,below.
4. Assignment.
a) Assignment by the Owner.
The Owner chall notify the Contractor of the name and address of any purchaser of the property
on which the system is located. The Owner chall also notify any purchaser of the property on
which the systrur is located of the existence of this Agreement and shall assign all rights and
duties under this Agreement to said purchaser.
b) Assignment by the Contractor.
The Contractor may assign its rights and duties under this Agreement to another management
entity,which is qualified pursuant to 15AN.C.Admin. Code 18 la%to manage a Type fi=
system upon thirty(30)days written notice to the Owner and to the local health department
5. Use of Subcontractors. The Contractor may subcontract with such manufacturers,suppliers and
contractors as it deems desirable to perform any of the Contractor's duties under this Agreement.
The Contractor shall at all times remain responsible for the performance of and payment for all
work performed by all subcontractors.
6. Representations. The Parties represent to each other that each has the power,authority and legal
right to enter into and perform its obligations as set forth in.this Agreement
INSPECTION AND MAINTENANCE AGREEMENT
7. Regulatory Amendments. References in this Agreement to sections of the Administrative Code shall
include such rules as they may be amended in the future.
8. No Implied Waiver. The waiver by either Party,of the default or a breach by the other Party of any
provision of this Agreement shall not operate or be construed to operate as a waiver of any
subsequent default or breach. The failure at any time of either Party to enforce any provision of
this Agreement(a)shall not be construed to be a waiver of such provisions,or of any other
provision;and(b)Shall not in any way affect the validity of this Agreement,or any part of this
Agreement,or the right of either Party thereafter to enforce each and every provision of this
Agreement
9. Notice. Every notice required under this Agreement shall be in writing and Ghat'be deemed
sufficiently given if delivered in person or sent by certified or registered mail,return receipt
requested,postage prepaid to the Party to be notified and addressed as follows:
To the Owner. a v- D PeWr wi CL t u
l�r Ghi trrt h
trvvr.b.e A�
To the Contractor: Lt)45tt — = d,0- 4sL4t d I6 4t '
P141a;en n` acrosa qis;v q t,510
To the Local Health Department C +C4.W 111 at. C' 11�/ I!. 8ca 14-1
P box 3“R
;63— eya'70
The date of any Notice shall be the date of personal delivery or the date shown on the return receipt
as the date of delivery or attempted deliver,as the case may be. Changes in the respective
addresses to which notice may be directed may be made from time to time by either Party by notice
to the other party.
10. Place of Agreement. This Agreement and any questions concerning its validity,the system
construction or performance shall be governed by the laws of the State of North Carolina.
notwithstanding the place of execution,or the order in which the signatures of the Parties are
affixed.
11. Entire Agreement and Amendment This Agreement supersedes all prior negotiations,agreements
and understandings between the Parties with respect to the subject matter hereof and constitutes the
entire Agreement between the Parties with respect to the subject matter hereof. To be effective,any
amendment or modification to this Agreement must be in writing and must be signed by the Parties.
12. Severability. In the event that any provision of this Agreement shall,for any reason,be determined
to be invalid,illegal or unenforceable in any respect,the Parties shall negotiate in good faith and
agree to such amendments,modifications or supplements of or to this Agreement or such other
appropriate actions as shall,to the maximum practicable in light of such determination,implement
and give effect to the intentions of the Parties as reflected in this Agreement,and the
7/31/24,8:46 PM AT&T Yahoo Mail-3555 Mt Beulah signature page
1
INSPECTION AND MAMNTENANC.-AcBEMENT
other provisions of this Ageement shall,as so amended,modified,supplemented or otherwise
affected by such actions,remain in full force and effect.
IN TESTIMONY WHEREOF,the Parties hereto have executed this Agreement in duplicate
o:i nals,one of which is retained by each of the Parties,the Clay and year fast above written.
W.3.4k
(Owner)
•
ide
•
(Contractor)
Wastewater Solutions &Design
RussellB Williams
"Wastewater Specialist" _
0 Mold en.NC28650
Ph.9S0-429-1580
Fax-828.4283028 ^rilliotn%9534.abdfsnrrth.r:rt
"Certified Septic Installer,Inspector&Operator^
7i
rs
Margo Pemmaraju
General Contractor NC
Owner/Designer
2/3
aboutblank
,„687, CATAWBA COUNTY Case# IMPV-09-2022-180438
• ..111 Public Health Department Subdivision
i Environmental Health Division PIN# 368702970751
PO Box 389,25 Government Drive,Newton,NC 28658 LOTS 24C&ADJ
• w
Site Address: 3555 MT BEULAH RD,SHERRILLS FORD NC 28673
Name on Permit: MARGARET PEMMARAJU
Property Size: Acres 2.17
Directions: N Bus Hwy 16,right onto Mt Beulah,property is about 2 miles down Mt Beulah on left,property is before •
Lineberger Rd Intersection,red barn •
•
Improvement Permit
AN AUTHORIZATION TO CONSTRUCT MUST BE ISSUED PRIOR TO BUILDING PERMITS
THIS PERMIT IS NOT FOR SEPTIC INSTALLATION
Permit Category: Relocation Wastewater Flow 480 g.p.d
Type of Facility: Primary Residence
Basement? No Basement Plumbing? No Bedrooms: 4 -
Water Suppry: Private Well Maximum Occupants: B
_ INITIAL SYSTEM SPECIFICATIONS
Proposed Wastewater System: 50%REDUCTION VERTICAL .
System Classification: IVA-ANY SYSTEM WITH LPP DISTRIBUTION •
Pump Required ***** Operator Required s
_ REPAIR SYSTEM SPECIFICATIONS
Repair System Required? Required
Proposed Wastewater System: 50%REDUCTION VERTICAL •
System Classification: IVA-ANY SYSTEM VVITH LPP DISTRIBUTION
Pump Required ***** Operator Required
Permit Conditions:
Landscaping or other site alterations that potentially divert groundwater or surface water toward the septic system, or prevent proper
drainage away from the septic system, including the direction of gutter flows or foundation drains,is not approved,and may result in failure to- • -"
approve the initial system installation.or the suspension/revocation of existinp permits.
The issuance of this permit by the Health Department does not guarantee the issuance of other permits. It is the responsibility of the applicant -
/property owner to insure that all Catawba County Planning/Zoning and Building Inspections requirements are met This Itnpmvement Permit
is subject to revocation if the site plan,plat or the intended use changes,or if site conditions are altered. The Improvement Permit is not
affected by a change in ownership of the property.This permit was issued in compliance with the provisions of the North Carolinalaws and
flutes for Sewage 7Yearment and Disposal Systems'(15A NCAC 18A.1900). Neither Catawba County nor the Environmental Health
Specialist warrants that the septic tank system will continue to function satisfactorily for any given period of time.
Any permit issued for a conventional system maybe used for an accepted system without Environmental Health authorization or permit
modification.Please notify Environmental Health of this change prior to system installation.
•
•
•
•
• 09/18/2022 F•:--
Authorized State Agent Permit Issuance Date
9/16/2027
Permit Expiration Date
No grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department.
ehpemut 09212022 14:17
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RSPR-07-4V-11162111
! Catawba County Environmental Health ili7/1/-CW.42,_f` CS
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Parcel: 368702970751,3555 MT BEULAH RD lln=60ft
SHERRILLS FORD, 28673
This map/report product was prepared from the Catawba County,NC Geospatial Information Services. Catawba County has made substantial efforts I
to ensure the accuracy of location and labeling Information contained on this map or data on this report.Catawba County promotes and rarx,mmands I
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.
Copyright 2021 Catawba County NC
09/16/2022
. auk.-4 - -(9c/X.- M)gis
e p,-I L MAINTENANCE REPORT FORM 1
-- Date of Inspection
COUNTY/STATE COMPLIANT YES I()NO
ii PRQPERTY ADDRESS:
STREET (f 5 S- �T_t)`gu-��l n NAPHASE-
CITY SI.er ` i 5 'b lid NC' ` ZIP ci2 7 -
SEPTIC TANK- 10� PUMP-IMP Model Volr ii;
PUMP TANK- IC � s Pump present and operating -
Risers accessible -
✓ Design GPM__Actual GPM '
Signs of Infiltration Ni° — f
Structurally Sound Ur High water alarm operating,propl-..rly-✓ -
Pipework in good condition ✓
Landscape Positi,
Filter CIeaned Control panel in good condition_..
SN-SEE NOTES BELOW Control floats operating grope
Straps and float tree
Effluent free and clear of solidi 1/ .
SYSTEM TYPE •
- 64A ( )25% RED. ( )CONV. •
o ( )GRAV. ( ) PM i..(Atd Pi eic.t,` `e-' pp
(0'� LIN. ET. (/) LINES @ FT. LONG lla�"�CGLJ1-e /!4f 111
( )POLY ( )CHAMBER ett,t j ca j p p.I�? -
o NO EFFLUENT SURFACING TRAFFIC PROTECTED)7 '
Vo SURFACE WATER DIVERTED DISTRIBUTION SE' '
o LINE COVER MAINTAINED REPAIR AREA RESERVED
LOW PRESURE SYSTEM
, ? TURN-UPS,CLEAN-OUTS,VALVES LOCATED/PROTECTED • - .
o LATERALS FREE OF EXCESS SOLIDS
*IliLATERALS FLUSHED
PRESSURE HEADS FOR EACH LINE ON BACK OF PAGE
•
NOTES FOR CORRECTIVE ACTION(LOT#: I -
- Sc)t ick Cs 1k45 e) I ee;e,t i A 4-s H;c 14k is:CUT really at.. e
t'1ti�` 'ccuik Sk�t(cl Ale_ puvn �d u1na -t-ii Level reach es• _Egli oi: . in,,,"�
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3 , ee.r4 vaiv due,tivs ca' .vri E5-Fl Aes ioi.IA. LY tkeit L-ss
4.
Wastewater Solutions &Design
5. NO CORRECTIVE ACTION NEEDED
Russell B Williams
"Wastewater Specialist"
CorKe I 0 ptuttfo r eivt,q4ig .
Maiden,NC 28650
Ph.980-429-1580 - s
Fax.828-428-3028 22 years experien
•
"Certified Septic Installer.Inspector&Operat
a
Wastewater Solutions&Design Invoice
Russell Williams
"Wastewater Consultant" Date Invoice#
4919 E Maiden Rd 4/21/2025 5211
Maiden,NC 28650
Bill To
Margo Pemmaraju
3555 Mt Beulah Rd
Sherrills Ford,NC 28273
Description Amount
Type 4a LPP Maintenance Visit at 3555 Mt Beulah Rd Sherrills Ford,NC and Invoice for the upcoming year. 400.00
We appreciate your prompt payment.
Phone# E-mail Total $400.00
9804291580 rwilliams9534@bellsouth.net