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HomeMy WebLinkAboutLSSP-12-2022-185907.TIF 3q �, ��.n o L155P-O-)L:)) - 1$ 'il7 RECEIVED 12161.)k -D-)o ) .gYY1)11 UDC T ;? c STATE a, �d""„,,e.,,,, % ROY COOPER•Governor �C,: ry NC DEPARTMENT OF KODY H.KINSLEY•Secretary = Q, I1kWICES HELEN WOLSTENHOLME• Interim Depu�rd2: fe t i}�ealth ., - 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 �%1 aa � r LHD USE ONLY: Initial submittal of this NOI received: Y �� ` 1 ,t by I` Date Initials PART 1:Notice of Intent to Construct(NOI)-Please check all that apply V 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/L55 COVID 19/AOWE Permit Number 1. Facility Owner's name:(Owner,Company Name, Utility,Partnership, Individual,etc.): Bolick Management, LLC c/o Jeff Bolick Mailing address:1236 Buffalo Shoals Rd City:Catawba State: NC Zip: 28609 Telephone number: 828-312-2809 E-mail Address: bolick.jeff@yahoo.com 2. Licensed Soil Scientist(LSS)name:Caroline J.Edwards LSS License number: 1220 Mailing address: 991 Duncan Road City:Rutherfordton State:NC Zip:28139 Telephone number: 828-289-0122 E-mail Address: cjedwards234@gmail.com 3. Licensed Geologist(LG)(if applicable) name:_NA 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):3708 Bethany Church Rd #376114420528 new Lot 1 County Name: Catawba 6. Type of facility: ® Place of residence No. Bedrooms: 4 _ No.Occupants:4 ❑ 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/AFFIRMATIVE ACTION EMPLOYER COVID-19 Permit Option Common Form LHD Reference: U� ( (gc107 7. Factors that would affect the wastewater load: None 8, Type and located of proposed wastewater system: Illg Rear of duplex 9. Design wastewater flow: 480 gpd Design wastewater strength: ®domestic ❑ high strength ❑industrial process(For Industrial process wastewater,a Professional Engineer licensed In accordance with G.S.89Cshall 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(al)signed and sealed by a LSS is attached: ®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 Caroline J. Edwards 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.1938 and activities determined to be engineering as determined by the North Carolina Board of Examiners for Engineers and Surveyors. Z. Signature of Licensed Soil Scientist Date Owner self-submittal of NO1: I, hereby submit this NOl prepared by Print Name of Owner Print Name of Licensed PE pursuant to G.S.130A-336.1. Signature of Owner Date DHHS/EHS/OSWP--LSS C-19 COMMON FORM Updated April 2022 Page 2 of 6 • COVID-19 Permit Option Common Form LHD Reference: LsS e '(Z`'7 0 - k 0 l 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(S.L.2020- 97,Section 3.19(d)and G.S.130A-336.2(f)J 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 �� 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 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 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_ Date 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 L� 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. t (Copies of this signed form were sent to the LSS and the Owner on lvia Date Email,FAX LISPS,hand-delivered A copy of this NOI and tracking information was sent to the State on via Date Email,FAX,USPS,hand-delivered 71. Print Name of Authorized Agent of LHD Signature of Authorized Agent of the LHD Date DHHS/EHS/OSWP—L55 C-19 COMMON FORM Updated April 2022 Page 4 of 6 COVID-19 Permit Option Common Form LHD Reference: / i^ - I LZ7 j l 7 0 Re-submittal of NOI with missing items included This Section is for use by owner to submit items noted as missing during Lila Completeness Review above. Resubmittals must be accompanied by a cover letter from the LSS. LHD USE ONLY: This NOI resubmittal received: by Date initials Item#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 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,USPS,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,USPS,Hand-delivered A complete copy of this form with tracking information was sent to the State: via Date Email,FAX USPS,hand-delivered Print name of authorized Agent of the LHD Signature of authorized Agent of the LHD Date DHHS/EHS/OSWP—LS5 C-19 COMMON FORM Updated April2022 Page 5 of 6 COVID-19 Permit Option Common Form LHD Reference: L f i2 "Z,Z2-�yc1'J7 PART 3: Authorization to Operate(ATO) Except for dote 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 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 Dote 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 US 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 ❑ 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,LISPS,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 pursuont to G.S.130A-339. DIIiIS/EHS/OSWP—LSS C-19 COMMON FORM Updated April 2022 Page 6 of 6 • • -k CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) �... 09/09/2022 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(les) must be endorsed. If SUBROGATIONIS 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 NUTMEG INS AGENCY INC/PHS NAME; 76210781 PHONE (888)925-3137 FAX (A/C,No,Ext): (A/C,Ho): The Hartford Business Service Center 3600 Wiseman Blvd E-MAIL San Antonio,TX 78251 ADDRESS INSURER(S)AFFORDING COVERAGE NAICE INSURED INSURER A: Hartford Casualty Insurance Company 29424 Caroline Edwards DBA Earthwise Designs INSURER B: 991 DUNCAN RD RUTHERFORDTON NC 28139-7919 INSURER C: 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 TYPE OF INSURANCE ADDL SUER POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSR YWD _ (MM/DD/YYYY] (MM/DD/Y YYY) COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE 'CLAIMS-MADE OCCUR DAMAGE TO RENTED PREMISES IEe occurrence) MED EXP(Any one person) PERSONAL&ADV INJURY GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE POLICY PRO- LOC PRODUCTS-COMP/OP AGG JECT OTHER: AUTOMOBILE UABILITY COMBINED SINGLE LIMIT lEa accident) ANY AUTO BODILY INJURY(Per person) ALL OWNED SCHEDULED BODILY INJURY(Per aoddent) AUTOS _AUTOS HIRED NON-OWNED PROPERTY DAMAGE AUTOS AUTOS (Per accident) UMBRELLA L10.9 OCCUR EACH OCCURRENCE EXCESS LIAB CLAIMS- MADE AGGREGATE DED RETENTION$ WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABIUTY STATUTE ER ANY Y/N E.L.EACH ACCIDENT $500,000 A PROPRIETOR/PARTNER/EXECUTIVE N/A 76 WBG AA5OP1 07/24/2022 07/24/2023 OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $500,000 (Mandatory In NH) If yes,describe under E.L.DISEASE-POUCY LIMIT $500,000 DESCRIPTION OF OPERATIONS below _ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) Those usual to the Insured's Operations. 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. AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD ACG CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDIYYYY) 03/06/2022 T IS 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: Hiscox Inc. PHONE FAX 520 Madison Avenue (A/C.No.Ext): (888)202-3007 [(NC.No): E-MAIL 32nd Floor ADDRESS: contact@hlscox.com - - - New York,New York 10022 INSURER(S)AFFORDING COVERAGE NAIC 0 INSURER A: Hiscox Insurance Company Inc 10200 INSURED INSURER B: Earthwise Designs INSURER C: 991 Duncan Rd Rutherfordton,NC 28139 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 TYPE OF INSURANCE ADDL SUER POLICY EFF, POLICY EXP LIMITS LTR INSD WVD POLICY NUMBER (MMIDD/YYYY) (MM!DD/YYYY) COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S DAMAGE TO RENTED --- CLAIMS-MADE OCCUR PREMISES(Ea occurrence) $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY PRO- JECT LOC PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ AUTOS (Per accident) UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y�I N STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVE I I E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) EL,DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below • E.L.DISEASE-POLICY LIMIT $ A Professional Liability P100.217.339.8 04/20/2022 04/20/2023 Each Claim:$2,000.000 Aggregate:$2,000,000 DESCRIPTION OF OPERATIONS!LOCATIONS!VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached it 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. AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Earthwise Designs �v Soils&Land Evaluation 11/22/2022 Site and Soils Report with System Design On-site Wastewater System for Duplex 480 gallon/day; Two 2-bedroom units New Lot# l on Dreamy Lane Proposed new subdivision of 3708 Bethany Church Rd. Catawba Co. Parcel: 376114420528 Prepared for: Bolick Management, LLC This report is submitted under the rule: LSS COVID-19 PERMIT pursuant to S.L.2020-97,Section 3.19 and G.S. 130A-336.2 PART 1: Submittal of Notice of Intent to Construct(NOI) Earthwise Designs has performed a soils and site evaluation of the proposed lot referenced above. Six pits were evaluated to 48"+with favorable results. We have delineated an area Provisionally Suitable for a III g. gravelless trench system with 25%reduction,per NC General Statues 15A NCAC 18A .1900.The drain field area is relatively uniform and free of gullies, rock outcrops and other disturbances. A new well will be dug in the future. This is not a saprolite system.Drain field lines on the sketch were drawn conservatively on 10-14' centers to account for minor contour variations. Ample space exists. Note: Soils were assessed in the backyard of the existing two-bedroom home,to ensure there remains sufficient conditions for repair after the property is subdivided.The inactive well would have to be properly abandoned prior to installation of repair for that home. System Specifications Initial: 480 gallon/day F11 g. gravelless trench, Approved Accepted system with 25% reduction. Gravity fed from d-box. See site plan. • Soils: Group IV—Silty Clay • LIAR: 0.3 • Line length required=400' o Five 80' lines. • Recommend use of at-grade d-box,if available, for ease of periodic inspection. • • Trench width 36" • Trench bottom:26"on downhill side of trench. • Septic tank: 1500 gallons. Repair: III b.e. PPBPS(T&JPanel). Vertical installation. Use pressure manifold to distribute to lines of varying length in potentially split areas. • Soils: Group IV- Silty Clay • LIAR: 0.3 • Line length required=267' o See site plan for varied line lengths and location.If actual installed system allows,place all repair lines next to each other. • Trench width 24" • Trench bottom: 30"on downhill side of trench. Locations per Sub-meter GNSS Arrow 100 Receiver,EOS&ArcGIS software Pit 7:35.688877,-81.142041 Pit 8:35.688720,-81.142146 Pit 9:35.688606,-81.142282 Pit 10:35.688470,-81.142219 Pit 11:35.688580,-81.142077 Pit 12:35.6888755,-81.141880 Pit 13:35.689472,-81.141801 (Repair area for existing home) Existing well serving existing home:35.688872,-81.142294 Other site-specific requirements and notes: 1. No cut or fill can encroach on the drainfield area, initial or repair. 2. No structures or roads can be placed in initial or repair area. 3. Heavy machinery over the drainfield area must he avoided after installation_ 4. Earthwise Designs recommends the d-box be inspected every 1-2 years by private inspector. 5. The owner must ensure that the field is installed as described above;will be maintained to reduce erosion, shed water,retain a vegetative cover and not be disturbed. 6. Earthwise Designs makes no guarantees regarding installation,maintenance and operations. System design may not be accurate if improper site alterations occur prior to permitting and installation. Thank you and please contact me for further information, if needed. EARTHWISE DESIGNS 991 Duncan Rd Rutherfordton,NC 28139 Cjedwards234(e)gmail.corn 828)289-0122 cell ct • Caroline J. Edwards NC Licensed Soil Scientist#1220 � 9 sort So/Fti SC Professional Soil Classifier#117 ti o���E_ �::9 cpse,. 9 si• ., 7• , NC Land Application of Bio-Solids#10006173 , ,, r,v;.l���t� Attachments: Site Plan in two pages Soils Descriptions Proposed Subdivision Plat EARTHWI SE DESIGNS 991 Duncan Rd Rutherfordton,NC 28139 Ciedwards234 amail.com 828)289-0122 cell Iv J ! ! 1 • ..� o N h7 . - ................... . TT pp Dk Q CD f / CD / -).=. * .z f O v N. C, M 0_ /7-\\\\\N • K. o — v a 2 f 5-o 3 c Q r o /C Vl n 0, 3 N I v g z r CD 11 ono X •* -Ii. ---71 \\4:\ �z o - o _--// ' Za - c(Iglci -R ..1 ut2) (4)fis I 1 4VSNN/I.I.,I N tol 4.'1.,V...rn.u.".9,i,I.:AIN'o!...9%is:i 1 1'...T.I __ .... .41".`-'Nr:4\ ZZOZ •voluxvi vvitmeng.do 9 Ina..r.wa Idn“krannAnna.gi%Inn.nn,non n Si 9 nil P,..dM 1 VI.6 I:i .., ,,, 1==:11 .11 Vultmlf)'1,S9.•••••PilN.......41, VXM)*VII hi to VW WON Sadd,L9Z Jledall-A- - / if 01 . • AONI ro y •., 'i: 4• ,) OL . •''x-I',,•-... 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'PwwD'vm'aMD'VHNbOoSW$VFI'N J�2d2a•:••• �► 1' 1 0£4 S9 0 A�� '°"""gwNNvl:rl'r+'l'V ask ,'a, P^1....', PI�FJ�I�OIgRIuI .. ,•' Pad uownnva 11 Q8 6008 J lid 5U6IS� 11iS t ai ' \ • `. ,% � ace / 1/• .ed • `/:. tad ti 1 I �� �r ' .' iiiir * Ld \, All $ • f° 111, ° • Ld .IF+%MWJ7MUI Joia 2Won 1 i +'£ If� FQ • saxajdn0 maw j qv'Aureala ' id alis i e-1*A° Owner/Buyer 801116i Date Evaluated 1/-g-2 Z Location of Situ,arof/Y'h./'i' ee h 71 I Co; Cw474-,Z4 Proposed Facility.0 y lex Proposed Design Flow(.1949) 0 esVdavProperty Size,90ac. Well Supply(PLivater Fabric, eii Spring,Other )Evaluation Method(Aug P! Cut) • Profile Flag Landscape Horizon depth Texture Sotl structure Mineralogy Boil color Scat calor Notea/LTAR Color grade/ (ls) consistence moist/wet Matrix Moues Slope Grade Clan Type CAV4/) S' i3/-7 0-i? -ccL L' vr- S3/4 PA As- Mt' .r74J 64a- 6le A'S. ¢ 7 1✓ 6?-2- (L Si C Z F I/3i FR jS ,_/4f12.$)Q p/� 1-7-AR 0-? /3C 3V-Vf caii_ / F ,�3Y, as Hp ..rrR%s9 .r % , 8.4 ' o-q se/re / tip. so!{ I/, Ns,/YP sy4¢/3 orSGnir 'Gr q 211 PS• � .e L a1- 1-�14- C. - F raw FR S.r SP 0.__ • /,)r D 2/ ccL ( 1/;, .5:0frj F4 /P.S /Ye J>%f b/u. _Gmt.r2- f?.3 1,iS t 9 )) t *. //-.3 qq_� .Y G fc, z , Sik FA ss sP 2.e r7t PI' • 0,.3 _ l3c. i?-`1-rF ct- / n't lta4 FR Air 40' P Of-s 0-/o scc. l F 5-S GA lr /Yr R' Gn7y„ - f?...5- /0 I l i'f+C/0-19v,f- ,Sr-c 1 F- sek FA' Sj /4)c) e, 2i9 r 0•- rat, ' 0-6 sc.1. I P .C8 19 yt r3,,, .,rf �,, GJv1,. .7a' ,or 14 11 ?i'L b 1 c/s;` 2_ P 5PK , sf_ z.J-7r/t P(f /3c 0-3'1 GL 1 i .4Qk Fri N5 // .,s'7�e fit% AS,t7� 0-9- SGr I ( file F/ /vs /P R ,i 1 �f_ ,GIIN4 9 L b (I-fibb G z. , ( 1't/4 F.1, ssc• SP 2 t `* O,2 T�. ?c )i-q;-- cL I pi /90 A( g, 4Lla F • TEXTURE STRUCTURE !MINERALOGY _ GRADE TYPE MOIST Cane Send COS I Very Floe Sandy Loam MI. St:melamine 0 Cranukr OR Loam L Sand S Lama L ' Week I My ABK vor,Nol+te I --4PA Fine Sand FS SIR loam SU, Madame } Sabeeind+jSknky SBK , Friable FR p io4 Vrry_Flne Seed VPS 8(h II Strong S Platy P. Flat PI a..as op Loamy Caw Sand EGOS Sandy Clay Loam SCL CLASS Wedge WEO Very Ern VF( '�cr°fir,,, Loamy Sand, LS Clay Lawn CL Very flee VP Hamada PR Eon,fire FF1 I .�,.•. `. (L,S..;, Loamy Roe Sand LFS Slay cloy Loam S1CL Pine P Columnar COL 'NW_ 3 Loam y Very Fite Sand LVPS Sandy Clay SC Medlum Id_ llon.85cky M8 �,, y= Care Sandy L'OSt. Siltypoy SIC Canes CO SingleOrale SOIL Slightly&inky 88 • 4 d!'" Sturdy roam SL Clay C Thick(PL) TK Masalso MA Moderatei4 Sticky _ S . Eno Sandy Loam FSL Very Canna VC Very Shaky VS Vary Mitek(FL1 VK Cloddy COY Nan-Panda Np Enremdy Comae IC Slightly Plastic sp Modena*P leado p Very Plane Vp • 13 4 k 4.• e -crop pip/ ,9ew d /off Q 27o " ,�d, Ow ner/Buyer /tea/14X d'Date Evaluated P-- -ZZ- Location of.$ite.5' ;, iiW+t-19-=4/•G/Y4 Co: (-47‘04 Proposed PaeSity S1`/I Proposed Design Flow{.1949) 2 Yi, ital/dsy Property Size sc. • Well Supply(Private,Public, ell 'prim Other )Evaluation Method(Anger li Cnt) 1 Profile Nag landscape Horizon depth Texture Soil structure Mineralogy Soil color Soncelor NotedLTAR Cofer grade/ (In) contlstencemoist/wet Matrix Moan Slope Grads Chas Type NMI 0-/f S4 t. © 1 'S'<' —i KMS'77Y b 4t- — /' i�V• /3 k, it 4,-y11111 7)7 ii fr:/f s:..c it.r Nts 0.3 Z...7- . MEM iiiii NM= MEM III 111 �ewig ..IL _ ._..... 1111 MN 111111111111111 I Ei illirrourlftillilll STRUCTURE11.11 NM IIIIIIIM MINERALOGV �v GRADS TYPE Caere Send COS V Rae Send Locra VFSL StrecurelemOranalsr GR iF L 1 Vd PI toA Loam Caaraa Sand Sand CLASS -d,. Q�.ra �(�1 �� Vs Mae © 0 chi R.�` Laomy Poe Sand LFS Silty Clay Loam SICL Fine Columnar COL WET r•;; ( Lamy Very Floe Sand LVFS SandYClp� SC Medium Nnn-Steky NS �, s4:;:i : •`C 'C.or ' YnelaOnin SCR SllghdySticky SS i;' �•' Coarse Sandy Loam COS[. Silty Clay SIC Coarse COe S mi l' Sandy team SL C Tick via Mao Yc MA Modesto%SBoky B '`, col Rao Sandy Loam FSL Very Coarse VC Very Ricky . vs Verymiok(PL) VK Cle CDY Nan-PLctla RP • EaeemdyCorse EC Sliyhdy?laate SP Moderately P(ntla p I V Plane VP . .. 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