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Home My WebLink AboutEXSY-12-2022-185619.tif • 4. CATAWBA COUNTYC( Case# EXSY-12-2022-185619 ' 11) Public Health Department Subdivision GOLDEN MEADOWS Environmental Health Division PIN# 369803106058 PO Box 389,25 Government Drive,Newton,NC 28658 LOT# 6 air w Site Address: 6184 LITTLE MOUNTAIN RD, SHERRILLS FORD NC 28673 Name on Permit: OSCAR MARTINEZ Property Size: Acres 1.24 Directions: E NC 150 Hwy, Left Little Mt Rd, 3 miles on left just past Mountain Creek Dr Owner/Authorized Representative Acknowledgement of Permit Receipt I certify that I am the owner or authorized agent(owner's authorization required)representing the owner of the property described above. As the property owner or authorized representative, I have received the above referenced permit(s)as requested in the application for service RBPR-07-2022-41629,by the following method(s): Received in Person Facsimile Transmittal (Return form with signature required) Electronic Image Transmittal/E-mail (Return receipt required) 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(15A 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: 12/06/2022 Owner/Authorized Representative Signature Date Documentation of Permit(s)Transmittal (permit transmitted by electronic or other means) Permit transmitted by (name of person sending permit) Signature Date/Time_ Method: Fax Email US Mail Other Owner's request to send by the above indicated method of transmittal in lieu of signature We wantt tto hear from yoiPlease ttake a few momentts tto complette our custtomer service survey att http://www.surveymonkey.com/s/EHCusttomerService chp,,,,Ii I2/09/2022 10:22 1 catawba county public health EXISTING SEPTIC SYSTEM INSPECTION NOT FOR LOAN APPROVAL Case Number:RBPR-7-22-41629 ❑ Reconnection to Existing System Property Owner/Applicant:Oscar Martinez ❑ Mobile Home Park Reconnection Site Address:6184 Little Mountain Rd Sherrills Ford NC 28673 ® Applicant Request Type of Facility: ❑ House ® Mobile Home Number of Bedrooms 3 ❑ Business ❑Other Prnpnenrl Arlrlitinn/Arrnccnry Ctrnrtnre- 711'1711' carport at rear nf hnme 1Q'YIR' new clerk at front nf hmms. ® Approved ❑Not Approved Reason ❑Approval Not Required/System Location Only Evidence of System Malfunction El YES ®NO System Type/Description 11A Gravel Trenches See Permit#3003 Noncompliance Items and Note No signs of outbreak during inspection on 11/1W22. Do not grade, drive, or till over septic system or repair area. hyture repair will require a new application and soil evaluation. This approval does not guarantee the existing system to function for any given length of time or act as a warranty. Recommend pumping tank every 3- years as needed. Variance approval for well setback to front porch approved by Jon Brooks. Received by Catawba County on 12/9/2022. Authorized State Agent Date 12/9/2022 01 catawbacountync.gov Environmental Health Catawba County Government Center 25 Government Drive I PO Box 389 I Newton NC 28658 1828.465.8270 MAKING. LIVING. BETTER. Catawba County Environmental Health • Ea. �, CP rV iT • cn u-) --------------- • e- X S w '°"mot a I � /i,A N •,,� J La / 7-0 XZD _AIN�—) j LGcr�r •6184 r 'st 138. I. •6172 B" T��t � r/'}-- N,.a IdrXfEr 13 o z 13 wa,i1 m X 0 C ,3 CV st ' 1 50 (76) (80) 120,00 139.10 LITTLE MOUNTAIN RD 4T3oti3 F, c 5e-01-. — t n P J Parcel: 369803106058, 6184 LITTLE MOUNTAIN 1 in=60ft RD SHERRILLS FORD, 28673 RSPI1 - 7 _ 2, 2 _ yI0Z1 3An1 - 11 - 1 Z - i ? s31 ! r ( Sy - 1Z _ -ZL— I2S5615 This map/report product was prepared from the Catawba County,NC Geoepallal Information Services. Catawba County has made substantial efforts to ensure the accuracy of location and labeling Information contained on this map or data an this report.Catawba County promotes and recommends the Independent verification of any data contained on this map/report product by the user.The County of Catawba,Its employees,agents,and personnel,disclaim,and shall not be held liable for any and all damages,loss or liability,whether direct,Indirect or consequential which arises or may arise from this map/report product of the use thereof by any person or entity. Copyright 2021 Catawba County NC 12/06/2022 Scanned with CamScanner surF a` .. ROY COOPER•Governor : NC DEPARTMENT OF KODY H. KINSLEY • Secretary p 1 ,z% HUMAN SERVICES HEALTH AND HELEN WOLSTENHOLME• Interim Deputy Secretary for Health •.. "••^ MARK T. BENTON •Assistant Secretary for Public Health Division of Public Health Onsite Water Protection Branch December 7, 2022 Oscar Martinez 6184 Little Mtn. Rd Sherrill's Ford, NC 28673 Re: Approval No. JMB2845 Private Well Located Less than 25' from Building Perimeter [Rule 15A NCAC 2C .0107(a)(2)(P)] Property location: 6184 Little Mtn. Rd Sherrill's Ford, NC 28673 Dear Mr. Martinez: On December 6, 2022, the On-site Water Protection Branch received your request for a variance from the Well Construction standards, Title 15A North Carolina Administrative Code Subchapter 2C .0100. The request for the variance concerns a water supply well on the referenced property. A structure is proposed to be within twenty-five feet of the well. Specifically, the variance request grants you permission to use a water supply well at a distance closer than the twenty-five-foot setback to a building perimeter. Achieving the twenty-five-foot setback would be difficult given the challenges of the property. Based upon information provided by you, and the Catawba County Health Department, it is my finding that based upon current conditions as the site exist today (as well as the current proposal for use of the structure) you meet the conditions necessary for approval of a variance as specified by 15A NCAC .0118 (a) (1) and (2). On that basis and if the following conditions are met, the requested variance is approved: 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 1) The well/wellhead shall meet all current 2C. 0100 standards, including but not limited to being properly grouted,terminated at least 12" above land surface, properly sealed, and having a thread-less sample tap etc. 2) The well shall be sampled for the same parameters required of a newly constructed well. If samples indicate contamination, further repairs or treatment will be necessary. 3) No potential sources of groundwater contamination shall be stored near the well-head. 4) No termite treatment shall be applied to the structure within twenty-five feet of the well unless alternative methods are approved by Catawba County Health Department. The granting of this variance is for the well location only. It in no way relieves the owner or agent from other requirements of the North Carolina Well Construction Standards including, but not limited to the requirements in 15A NCAC 2C .0113(b)to repair or to abandon any well which acts as a source or channel for the migration of contamination. This approval does not imply sufficient water quality. Further, the approval does not relieve your responsibility to comply with any other applicable Federal, State, or local laws or regulations. If you have any questions regarding this variance, please contact me at (828) 713-3335. Sincerely, John M. Brooks R.E.H.S, MS 2