HomeMy WebLinkAboutAUTH-03-2023-191605.TIF owr CATAWBA COUNTY
o .t. +4 Public health Department Subdivision
s Environmental Health Division PIN, 462705079831
Notron PO Box 389,25 Government Drive.Newton,NC 28658 1.011 PT 3
Site Address: 3532 OSPREY CT,TERRELL NC 28682
Name on Permit MONTE MASONBRINK
Property SUE Acres 0.87
Directions: Hwy 150 East,turn on Greenwood Rd,Turn on Osprey Ct,lot on left
Owner/Authorized Representative Acknowledgement of Permit Receipt
x4"""I certify that I ant the owner or authorized agent(owner's authorization required)representing the owner of
the property described above.
4.0-' As the property owner or authorized representative,I have received the above referenced
permit(s)as requested in the application for service RBPR-04-2021-37506,by the following method(s):
_ Received in Person
_ Facsimile Transmittal(Return form with signature required)
Electronic Image Transmittal/E-mail (Return receipt required)
�: iptij,,_ 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:03/17/2023
Owner/Authorized Representative Signature___4IAIL-----Zi.---------
Date 3/30/L3
Documentation of Permit(s)Transmittal
(permit transmitted by electronic or other means)
Permit transmitted by (name of person se ding permit)
Signature £ Date/Time 3 427/)3
Method: Fax J Email _US Mail Other
Owner's request to send by the above indicated method of transmittal in lieu of signature
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.yt3' CATAWBA COUNTY Case 8 AUTI-1-03-2023-191605
i� .i.ii ,? Public Health Department Subdivision
U.,., _ Environmental health Division PINS 462705079631
�J PO Box 389,25 Government Drive,Newton,NC 28658 LOI# PT 3
/. .2 A.
Site Address: 3532 OSPREY CT,TERRELL NC 28682
Name on Permit: MONTE MASONBRINK
Property Size: Acres 0.87
Directions: Hwy 150 East, turn on Greenwood Rd,Turn on Osprey Ct, lot on left
Authorization to Construct Permit
Permit Category: New Septic Wastewater Flow: 480 g.p.d.
Type of Facility: Primary Residence-New House
Basement? No Basement Plumbing? No Bedrooms: 4
Water Supply: Private Well Maximum Occupants: 8
Soil LIAR: 0.3 g.p.d.ft2
WASTEWATER SYSTEM REQUIREMENTS
Proposed Wastewater System: 50% REDUCTION VERTICAL
System Classification: IVA-ANY SYSTEM WITH LPP DISTRIBUTION
Septic Tank: New Tank: 1,000 gal
Pump Tank 1,000 gal Grease Trap_gal
Dosing Volume 210 gal Pump Specs: 39.17 GPM @ 43 TDH
Pressure Head 2 ft Draw Down 10 in
Drainfield: Total Area: 810 sq ft Total Trench Length: 270 ft
Aggregate Depth: in Maximum Trench Depth on Downhill Sidewall: 32 in
Minimum Soil Cover: 6 in Minimum Trench Separation: 8 ft on center
Number of Drain Lines: 6 Trench Width: 2 ft
Distribution: LPP
Pre Treatment: NONE
Pump Required ***** Operator Required
Additional Specifications:
*Install 63 blocks total. The 55 ft lines will have 13 blocks each, the 40 ft lines will have 9 blocks each, and the
25ft line will have 6 blocks.
*Use 3/16 holes in the distribution pipe.
*Stay at least 15ft from the ditch along the driveway and 10ft from the property line with the drain lines.
*There must be a water diversion system in place between the cul-da-sac and the septic drainfield to divert
surface water away from the drain lines. This must be in place before the Operations Permit will be issued.
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? Required Soil LIAR: 0.3
g.p.d.lft2
Proposed System: 50%REDUCTION VERTICAL
System Classification: IVA-ANY SYSTEM WITH LPP DISTRIBUTION
Pump Required ***** Operator Required
03/22/2023 08:24
_t13 4 CATAWBA COUNTY Case# AUTH-03-2023-19I605
f. t I ,y Public Health Department(.......
Subdivision
drri) "� Environmental Health Division PIN# 462705079631
PO Box 389,25 Government Drive,Newton,NC 28658 LOT# PT 3
8, w
Site Address: 3532 OSPREY CT, TERRELL NC 28682
Name on Permit: MONTE MASONBRINK
Property Size: Acres 0.87
Directions: Hwy 150 East, turn on Greenwood Rd, Turn on Osprey Ct, lot on left
The issuance of this permit by the Health Department does not guarantee the issuance of other permits. It is the responsibility of the applicant
/property owner to insure that all Catawba County Planning/Zoning and Building Inspections requirements are met. This Authorization to
Construct Permit is subject to revocation if the site plan,plat or the intended use changes,or if site conditions are altered. The Authorization to
Construct Permit is not affected by a change in ownership of the property. This permit was issued in compliance with the provisions of the
North Carolina'Laws and Rules for Sewage Treatment and Disposal Systems' (15A NCAC 18A.1900). Neither Catawba County nor the
Environmental Health Specialist warrants that the septic tank system will continue to function satisfactorily for any given period of time.
Any permit issued for a conventional system may be used for an accepted system without Environmental Health authorization or permit
modification.Please notify Environmental Health of this change prior to system installation.
P/14/(
03/17/2023
Authorized State Agent Permit Issuance Date
3/17/2028
Permit Expiration Date
No grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department.
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Parcel: 462705079631, 3532 OSPREY CT
1 in=60ft
TERRELL, 28682
This map/report product was prepared from the Catawba County,NC Geospanal Information Services. Catawba County has made substantial efforts
to ensure the accuracy of location and labeling Information contained on this map or data on 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 or the use thereof by any person or entity.
Copyright 2023 Catawba County NC
03/17/2023
eaCamScanner
STATE OF NORTH CAROLINA
COUNTY of Catawba
CONTRACT FOR INSPECTIONS OF ON-SITE WASTEWATER SYSTEMS
TYPE II, III, IV and V
This Contract is entered into this 21st day of August, 2023 by and between TCW Wastewater Management, Inc., a
North Carolina Corporation of Mecklenburg County, North Carolina (hereinafter"TCW') and Monte Masonbrink
Preamble
TCW is contracting with The Owner to provide inspection services as described on Attachment A for the fees or
charges also shown in Attachment A.
The Owner owns or controls the property upon which a ground absorption sewage treatment system ("System") is
installed, such System being designated as a type II, Ill, IV or V system under the Rules for Sanitary Sewage
Collection. Treatment and Disposal found at 15A N.C. Admin. Code 18A. 1900 et seq.; and 15A N.C. Admin. Code
18A.1961 requires that a condition of the Operation Permit for certain systems be that a properly executed
inspection contract between the System Owner and a management entity shall be in effect for as long as the
System is in use. TCW is a management entity which employees certified operators of a type authorized by 15A
N.C. Admin. Code 18a.1961 to manage and inspect type II, Ill, IV, and V systems.
In consideration of the premises and of the mutual covenants and promises contained in this Agreement, it is
hereby agreed by and between the Owner and TCW as stipulated below.
Conditions of the Contract
A. TCW, in consideration of the payment by the Owner as set out in the schedule of services and charges in
Attachment A, incorporated herein, agrees:
1) To provide the services set out in Attachment A according to the minimum schedule of
inspections/services required by regulations for the lots or parcels set out in Attachment B.
2) To report results of the inspections to the local environmental regulatory agency having jurisdiction
as required by applicable laws or regulations.
3) If inspections indicate the need for System repairs:
a) to notify the local environmental regulatory agency within 48
hours.
b) to give notice to the"Owner" of needed repairs, and, if the
necessary repairs are outside the scope of the routine
maintenance described in Attachment A, then The Owner may
request TCW to provide an estimate. At the authorization of The
Owner TCW will perform the necessary repairs at TCWs then
prevailing charges for services and materials.
4) If TCWs services are terminated, TCW will notify the local environmental regulatory agency within
48 hours.
TCW
PAGE 2 OF 6 PAGES
B. The Owner, in consideration of the services performed, agrees:
1) To pay TCW for its services according to the schedule of charges as set out in Attachment A.
2) Within 30 days of receipt of notice of repairs under A(3) above, the Owner(s) must provide proof
that repairs have been performed by a licensed or qualified entity and the System is functioning
properly or request and authorize TCW to complete the needed repairs.
3) To notify TCW promptly of any emergency or malfunction known to it which may violate
environmental, health, or other laws and regulations, and to authorize immediate repair as
necessary to restore the System to proper function and operation.
4) To use reasonable efforts to provide and to maintain at all times, such access to the Systems as is
reasonably necessary for TCW to comply with its obligations under this Agreement.
C. Terms of the Agreement
1) This Agreement shall be effective for one year from the date of this contract, and will be
automatically renewed from year-to-year thereafter, unless written notice of termination and non-
renewal is given to the other party not less than 60 days prior to the end of the then current annual
contract year.
2) The real property to be serviced under this contract is listed on Attachment B.
3) This Agreement automatically terminates if the Operation Permit for the system is revoked and all
appeals of the revocation are exhausted or time for making an appeal has passed.
4) The parties may terminate at the end of the then current term by consent of each party or by not
less than 60 days written notice to the other party prior to the end of the then current contract year,
and not less than 30 days written notice to the local environmental regulatory agency.
5) This Agreement may be terminated for cause for breach which remains unremedied after 15 days
written notice to the defaulting party.
D. Limited Warranty
TCWS SOLE DUTIES AND RESPONSIBILITIES UNDER THIS AGREEMENT IS TO PROVIDE
INSPECTION AND ROUTINE MAINTENANCE ONLY AS SPECIFIED IN THIS AGREEMENT.
INSPECTIONS WILL COMPLY WITH APPLICABLE CODES, LAWS, AND REGULATIONS IN FORCE AT
THE TIME OF THE INSPECTION AND REPORT. WORK AND MATERIALS USED IN REPAIRS ARE
WARRANTED ONLY TO BE OF GOOD WORKMANSHIP, FREE OF DEFECTS, AND CONFORM TO
THE SYSTEMS SPECIFICATIONS AND EQUAL TO THE ORIGINAL PARTS AND EQUIPMENT. THE
OWNER'S SOLE REMEDY UNDER THIS EXPRESS WARRANTY IS REPAIR OR REPLACEMENT AND
CONSEQUENTIAL DAMAGE OR DAMAGES FOR DELAY ARE LIMITED TO TOTAL SUMS PAID TCW
UNDER THIS AGREEMENT FOR THE PARTICULAR LOT OR PARCEL FOR THE THEN CURRENT
YEAR. ALL OTHER WARRANTIES, EXPRESS OR IMPLIED, INCLUDING MERCHANTABILITY OR
FITNESS FOR PARTICULAR PURPOSE, ARE EXPRESSLY AND SPECIFICALLY EXCLUDED.
REPAIRS, REPLACEMENTS, ADDITIONS AND CHANGES BY OTHERS TO THE SYSTEMS COVERED
BY THIS AGREEMENT WITHOUT PRIOR NOTICE TO TCW OR ACCEPTANCE OF THE WORK BY
TCW DURING THE TERM OF THIS AGREEMENT VOIDS ANY WARRANTY GRANTED HEREIN AS TO
TCW.
TCW
PAGE 3 OF 6 PAGES
E. Miscellaneous
1) Transfer of rights, responsibilities, and duties under this Agreement by any party shall be valid only
on written notice and consent signed by all parties, which consent shall not be unreasonably or
arbitrarily withheld.
2) TCW may perform its duties and responsibilities by subcontract but TCW will remain directly liable
and responsible to the Owner under the terms of this Agreement.
3) Waiver of default or a breach of the Agreement by any party shall not operate nor be construed as
a waiver of further or subsequent defaults or breach of this Agreement. Failure to take action in
any default or breach does not bear action on such default at any time subsequent to such breach
or default.
4) This Agreement constitutes the entire agreement of the parties, incorporating, and superseding all
prior representations and negotiations and may not be changed or amended except in writing
signed by the parties. The Agreement shall be interpreted under North Carolina law, Any part of
the Agreement declared void, illegal, or unenforceable will not affect other provisions of the
Agreement.
5) Disputes arising under this Agreement shall be determined by any method of Alternative Dispute
Resolution the parties choose, including but not limited to, mediation or arbitration, under the
Uniform Arbitration Act of North Carolina or its equivalent, or such means or methods as the parties
agree to in writing.
6) Notices are deemed delivered if delivered in person; by certified or registered mail; by courier; or
delivery service, if properly receipted, charges and postage prepaid, as follows:
Owner: Mr. Monte Masonbrink
3532 Osprey Cove Ct
Terrell, NC 28682
Operator:
TCW Wastewater Management, Inc.
5600 Lakeview Rd
Charlotte, NC 28269
Environmental Regulatory Agency:
Catawba County Health Dept
P.O. Box 389
Newton, NC 28658
A party may change its address my giving notice in the manner provided above.
TCW
PAGE 4 OF 6 PAGES
Each party has executed this Agreement with full power, authority, and legal right to enter into; to bind itself to the
rights, duties and responsibilities under this Agreement, which is binding on the parties, their successors and
assigns, heirs and personal representatives, on the date first above written.
WITNESS: OWNER:
9a4ge`-
:lnntc hasonbriaF(Aug 23,2023 12:25 EDT!
TCW Wastewater Management, Inc.
• BY:
TCW
PAGE 5 OF 6 PAGES
EXHIBIT A
TYPE II, III, IV
MONITORING & INSPECTION PLAN
1. COST: INITIAL CONTRACT YEAR: $ 350.00 (2 required inspection)
$ N/A (0 required lab)
$ 350.00 Total Initial Year
RENEWAL YEARS: $ TBD (2 required inspection)
$ N/A (0 required lab)
$ TBD Total Renewal Years
a. The Owner shall pay to TCW the aforementioned sums for each parcel listed on
Attachment B. The initial annual fees are payable upon the execution of the contract.
Annual billings will be made thereafter and payable within 30 days of billing. The
annual billings will be made on the anniversary dates. The annual renewal fees may
increase no more than 5% per year. The Owner shall pay to TCW his normal and
customary fees for any authorized work performed on the System as a result of non-
scheduled service or maintenance calls. These fees are due and payable within 30
days of billing. Payments due to TCW, and unpaid by the Owner after 30 days, shall
be assessed late payment fee of 15% per month, accruing monthly on the unpaid
balance.
2. PERFORMANCE DUTIES:
• Inspections and services that meet state requirements, i.e., inspections of System using
an itemized check list, monitoring "septic tanks" to insure proper operation, and make
adjustments of imbalances to systems through the distribution devices.
• Inspection report copies are sent to the environmental regulatory agency (if applicable)
and homeowner
• Emergency service calls at no additional charge.
• 24-hour availability
• The Owner will be advised of any repairs needed and estimated cost or repairs. Repairs
will not be made without Owner authorization.
• The Owner will be advised when pumping is recommended
Bacteria Additive Option —Additional $60 per year:
• The addition of a bacterial product into the individual septic tank as needed to maintain
the proper level of bacteria.
TCW
PAGE 6 OF 6 PAGES
EXHIBIT B
1. PHYSICAL ADDRESS OF SYSTEM(S):
3532 Osprey Cove Ct
Terrell, NC 28682
Osprey Cove Lot 3
b.
c.
d.
r� Lek-03-eloo - 15iLos
SUBSURFACE WASTEWATER INSPECTION FORM
/
System Manager: Date of Inspection _Initial ✓8 month _12 month
TCW Wastewater Management, LLC 3 (9„6 -•02 _Follow-up _Service call `Other
5600 Lakeview Road,Charlotte,NC 28269 County System Type Drainfield
•. p Tele.704.776.4443 -Pkt4i&,vilfr '` On-site -Off-site
info@tcwwastewater.com Time: ( % S.- A/I initials AA
Location of System 1 Drainfield(of site)
Monte Masonbrink
3532 Osprey Cove Ct
Terrell,NC 28682
Lot# Phase Subdivision
Compliance Statu . I Compliant Non-Compliant Malfunctioning
-
Cvpitab, lemeowner ✓DFH Builder Owner's Association Developer
.4=Satisfactory NI'=Marginal X=Unsatisfactory N=Not Evaluated NA NotAppl-ttcable }
Septic Tank: size: f r.7 gallons 1000=5.'LL 1500=43"LL 2000=49"LL
Tank risers are accesssib(e v dunes i'
Riser Type ht- , ( Height ! Diameter •1,f1 " Inlet End of Tank
Na odors present f/ Scum Level Sludge Level
There are no Infiltration problems f to Surface Subsurface_ 0 " ` G�
Surface water Is being diveriod away Scum plus Sludge level C " (SST)
Tanks and accesses are structurallysound Filter End olTank .SST "/liquid Depth "x 100= A
Inlet pipe at proper angle yes �/ Can't observe / Scum Level Sludge Level Tank Needs Pumping: yes No
Inlet tee is In good condition N/A J __0_." <30%=No >30%=Yes
Inlet Tee is cleaned today N/A
Effluent Filter clogging percentai(<to,2s.5o,75,toa) i1. ° N/A Type; ferry Sample of tote water column
Effluent Filter was cleaned No_ Yes N/A Three dIstincl zones: good_.__ medium murky_
Effluent Fillter Is In good condition N/A
Effluent Filter Canister Is in good condition / N/A!
Effluent Filter Is snapped In place i/ A_ Bacteria: Added at Inspection Left with homeowner
Effluent Pipe at proper angle J Pulp pks Pulp_pks
Water level Is at proper level to Yes "/ Freeboard_ Regular_pks Regular pks
Effluent Dosing Station:size: _/OCPS gallons 1000=50"=20 GP! r 1500=52"=28 GPI 2000=59"=34 G Scum eve) Sludge Level
Tank Riser Is at prop he hl " plus n "
Riser Type p p • Height R., Dia r 21 " Total Scum+Sludge f/
No odors present
No Infiltration Issues: Surface,^ Subsurface Tank Needs Pumping. yes_ No I>4" yes)
Required pumps are present&operating properly / Amp.Draw /
High Water alarm Is operating properly // Canl Observe Filter Cleaned today No— Yqd N/A
Floats,pipes,valves, disconnects are In good condition Pump make and model Filter Is In good condition �/ N/A
Pump Is installed on block or raised platform(min.0 Inches) N/A Root Kilter Added 1LB_ 2LBS_
Pump float is not resting on lop of pump ,_/ N/A_
Control panel enclosure/components are in good condition Elapsed Time Readings:
TCW sticker Is placed on front door of Panel Pump#1-C •P =Usage hrs
Duct Seal Is present in at conduit openings Usage /days =Use Per Day hrs
Effluent_eppears clear and free of solids / Firs x 60= min.x GPM = GPD
Telemetry/Dialer is working property —N/A N/A J Average_(<275)_ Above average(>276) Very jgh_(?3a0)�__
Pressure Bell settings; Off 4",On 10"-12",Tale 16", Alarm 22" Pump 01-CC - PG = Useage
Grinder Lift Station: Authorized to inspect Not Authorized to inspect
Tank Riser Is at proper height I. Burled - / '•
No odors present
No infiltration Issues: If>. urla•: _ Subsurface
Required pumps are present&operating properly t
High water alarm Is operating properly Can't 0 r
Floats,pipes,valves, disconnects are In good conditlo ,
Pump float is not resting on top of pump —
Control panel enclosure/components are in good co ditlon
Grease Trap Section N/A size: gallons 100r -10=43"LL " Scum Level "
Tank risers are accessible _ ► Burie• inlet Outlet
No odors present _
There are no Infiltration problems Surfac, •surface Tank Needs Pumping. yes_ No— I>3"yes)
Surface water is being diverted away
Tanks and accesses are structurally so,
Inlet pipe at proper angle Sample of total water column
Inlet tee Is In good condition - _ Three distinct zones: good_ medium ,„_ murky—
Inlet Tea Is cleaned today
Effluent Filter clogging percentage Yo Filter lyr
Effluent Filter was cleaned No Ye
Effluent Filter Is in good condition _
Effluent Filter Canister is In good•ondition
Effluent Filter Is snapped in place __r.
Effluent Pipe at proper angle -
Water level Is et proper level No Yes Freeboard
I,Plg8a 1119T2 hu
RECEIVED
APR 1 0 2025
Ground Absorption Fields: I
No odors present There Is no evidence of effluent surfscir Drop boxes used In lieu of Distribution box No Yes_ Environmental Health
Vegetative cover is maintained properly Distribution box(es)In good condition
Field Protected from traffic/destructive i Disiribuiton'box(es)In proper adjustment
Surface water Is being diverted away
Lines are not pending or holding water ® if pending is occuring,how much?
No tow areas or settling occurring 7
Line cover(soil)is adequate Repair area Is properly reserved,maintainec
-
Pressure Manifold Systen #of 1/2"taps = G rmula: @ 3 feet head-Taps X 6.71 GPM; @ 2 feet head-Taps X 5.48)
Manifold vault,valves,piping ere In goad condition iacement needed: Lid_ Valves / qty; Repair needed: Box
No evidence of leakage,blockage In discharge lines eaning needed Corrected Today
No evidence of effluent backing up into box -
Pressure heed is properly adjusted C led Tod& 1
Low Pressure Plpe System: — -<
Turn-ups/cleanouta/valvos are Intact and accessible / _Corrected Tode Need extensions? Yes /-
_ Laterals are free of excess solids / letting necessar _ CPDR= GPM; Efficiency
Laterals ware flushed this Inspection No Yes
Zone valves ere operating properly Corrected Tode _ Need replacing? Yes / qty
Pressure heed is properly adjusted Corrected Torts _
Tum-up buckets are dry Insid Buckets needs replacing? Yes I. qty
Valve box or buckets are d nside Buckets needs replacing? Yes /-qty
L
Pump Tank Size(Gallons): 1000 1500 _2000 Design Pump Delivery Rat _VP GPM 'Design Dose Gallons
1000 Gallon=50"=20 GPI 1500 Gallon=52"=28 GPI 2000 Gallon=59"=34 GPI
Level End Dose - Level Begin Dose =Difference Inches X GPI =Current Dose Gallons
Level End(large 1/)7-- y 2 Level Begin(small 9) _ (D X vo GPI= 12 O ÷ �S n Min.Run Time= CID GPM(CPDR)
Current GPM(CPDR) s Design GPM(DPDR) = X 100= SS Efficiency
Valves Lines Da$) n Oh = a Adjus'U Valves Lines Design Observe Adjusted
5 _ _ = _ _
- _ _- _.
.
Recommendations to Owner: /Ys4t,idt t euKc Uv •f)od,
l.,r : fUGst, //�(+ .hSPe 10tr'
Signature of"ORC" / ,����--( /JJA _-•-
1
Revised 6124/e7
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