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HomeMy WebLinkAboutLSSP-11-2022-184973.tif Lot 3 - Lakeside Lane State of NC LSS Permit Option COVID-19 LHD Reference: 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 LSS's report that includes: a. Signed and sealed evaluation of soil conditions and site features ❑X Yes ❑ No b. Drawings,specifications,plans X❑Yes ❑ No c. Reports on special inspections and final inspection ©Yes ❑ No d. Management Program manual ®Yes ❑ No e. On-site Wastewater Contractor's signed statement ❑X Yes ❑No 2. Fee (as applicable) ®Yes ❑ No 3. Notarized letter documenting Owner's acceptance of the system from the LSS ®Yes ❑ No 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. ramon gonzalez 16,2023 22:23 EST) 11-16-23 Signature of Owner Date This section for LHD Use Only. LHD Review of required information for the ATO ❑ INCOMPLETE 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,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 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 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 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 8,2020 Page 6 of 6 November 16, 2023 Subject: Septic System Installations Lakeside Lane—Lots 1, 2, and 3 Keisler Dairy Road Conover, NC 28163 The septic systems installed on the above-referenced properties were specified by Larry Thompson, LSS, and installed by Dewey Grant. Mr.Thompson has shared the closeout packages and maintenance plans with us. We do hereby accept the septic system installations for Lots 1, 2, and 3— Lakeside Lane. Sincerely, racoon Gonzalez(Nov 16,2023 22:23 EST) Four Corner of Charlotte LLC November 16, 2023 RE: Septic System Installations Lakeside Lane—Lots 1, 2, and 3 Keisler Dairy Road Conover, NC 28163 The purpose of this letter is to confirm that the septic system installations for the above referenced properties were installed in general accordance with the proposals submitted to your office by Larry Thompson, LSS. Sincerely, De y L Grant Nov 16,2023 23:57 EST) Dewey Grant Maiden Grading and Septic Tank A DATE(MMIDorfYYY) CERTIFICATE OF LIABILITY INSURANCE 07/07/2023 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). coNT PRODUCER NAMEACT Lisa Lynch Davis Mauney Insurance Agency, Inc (A/C,No,Fst): (828)428-8231 NE A/c, Not: (828)428-8237 1205 E Main Street E-MAIL ADDRESS au Idavis�mneY insurance.com INSURER(S)AFFORDING COVERAGE NAIC# Maiden NC 28650 INSURER A: Erie Insurance Exchange 26271 INSURED INSURER B: Maiden Grading and Septic Tank INSURER C: 214 S Main Ave INSURERD: 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 ADDL SUER POUCY EFF POUCY EXP W LIMITS LTR WSD VD POLICY NUMBER IMM!DD!YYYYI (MMIDD/YYYYI X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1000000 DAMAGE TO RENTED 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 PET LOC PRODUCTS-COMP/OP AGG $ 2000000 OTHER: $ AUTOMOBILE LIABILITY (Ee eBINED SINGLE LIMIT $ 1,000,000 ANY AUTO BODILY INJURY(Per person) $ A OWNED 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 UAB _ OCCUR EACH OCCURRENCE $ EXCESS UAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION X PER OTH- ERAND EMPLOYERS'LIABILITY STATUTE A OFFICER/MEMBANY ER EXCLUDED?PROPRIETOR/PARTNER/EXECUTIVE YYN NIA 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 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ $1,000,000 DESCRIPTION OF OPERATIONS!LOCATIONS!VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Thompson Enviroinental Consulting, IncACCORDANCE WITH THE POLICY PROVISIONS. Post Office Box 541 AUTHORIZED REPRESENTATIVE I Midland NC 28107 Fax: Emali:larry@thompsonenv.corn ©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 • WA ,S' T"EWATER ♦ WETLANDS November 16, 2023 RE: Septic System Installations Lakeside Lane—Lots 1, 2, and 3 Keisler Dairy Road Conover, NC 28163 The purpose of this letter is to confirm that the septic systems for the above referenced properties were installed in general accordance with the permit package submitted to your office. The systems has been inspected for the LSS COVID-19 permit closeout process. Sincerely, e / ' . ;4"66e44.*"..'"."- if- 4g2 6/Larry B.Thompson, Jr. I'O BOX 341 • MIDLAND, NC • 28107 PHONE: 704-301•4881 • EMAIL: 1.ARRY@TIIOMPSONENV.COM WEB: \VW1\'.THOMPSONENV.COM Residential Subsurface Wastewater Treatment and Disposal System LSS COVID-19 Proposal for Lot 3 - Lakeside Lane Keisler Dairy Road Conover, NC 28613 Tax Parcel #375114348027 November 15, 2022 Prepared for: Four Corners of Charlotte LLC 1612 Seattle Slew Court Waxhaw, NC 28173 704-713-2602 Prepared by: Michael G. Wood, LSS Thompson Environmental Consulting, Inc. G*"05 SOIL o'�� PO Box 541 °oor �� Midland, NC 28107-0541 )14eas �4kl�k� °,• Phone: 704-301-4881 larry@thompsonenv.com 1219 Lot 3—Lakeside Lane Details Century Complete has contracted with Thompson Environmental Consulting, Inc. (TEC) to prepare LSS COVID-19 septic proposal for the 3-bedroom single family residence to be located on Lot 3 - Lakeside Lane, Leeland Terrace, Keisler Dairy Road, Conover, North Carolina. Based upon a soils investigation performed by TEC, it has been determined that a sufficient amount of "Suitable" Group IV soils is available for the installation of gravity-fed Accepted System with a 25% reduction for both the initial and repair systems at a 0.30 GPD/ft. sq. long term acceptance rate (LTAR). The property is served by a municipal water supply. The enclosed Licensed Soil Scientist Evaluation is being submitted pursuant to and meets the requirements of SL 2020-97 Section 3.19. The owner would like to request that the county issue the appropriate permits for a subsurface wastewater treatment and disposal system based upon the enclosed LSS COVID-19 permit option. Location From Newton, head north on Main Street, right on E 20th street. In 2.0 miles, right on Emmanuel Church Road, left onto Keisler Dairy Road, intersection with Lakeside Lane will be in 0.4 mile. 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, December 6, 2018. Accepted Wastewater System No. AWWS-2005-02-R6; North Carolina Department of Environment and Natural Resources, Division of Environmental Health, On-Site Wastewater Section, August 21,2015. Primary Investigator's Credentials NC Licensed Soil Scientist No. 1219 NC Authorized Onsite Wastewater Evaluator No. 10025E SC Professional Soil Classifier No. 114 VA Professional Soil Scientist No. 415 2 Lot 3—Lakeside Lane 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. 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. 3. The supply line from the pump tank to the distribution box (D-Box) shall be 3-inch Schedule 40 PVC (approximate length of supply line is 10 feet). C. Distribution Method—D-Box 1. The system will be gravity fed to a D-Box. D.Drainfield Installation 1. The drainfield has been previously laid out on-site utilizing metal stemmed flags. The property owner/builder should mark this area and isolate it as much as possible from construction traffic 2. Under no circumstances shall any construction take place within the drainfield area while the soil is in a wet condition. 3. The specified system is the shallow placed innovative wastewater system Infiltrator Quick4 Chamber System. 4. The drainfield consists of three (3) lateral trenches 3-foot wide and 100-feet long. 5. The trench depth for this system shall be 25-inches on the low side of trench. 6. The laterals are to be installed on contour with the land, keeping the individual trench bottoms level from beginning to end. 7. The trenches should be left open for the final inspection. 8. Each trench shall be placed on a minimum of 9-foot on centers. Lot 3 Lakeside Lane Initial and Repair Septic Systems - Field Line# Color Initial/Repair ( Field Length System Length Setup#1 Relative Elevation 1 W Extra — 100 — 5.5 100.0 2 Y Initial 100 100 5.9 99.6 3 B Initial -_ 100 100 6.4 99.1 4 G Initial 100 100 6.95 98.6 5 Y Re it 100 100 7.5 98.0 6 B Repair 185 100 8.1 97.4 7 p Repair 130 100 8.4 97.1 3 Lot 3—Lakeside Lane E. Final Landscaping 1. Final cover over the drainfield shall be at least 6-inches deep. Additional soil cover may be required to achieve the 6-inch requirement. 2. The drainfield shall be shaped to shed rainwater and be free from low spots. 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 fertilized prior to planting.After applying grass seed, the area should be heavily mulched with straw or other suitable material. F. 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. If there are any questions regarding preferred routes, contact the County as soon as possible. 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 drain field area. Maintenance G. In General The designed system does not require ongoing maintenance via a person certified (Certified Subsurface System Operator)by the North Carolina Department of Environment and Natural Resources to operate subsurface wastewater systems(Section .1961 Maintenance of Sewage Systems). However,the following maintenance should be considered by the owner. 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%of the volume of the tank. In some situations, the tanks may need to be pumped more frequently. If you are using a garbage disposal, it is recommended that the septic and pump tanks be cleaned out annually. 3. When it becomes necessary to clean the effluent filters,the filters should be removed, and the accumulated debris washed back into the septic or pump tank—not onto the lawn. 4. Any damp areas, leakages or malfunctions in the drainfield should be addressed immediately. 5. Divert gutter downspouts and surface water runoff away from the drainfield and septic and pump tanks. 4 Lot 3—Lakeside Lane Initial System Design Specifics Daily Design Flow: 360 GPD—3 bedroom house Effluent Loading Rate: 0.300 GPD per sq. ft. Drainfield Type: Accepted(25 %Reduction) Maximum Trench Depth: 25 Inches on low-side Supply Size: 3 Inch Supply Line Length: Approximately 10 feet Number of Drainlines: 3 **Drain Lines: 3' Wide x 100' Long **Drainline Spacing: 9 Foot on Centers Total Trench Length: 300 Linear Feet Distribution Method: D-Box ** See drainfield layout for site locations and more details. Repair System Design Specifics Effluent Loading Rate: 0.30 GPD per sq. ft. Drainfield Type: Accepted (25% Reduction) Maximum Trench Depth: 25 Inches on low-side Supply Size: 3 Inch Supply Line Length: TBD Number of Drainlines: 3 **Drain Lines: 3' Wide x 100' Long **Drainline Spacing: 9 Foot on Centers Total Trench Length: 300 Linear Feet Distribution Method: D-Box 5 � o sou�� I Tax Parcel 375114348327 Tax ParceI375004349344 THO,NA F1+. N/F GREGORY K.& N/F JOEL E.CLINE f 9 spOrr,_x_ I� /...______ DONNA C.GENTRY i DB 2034 PG 733 11....:1)1* DB 2266 PG 833 RAMS OP BEARING: '�REF. PLATI icps,:il - 123.44, • 75.46' I2E I _ 10's.y. -{ - 1 � j �; 43.66' �„ ""�-' propose. ��\�� I ifel?- — --_...._.. driveway I \ ����—;�� 6 • a 7 ,i I I proposed 8 S� _ �i • y l house I26428ft.0.61 acres - DRAIN UNE SEGMENETS d - --r-�,=?=- UNE LENGTH RELATIVE FLAG SYSTEM lir --: o , - -' _ # WTI ELEVATION IFrI COLOR co 10'g•y. I 100 100.00 WHITE NOT USED l 3"SCH.40 PVC 2 100 99.60 YELLOW INITIAL 199.22' 3 100 99.10 BLUE INMAL 1000 GAL. 4 100 98.65 GREEN INMAL SEPTIC TANK 5 100 98.20 YELLOW REPAIR 6 185 97.60 BLUE REPAIR I LOT 2 I 7 130 97.30 PINK REPAIR N/F FOUR CORNERS OF CHARLOTTE,LLC Tax Parcel 375114gg1p82 �° PB85-21 N/F HILDA T.DEAL I DB 3285 PG 830 '-i r LEGEND INITIAL DRAIN LINE SOIL BORING • rximpson 2026 LAKESIDE LANE REPAIR DRAIN LINE ==== PROPERTY CORNER 0 Eflviron198EALa CSOLN202EOR-�97C NOT USED DRAIN LINE PROPERTY LINE MUM* • SEPTIC TANK 0 UTILITY POLE % (" = 30' SUPPLY LINE --•- - POWER LINE Thompson Environmental Consulting,Inc. 30' 0' 3'6' 90' PO Box 541 ■ ■ ■ ■ ■ .m...mm DISTRIBUTION BOX ❑ BUILDING SETBACKS - -- • Midland, NC 28107 GRAPHIC SCALE i nompson Environmental Cons Idng,Inc. Shaw i le a PO Box 541 PROPERTY ID 0: 374.11`L.?'i '4- Midland,NC 28107 • COUNTY: C'Vwfk, SOIL/SITE EVALUATION for ON-SITE WASTEWATER SYSTEM OWNER: ADDRESS: DATE EVALUATED: 2-2C 2 2. PROPOSED FACILITY: Res. PROPOSED DESIGN FLOW(.1949) 361) q p d PROPERTY SITE: /•fr`I •c, LOCATION OF SITE: Y<<..A 1✓ (1 .), — I ar•k.,J PROPERTY RECORDED: WATER SUPPLY: 0 Private ®Public 0 Well 0 Spring 0 Other EVALUATION METHOD: VAu�er Boring 0 Pit 0 Cut TYPE OF WASTEWATER: VServage 0 IndnstrW Prac CI Mixed ..�+ • • P 8 BOIL MOBOLOGY OTHIR pp �(JWI) PROFILE FACTORS t .1018 E L11isacSlS mulagolv PROFILE I S % (MI1!W .1941 Jam. .NI .i 1961 CLASS osmium comminnicai warns; a)n. SAPRO iili3TR. 8 LTAR T.>nrrun lLOGY coLat DEPTH CLASS 1 6 - 5, I v h-/,51.4PANf03 Val ? .�13 O.. ez l�'jss/sP/5:,� Jir . PS 1 �\/�,`Q 3 y 0.3 ` _a , rji.. 06V/4S/"P1 l.tj �1.' GIB i/sf/s4 �ki 0-0-,. PS x 0.3 Z r' r`' At NP RAW .1.,:', i. LS a -Li F G (o D fi �CL , ,,II° PS 3 a'b 0.3 Illigiffenn r'' rr/sP�ao a (4 • PS . '�,`° ,l b h Ci FA /s.4e/ /c A. t.�U �� l • *.0.3 111111111111111111 g Is "ToM 1 ��,BMW REPAIR 81�87''614t OTfII3R FACTORS(.I446r 'e! ,�ih S :s::::45) EVALUATED BY: Si $/,y'T' `r0 �.+ Accepted Accepted O7}ims)PRE9ENT: �' „i '. ?� System 7Ype(s) �:7r� ����,t gifoLTAI1 0.3 0.3 ` �� �, [tM[, ' 128 7 pal SOIL/SITE EVALUATION. t,r? Z (Continuation Shed-Complrtr afield In fill) PROPERTY ID#: 3.9S(1'13 Ykaa?- DATE OF EVALUATION: Z-Zg ' Vt 'L L' COUNTY: e_..'L -J (o, FEP SOIL MORPHOLOGY OTHER ,F I910 (1941) PROFILE FACTORS �lr ' HOR`Z .SRO .041soilasp .ismswSLOPE% 1»u7>3[ all rr COBIRSTUIcrr WETN &I �, MPRO R/lA1t CLASS f�) 11T�11� Darn" CLASSLMARI ALOGY COLOR R ROI= & f Jii. b ,3 1 1 /NS1"r1^`� c ,/ 0 -3 'ti 50\ ( n I xr koise,t9 4!‘, ..„.4 � . . P S *lit �t- 0 - 5r 1 V , .1Ns1P N' ye ( 2+l0 11 '1 �# (> ,, /C /919Atw , Lit i #.... `;.1':' : ,o 3-. • t a 3 I V /r/rs 419,W czo t../5 ' -- ft) , b `Il C... F�/sf /SPi�reo P S 1 AtAtt 9-`'�I 4J f-,/ti /ir 1.rn�P L ,1 (�( i PS -5 I I. 0.3 1 4+t t 7OMMFNTS: • I/u1ck4M STANDARD CHAMBER — 52" Quick4 Standard Chamber — 48" — (EFFECTIVE LENGTH) mg®EEC MM E Mia'AS Vim_ I$ m'm.cE�®®ga= gatm.aa_mEg_agam 34" SIDE VIEW SECTION VIEW MultiPort End Cap imm mom 04--1 n , .. . _ 11;...... 12" 111.4)4(.7. .,..tel 4 �� — i.:.... ,. .. • . , kil1/4, ii „ tall sminsimi 11111, IMIIIIIEM=1 IMMIIIIIIM i allil\ISIAMIlliiiii/'' 34" SIDE VIEW TOP VIEW FRONT VIEW Quick4 Standard Chamber Nominal Specifications — MultiPorl End Cap Nominal Specifications Size (WxLxH) 34"x52"x12" Size (WxLxH) 34"x16"x12" Effective Length 48" Invert Height 8"or 1.25" Invert Height 8" INFILTRATOR SYSTEMS,INC.STANDARD LIMITED WARRANTY (a)The structural integrity of each chamber,end plate.wedge and other accessory manufactured by Infiltrator("Units").when Installed and operated in a leachfield of an onale septic system in accordance with Infittrator's instructions.is warranted to the original purchaser FHoldr-"I against defective 'tam materials and workmanship for one year from the date that the septic permit Is Issued to the septic system containing the Units;provided,however, thet if a septic permit is rot required by applcable law,the warranty period vat begot upon the date that Installation of the septic system commences. To exercise as warrantyof rights,Fielder roust p re raceme in Units at its Corporate Headquarters IntOld Saybrook Connecticutrd Limited fifteen(15) I N FI LTRATO R days of the alleged defect.Infiltrator exc excludes s will supplyst at a Units for Units n of the ni by Infiltrator to be covered by this Umlted Warranty Iniptrators Inability specifically excludes the cost of removal and/or installation of the Units. lb)THE LIMITED WARRANTY AND REMEDIES IN SUBPARAGRAPH(a)ARE EXCLUSIVE.THERE ARE NO OTHER WARRANTIES WITH RESPECT 5YETE M S I N C TO THE UNITS,INCLUDING NO IMPLIED WARRANTIES OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE (c)This Limited Waverly shall be add If any part of the chamber system is manufactured by anyone other then Infiltrator.The Limited Warranty does not extend to Incidental,consequential,special or indirect damages.Infiltrator shall not be liable for penalties or liquidated damages,including loss of Environmental Onsite Wastewater Solutions'" production and profhs,labor and materials,overhead costs,or other losses or expenses Incurred by the Holder or any third party.Specifically excluded from Limited Warranty coverage are damage to the Units due to ordinary wear end tear.alteration.accident,misuse,abuse or neglect or the UNts:the Units being subjected to vehicle traffic or otter conditions which are not permitted by the installation instructions;failure to maintain the 6 Business Park Road •P.O. Box 768 minimum ground covers set form in the installation instructions;the placement of improper materials into the system containing the Units;faikxe of the Units or the septic system due to improper slang or improper sizing,excessive water usage,Improper grease disposal,or improper operation;or Old Saybrook, CT 06475 any other event not caused by Infiltrator This Limited Warranty shall be void if the Holder falls to comply with all of the terms set forth In this Limited Warranty. 860-577-7000• FAX 860-577-7001 Fuller,In no event shall Infiltrator be responsible for any loss or damage to the Holder,the Units,or any third party resulting from installahat or ship menu.or fromany product liability claims of Holder or any third party For this Limited Warranty to apply,the Units must be installed in accordance 800-2L 1-4436 with all site conditions required by state and local codes;all over applicable laws;and Infiltrators Installation instructions. Id)No representative of Infiltrator has the authority to change or extend this Limited Warranty No warranty applies to any party other than the origi- nal Holder The above represents the Standard Limited Warranty offered by Infiltrator.A limited number of states and counties have different warranty require- ments.Any purchaser of Units should contact Infiltrators Corporate Headquarters in Old Saybrook,Connecticut,prior to such purchase,to obtain a copy of the applicable warranty,end should carefully read that warrarty prior to the purchase of Units. U.S.Patents:4,759,661;5,017,041;5,156,488;5,336,017;5,401,116;5,401,459;5,511,903;5.716,163;5,588,778;5,839,844 ;: Canadian Patents:1,329,959;2,004,564 Other patents pending. Infiltrator,Equalizer and SideWinder are registered trademarks of infiltrator Systems Inc.Infiltrator is a registered trademark in France.Infiltrator Systems Inc. « is a registered trademark in Mexico.Contour,Contour Swivel Connection,MicroLeaching,PolyTuff,SnapLock,ChamberSpacer,PosiLock,QuickCut,QuickPlay RECYCLED PAPER and Quick4 are trademarks of Infiltrator Systems Inc.©2003 Infiltrator Systems Inc.Printed in U.S.A. 0011203HP-0 . 1 k Pk- 1 I - 2027-liz$2 ;0)6 Jk}_t 5.111f IA C Ono vier . . LcsV-- 11 -2022 - N-1173 �co.° q ROY COOPER •Governor ! NC DEPARTMENT OF KODY H. KINSLEY • Secretary *1/03) HEALTH AND . M1i �� HUMAN SERVICES HELEN WOLSTENHOLME• Interim Deputy Secretary for Health .ate,, MARK T. BENTON•Assistant Secretary for Public Health 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.2020.97,Section 3.19 and G.S. 130A-336.2 LHD USE ONLY: Initial submittal of this NOI received: I f 17 22 re by t' r j Initials PART 1: Notice of Intent to Construct(NOI)-Please check all that apply El Single System or ❑ Multiple Systems AND Q 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 L55 License number: 1287 Mailing address: PO Box 541 City: Midland State: NC Zip: 28107 Telephone number: 704-301-4881 E-mail Address: tarry@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: Q LSS ❑ LG 5. Property location (physical address,tax parcel identification number or subdivision lot, block number of the property to be permitted): Lot 3- Lakeside Lane, Conover, NC 28613 (PO Parcel: 375114348027) County Name: Catawba 6. Type of facility: ❑� Place of residence No. Bedrooms: 3 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 MAIL ING ADDRESS 1642 Mail Service Center,Raleigh, NC 27699-1642 www.ncdhhs.gov • TEL. 919-707-5874 • FAx 919-845-3972 AN EQUAL.OPPORTUNITY/AFFIRMATIVE ACTION EMPLOYER COVID-19 Permit Option Common Form LHD Reference: ISSN I I-2622 l S`1C( 3 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 accepted system located behind the proposed house site. System Type III(g). 9. Design wastewater flow: 36° gpd Design wastewater strength: Q domestic ❑ high strength ❑ 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: Q Yes ❑ No A site plan as defined in G.S. 130A-334(13a)is attached: Q 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(al)signed and sealed by a LSS is attached: 0 Yes ❑ No 13. Evaluation of geologic and hydrogeologic conditions signed and sealed by a LG is attached ❑Yes NA 14. Proposed landscape,site,drainage,or soil modifications are attached: ❑Yes ❑■ 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 1SA NCAC 18A ,1938 -ti"ities determined to be engineering as determined by the North Carolina Board of Examiners for n and rveyors. 11-15-22 Signature of Lic 671 ffntlst Date Oi4'cr self-submittal of NOI: hereby submit this NOI prepared by Pont Name of Owner Print Nome of Licensed PE pursuant to G.S. 130A-336.1. Signature of Owner Date DNNS/ENS/OSWP-LSS C•I9 COMMON FORM Updated April 2022 Page 2 of 6 COVID-19 Permit Option Common Form LHD Reference: [- Sf !i�2C'Z2 - 11611 1/-) NOTES: LIABILITY: The Deportment, 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[S.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 Deportment 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-I9 COMMON FORM Updated April 2022 Page 3 of 6 COVID-19 Permit Option Common Form LHD Reference:L}C f'I -2022 -1 g4173 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 department 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 department 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 oct 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 department 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 Dote via with directions to re-submit missing items using Page 5 of this form. Email,FAX,USPS,hand-delivered Print Nome of Authorized Agent of the LHD Signature of Authorized Agent of the LHD Date Igf 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. Copies of this signed form were sent to the LSS and the Owner on t)Ia 11 via 1tr lCfil Dote Email,FAX,LISPS,hand-delivered A copy of this NOI and tracking information was sent to the State on via Dote Email,FAX,LISPS,hand-delivered {"(kelei\ 1'� r,( . ��`-�: i 1 z�Print Norof Authorized Agent of the LHD Sign tur of Authorized Agent of the LH Date DI-IHS/EHS/OSWP—LSS C-19 COMMON FORM Updated April 2022 Page 4 of 6 • COVID-19 Permit Option Common Form LHD Reference: LSS -11 -2022" 1g(// / 5 Re-submittal of NOI with missing items included This Section is/or use by owner to submit Items noted os missing during LHO Completeness Review above. Resubmittal5 must be accompanied by a cover letter from the LSS. LHD USE ONLY: This NOI resubmittal received: by Burp ;11rfr015 Item p from initial NOI Resubmittal description Attestation by LSS pursuant to S.L.2020-97,Section 3.19 I, 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 Deportment use after submittal of items noted os 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 Date 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 LHO Signature of authorized Agent of the LHO Date DHHS/ENS/OSWP—LSS C-19 COMMON FORM Updated April 2022 Page 5 of 6 • • COVID-19 Permit Option Common Form LHD Reference: L..s 1)— -2C Z2" 10LI 11> 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 Date 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 LSS'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. Signature of 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,USFS,Hand-delivered Print name of authorized Agent of the LHO Signature of authorized Agent of the LHD 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 Error?,FAX,USPS,Hand-delivered Print name of authorized Agent of the LHO Signature of authorized Agent of the LHD Date ISSUANCE OF CERTIFICATE OF OCCUPANCY: Once the LHO 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/FHS/05WP—LSS C-19 COMMON FORM Updated April 2022 Page 6 of 6 AGENT AUTHORIZATION FORM PROPERTY LEGAL DESCRIPTION: LOT NO. 1 , 2, and 3 PHASE PARCEL ID: 375114348027 STREET ADDRESS: Lakeside Lane Conover, NC 28613 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 r 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. Ow r Signature: Owner Signature: racoon gonzalez(Nov 15,2022 19:56 EST) Date: Nov 15, 2022 Date: • • ACCORD—1-' CERTIFICATE OF LIABILITY INSURANCE DATE(MMfDD1YYYY) liten 9/7/2022 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: uaviu Vaughan Higginbotham Insurance Agency, Inc. PHONE - -FAX 500 W. 13th Street Uvc,NE,ExtL 9187797880 (A/C.No):817-882-9284 Fort Worth TX 76102 ADORREss: dIvjr@higginbotham.net INSURER(S)AFFORDING COVERAGE _ NAIC# Licenself:2081754 INSURER A:Mid-Continent Casualty Company 23418 INSURED THOMENV-01 INSURER B:Hartford Underwriters Insurance Company 30104 Thompson Environmental Consulting, Inc. `- PO Box 541 INSURER C: Midland NC 28107-0541 INSURERD: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:1600075032 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 'ADDL SUER POLICY EFF POLICY EXP LTR TYPE OF INSURANCE _INSD MO POLICY NUMBER SMM/DD/YYYY) (MM/DD/YYYYI LIMITS A X COMMERCIAL GENERAL LIABILITY 04-GL-001086672 9/25/2022 9/25/2023 EACH OCCURRENCE $1,000.000 DAMAGE TO RENTED CLAIMS-MADE X OCCUR PREMISES(Ea occurrence) $100,000 X Professional MED EXP(Any one person) $Excluded PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: 1 GENERAL AGGREGATE $3,000,000 X POLICY JEa LOC PRODUCTS-COMP/OP AGG $3.000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) S EOWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY ,_ AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY (Per acddenl) $ UMBRELLA LIAR OCCUR EACH OCCURRENCE _$ EXCESS LIAB CL_AIMS-MADE 1 AGGREGATE $ __ DED RETENTION$ $ g ;WORKERS COMPENSATION } 38WECNW6175 10/17/2021 10/17/2022 X AND EMPLOYERS'LIABILITY Y/N _STATUTE ERH ANYPROPRIETORJPARTNERJEXECUTIVE N El.EACH ACCIDENT $1,000,000 OFFICERIMEMBEREXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 IIf yes,describe under DESCRIPTION OF OPERATIONS below I E.L.DISEASE-POLICY LIMIT $1,000,000 1 1 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may he attached If more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. For Informational Purposes AUTHORIZED R PRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD • Residential Subsurface Wastewater Treatment and Disposal System LSS COVID-19 Proposal for Lot 3 - Lakeside Lane Keisler Dairy Road Conover, NC 28613 Tax Parcel #375114348027 November 15, 2022 Prepared for: Four Corners of Charlotte LLC 1612 Seattle Slew Court Waxhaw, NC 28173 704-713-2602 Prepared by: Michael G. Wood, LSS Thompson Environmental Consulting, Inc. 4#°4S°u�erF,yl POBox541 . 00 t Midland, NC 28107-0541 J , ► � .� _v, Phone: 704-301-4881 . - tarry@thompsonenv.comge 1219 Lot 3—Lakeside Lane Details Century Complete has contracted with Thompson Environmental Consulting, Inc. (TEC) to prepare LSS COVID-19 septic proposal for the 3-bedroom single family residence to be located on Lot 3 - Lakeside Lane, Leeland Terrace, Keisler Dairy Road, Conover, North Carolina. Based upon a soils investigation performed by TEC, it has been determined that a sufficient amount of "Suitable" Group IV soils is available for the installation of gravity-fed Accepted System with a 25% reduction for both the initial and repair systems at a 0.30 GPD/ft. sq. long term acceptance rate(LTAR). The property is served by a municipal water supply. The enclosed Licensed Soil Scientist Evaluation is being submitted pursuant to and meets the requirements of SL 2020-97 Section 3.19. The owner would like to request that the county issue the appropriate permits for a subsurface wastewater treatment and disposal system based upon the enclosed I.SS COVID-19 permit option. Location From Newton, head north on Main Street, right on E 20th street. In 2.0 miles, right on Emmanuel Church Road, left onto Keisler Dairy Road, intersection with Lakeside Lane will be in 0.4 mile. References Laws and Rules for Sewage Treatment and Disposal Systems, 15A NCAC I8A, Section .1900, Department of Environment and Natural Resources, Division of Environmental Health, On-site Wastewater Section, December 6, 2018. Accepted Wastewater System No. AWWS-2005-02-R6; North Carolina Department of Environment and Natural Resources, Division of Environmental Health, On-Site Wastewater Section, August 21, 2015. Primary Investigator's Credentials NC Licensed Soil Scientist No. 1219 NC Authorized Onsite Wastewater Evaluator No. 10025E SC Professional Soil Classifier No. 114 VA Professional Soil Scientist No. 415 2 Lot 3-Lakeside Lane 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. 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. 3. The supply line from the pump tank to the distribution box (D-Box) shall be 3-inch Schedule 40 PVC (approximate length of supply line is 10 feet). C. Distribution Method—D-Box 1. The system will be gravity fed to a D-Box. D. Drainfield Installation 1. The drainfield has been previously laid out on-site utilizing metal stemmed flags. The property owner/builder should mark this area and isolate it as much as possible from construction traffic 2. Under no circumstances shall any construction take place within the drainfield area while the soil is in a wet condition. 3. The specified system is the shallow placed innovative wastewater system Infiltrator Quick4 Chamber System. 4. The drainfield consists of three (3) lateral trenches 3-foot wide and 100-feet long. 5. The trench depth for this system shall be 25-inches on the low side of trench. 6. The laterals are to be installed on contour with the land, keeping the individual trench bottoms level from beginning to end. 7. The trenches should be left open for the final inspection. 8. Each trench shall be placed on a minimum of 9-foot on centers. Lot 3 Lakeside Lane Initial and Repair Septic Systems Field Line if Color Initial/Repair Field Length System Length Setup#1 Relative Elevation 1 W Extra 100 5.5 100.0 • 2 Y Initial 100 100 5.9 99.6 3 8 initial 100 100 6.4 99.1 4 G Initial 100 100 6.95 98.6 5 Y Repair 100 100 7.5 98.0 _ 6 8 Repair 165 100 8.1 97.4_ 7 P Repair 130 100 8.4 97.1 • Lot 3-Lakeside Lane E. Final Landscaping 1. Final cover over the drainfield shall be at least 6-inches deep. Additional soil cover may be required to achieve the 6-inch requirement. 2. The drainfield shall be shaped to shed rainwater and be free from low spots. 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 fertilized prior to planting. After applying grass seed,the area should be heavily mulched with straw or other suitable material. F. Utility/Drive Conflicts I. 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. If there are any questions regarding preferred routes, contact the County as soon as possible. 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 drain field area. Maintenance G. In General The designed system does not require ongoing maintenance via a person certified(Certified Subsurface System Operator)by the North Carolina Department of Environment and Natural Resources to operate subsurface wastewater systems(Section .1961 Maintenance of Sewage Systems). However,the following maintenance should be considered by the owner. 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% of the volume of the tank. In some situations, the tanks may need to be pumped more frequently. If you are using a garbage disposal, it is recommended that the septic and pump tanks be cleaned out annually. 3. When it becomes necessary to clean the effluent filters,the filters should be removed, and the accumulated debris washed back into the septic or pump tank—not onto the lawn. 4. Any damp areas, leakages or malfunctions in the drainfield should be addressed immediately. 5. Divert gutter downspouts and surface water runoff away from the drainfield and septic and pump tanks. 4 • Lot 3—Lakeside Lane Initial System Design Specifics Daily Design Flow: 360 GPD—3 bedroom house Effluent Loading Rate: 0.300 GPD per sq. ft. Drainfield Type: Accepted(25 %Reduction) Maximum Trench Depth: 25 Inches on low-side Supply Size: 3 Inch Supply Line Length: Approximately 10 feet Number of Drainlines: 3 **Drain Lines: 3' Wide x 100' Long **Drainline Spacing: 9 Foot on Centers Total Trench Length: 300 Linear Feet Distribution Method: D-Box ** See drainfield layout for site locations and more details. Repair System Design Specifics Effluent Loading Rate: 0.30 GPD per sq. ft. Drainfield Type: Accepted(25% Reduction) Maximum Trench Depth: 25 Inches on low-side Supply Size: 3 Inch Supply Line Length: TBD Number of Drainlines: 3 **Drain Lines: 3' Wide x 100' Long **Drainline Spacing: 9 Foot on Centers Total Trench Length: 300 Linear Feet Distribution Method: D-Box 5 . ,nSt c tJ, �N,dR. ,4 s1$ tId w' 4 , _ak--',-.. ., \ ' z w D till Ali Z i I e-N\ 1 ZeW O; W ir. Y=ooZ'JW��p � � � �m� *ea. � � � am^ �* b� rdv' S Opt9. 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PROPOSED ream FLAW(.1949): .3b U Q pd PROPERTY SIZE:2....5C - LOCATION OP SITE Y.c.s L R J, - t o r.v J PROPERTY RECORDLLD WATER SUPPLY: 0 Private ®Public 0 Well 0 Spring 0 Other EVALUATION METHOD: PrAsser Baring 0 Pit 0 CM TYPE OF WASTEWATER: Industrial Pr oae ❑Industrial 0 Weed P Rce SOIL MORPHOLOGY OTHER P (J!A) PROFILE FACTORS L Me ELAIIIISC.APE ROM. M 1POSIT - - atoms 1�O 1M� CLASS Sum!is ON am flit ate. APO .tom .INl STRIXTEIatJ OOkVV wrnasw son. RAMO darn i LIAR TM= DlOIRALOOY COLOR DIMS CLASS gems b - 3 5/ 1 v ,-;-/t4 IvpA,. 1/(7 ; ,A) �h ci 7/cs/So/57,z) r PS 1 v��� 0.3 1v L13'' r. i i a -;. j r 11- HhoskoAAP Ly 41*1 Glf ,=flee/561/ke,n . /` PS 2 5,tw J- / F•/rrI0krxf U10 0.3 1'Ib r r,r NI' op J L L } c Ff. Sf •/S , t•L l PS 3 06, (p - D G F%lu l• sr_► 11° 0.3 1/ 0 - r- %l ' OP '01° L1 0 F t/ <, /si/tP4, • L-11) � 0.3 11111111.111.1 •ti REPAIR imaTIM OTHER FACTORS(.1946): 1/0 r Fs "Tv ar+ ...� `•`•.: DESCRIPTION SITE CLASSIFICATION(.1948): PS PS t.ZNda. '"A Mailable.SDI(.19'� EVALUATED BY: I-, 4,� �O �� Accepted Accepted OTTISR(S)p1�ENT: 1 > r • s' M System Type(s) y f��r Rho LIAR 0.3 0. , I eig4 4') Atom C SOIL JTE EVALUATION Ant Z / (Co Hammon sneer. ►p1.0 ailfidi is,full) 3-9C it Y PROPERTY m '�3 ka� - lAt 'L‘cLI" J. DATE OF EVALUATION: 2 -z$ * V 4 IJ. COUNTY: G.' PJ Cu? O SOIL MORPHOLOGY OTHER F (.1941) PROFILE FACTORS L .1940 E LANDSCAPE •Isis BOR roar rice � .111NI .1l41 SOIL Am .1984 .INM FRAME I a,o�% 1V*t cIVRx, COMMETION11 MIN arm, RAP11O RIM CLIR EWER =VIM PONVtALO(3Y COLOR DErni CLAM WW2 i LTAI (� O —3 5r 1 ,y/„,,A41,if.p ,. . V/ O -1J 501 CV r,f� /'r M t `' qa. ` PS t /7, I-a ISPArAQ ''-' 1 • , • s' --''' - 1.3 1 t g (i . ,Cs�A^\ �9 -iti 11}� C.L, F;/ss /�k0� tit. ,. .=- CP 2allo 1 (z i, As ��,�4w yt ) ... 4*Q.3 J A -J's 3 J L, <�rs A'jv , , t./5 5— to , _ CL, lib? kp Aen:) -- - 00 Lit , . . --, _ _. 1' 0.3 ,, l Z5 - r' i_ ,-/e4/iu P rN(4) 1,5 ) _4 r, Fi/f„fAP/ r,o *At 9-`lI 43k C. /r r, kfr 0Ll( Ps .�- 1-11.1 0.3 1 1 ( , i ‘...,NA 4A A • I/u1ck4 ii rnr STANDARD CHAMBER 52" Ouick4 Standard Chamber — 48" (EFFECTIVE LENGTH) 7_ 1iiritiiOiiiaiiiiirai 12" f 8" 34„ SIDE VIEW SECTION VIEW MultiPort End Cap _- - -______ jr(*, 16"10 • MI Lellkti 34' SIDE VIEW TOP VIEW FRONT VIEW Quick4 Standard Chamber Nominal Specifications MultiPort End Cap Nominal Specifications Size(WxLxH) 34"x52"x12" Size(WxLxH) 34"x16"x12" Effective Length 48" Invert Height 8"or 1.25" Invert Height 8" INFILTRATOR SYSTEMS.INC.STANDARD LIMITED WARRANTY lei The structural ntegdy of each Comber and plate.'wedge lM aFter eegs101y nenutectured by Infiltrator I"Units').widen Petaled awl operated in a leechfialo of en awe on ptio system in accordance with Idltrala's Ielructlofe.le warranted to the menet puniwser rHoirfeel age.st deleche materials ail workmanship to cons Year!ran In data:t urt eta septic ixrmit It Seed to the septic system conlerngl the Lhts prowled.however. ot it a septic permit y no:isrequiredvoid by nip Ilcaly law to warranty periodal o,orate I the date Mel d S tot.of the septic twros commences I N FI LTRAT4 R To ewi.cr-..a.:s wturmity rKJvs I kl<br nnn.rx>bty Id�lratty n wrung al Ca Corporate FWt�rnan n Old Saydodc.Car,eclW within IReen 1151 days or the a1000d detect nfltrela we dopy rnlxecernent U is br UMW dattleir rot by Vertu to be covered by nos united Wrarenty kxrkatafs leaky spediciny exclude:the cost el rertnvel and'a I en a hi UAW. O a lb)THE LMTED WARRANTY AND REMEDIES IN SUBPARAGRAPH II ARE E)ICWSNE THERE ARE NO OTHER WARRAMIES WITH RESPECT SYST�M S INC V TO THE UNITS,INCLUDING NO IMPLIED WAR+ANTES OF NERCFlWFAGIU Y OR FITNESS FOR A I RTICULAA PURPOSE Ic}This Linked Warranty skirl be cad 4 any pan of the Merrier waters a neadealred Of anyone be tan YMtrata The l need Warranty does not e.hnd to moonier.ca,aresu,ttet loeCM or Maid dYnlpy.Yenta shill not be labia lot penalties a keed•ted danletlet,ncludng loss of Environmental Onsite Wastewater Solutions- production end praxes.tabu'and reface*.assessed areas.of awes Osseo a opened*homed by the Holder many mid Wily °eto rely excluded from Prated Worrarmy coverage are daeeae lo to urns AN to anA,ery ear art leer asawlon.rootlet,wawa arise a neglect a the Urns,tie Oats beep suliected to Wide eel&a other caeseare what me not permitted by the•eteletion Irehchae fa,Wa to mantas tine 6 Business Park Road • P.O. Box 768 woman ceoerid cow sat krill n de.neraaarrp,aemcIorre-the taithemeni of Improper rne1enels ono the system ea:taring ilia Urns,feriae or :he this or the septic system the to.rpraper sag or'were song.a.oadve wow so,.letup.grease r>.eroaea Or.npruper opermtnr' is Old Saybrook, CT 06475 any other oaa,t not caused by Parma This hated Werw ry stied be void II t We o Holder to curvy ant:al of the terms set tea,n the Londe,' 860 577 7000•FAX 860 577 7001 Firma.n to event Jtee Iditeator be reapantle tot any loss a damage to the Hader.the Units.or any tort party reading tram/atasana,Or skip 800 221 It 436 went.a ken a.y otoctuut entity clatter,of Il010 a wry amid party Fa the Limited Warranty to apply.do Uses must be rstaled n accordance v V�LL �•Y JV with al see conditions fec ued by state and lad codes.all otter amlcabde ewe:and kisbataS nst:elato,.-emplane ill No e5yeoenla1,5 of nitretor hps do authority orrty to asp a ertet rIse I.sled Watw,ly No waratlY a,l0s In er y Italy oche than the aly. nal Hallo. -1e above represents the St ndad Lra10d Warranty Atoned by Infiltrator A erred Amber d Mlle Ind oxides have tMaert warranty redone- mans. Arty Pieria of Join shaad contact Intererols Corporate Headglalea n Old Sg4rodtl.Canacial.ploy to such purctoso.to obtan a copy of the apptutle wararty.and eixand meekly read Ow warranty pow to the purchased Hera. U.S.Patents:4,750,661;5.017,041;5,156,488:5.336,017;5,401.116:5.401.459:5.511,903:5.716.163:5.588.778:5.839.844 OS Canadian Patents.1.329.959:2.004.564 Other patents pending. L 4 • Infiltrator.Equalizer and SideWinder are registered trademarks of Infiltrator Systems Inc Infiltrator is a registered trademark in France.Infiltrator Systems Inc. is a registered trademark m Mexico.Contour,Contour Swivel Connection.Mlcroleacfuny,PolyTulf.SnapLock.ClrlmberSpacer,PosiLock.ouickCut.OulckPkay Meyerlo►ueKR and Otiek4 are trademarks of infiltrator Systems Inc 0 2003 lrttetrator Systems Inc:.Printed I1 U.S.A. 001 120311P-0