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CAfAWBACOUNTY Case# AUTH-12-2022-186721
Public Health DepartmentSubdivisionCOUNTRY CLUB HEIGHTS
:11111117
y Environmental Health Division PIN# 372014337178
PO Box 389,25 Government Drive,Newton.NC 2865R LOT# 1-8
s.
Site Address: 2656 SANDY FORD RD, NEWTON NC 28658
Name on Permit: TIMOTHY QUEEN
Property Size: Acres 0.93
Directions: Startown Rd, Sandy Ford Rd on corner of Maple 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 EHPR-10-2022-42512,by the following method(s):
Received in Person
Facsimile Transmittal (Return form with signature required)
7 Electronic Image Transmittal/E-mail (Return receipt required)
K 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: 12/28/2022
Owner/Authorized Representative Signature
27 Date
Documentation of Permit(s)Transmittal
(permit transmitted by electronic or other means)
Permit transmitted by (name of person sending permit)
Signature (4Date/Time I boil 3
Method: Fax J 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
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ehpermit 12/29/2022 09:39
�wa CATAWBA COUNTYCain Mill 112-2022-186721
f. x Public Health Department Subdivision COUNTRY CLUB HEIGHTS
< - , Environmental Health Division PIN# 372014337178
PO Box 389.25 Government Drive.Newton.NC 28658 LOT# 1-8
/g .
Site Address: 2656 SANDY FORD RD, NEWTON NC 28658
Name on Permit: TIMOTHY QUEEN
Property Size: Acres 0.93
Directions: Startown Rd, Sandy Ford Rd on corner of Maple Dr
Authorization to Construct Permit
Permit Category: Repairs Wastewater Flow: 360 g.p.d.
Type of Facility: Primary Residence-SFD
Basement? Yes Basement Plumbing? Yes Bedrooms: 3
Water Supply: Public Water Maximum Occupants: 6
Soil LTAR: .3 g.p.d./ft2
WASTEWATER SYSTEM REQUIREMENTS
Proposed Wastewater System: 25%REDUCTION
System Classification: IIIB-SYSTEM W/SINGLE EFFLUENT PUMP
Septic Tank: New Tank: 1.000 gal
Pump Tank 1.000 gal Grease Trap_gal
Dosing Volume 137 gal Pump Specs: 29.4 GPM @ 22 TDH
Pressure Head 2 ft Draw Down 6 5 in
Drainfield: Total Area: 900 sq ft Total Trench Length: 300 ft
Aggregate Depth: in Maximum Trench Depth on Downhill Sidewall: 32 in
Minimum Soil Cover: 6 in Minimum Trench Separation: 9 ft on center
Number of Drain Lines: 5 Trench Width: 3 ft
Distribution: Pressure Manifold
Pre Treatment: NONE
Pump Required
Additional Specifications:
`EXISTING TANK MAY BE USED IF IN GOOD CONDITION
`BASEMENT HOME= 15FT SETBACK
*PRESSURE MANIFOLD:
-5 SCH 80 1/2"TAPS
-GATE VALVE REQUIRED
-2"PRESSURE RATED SUPPLY LINE
-1000GAL PUMP TANK
See also attached site plan.
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 existing permits.
>>>>> Do not install system under wet conditions <<<<<
PROPOSED REPAIR
Repair System Required? Soil LTAR: g.p.d./ft2
Proposed System:
System Classification:
01 05,2023 10:39