Loading...
HomeMy WebLinkAboutAUTH-05-2023-195413.TIF t 1 y$. a CATAWBA COUNTY Case# WELL-05-2023-195608 ti .II ,� Public Health Department Subdivision s,l Environmental Division PIN# PO Box 389,25 GovernHealthment Urive,Newion, 461602593350 WE 28658 LO l'# 2 ; . w Site Address: 8527 FIELDSTONE DR, TERRELL NC 28682 Name on Permit: LUX CUSTOM HOMES LLC Property Size: Acres 1.048 Directions: NC 150, right onto Kiser Island Rd, right onto Fieldstone Dr, left onto Beechwood Trail Owner/Authorized Representative Acknowledgement of Permit Receipt t( I certify that I am the owner or authorized agent(owner's authorization required)representing the owner of the property described above. t As the property owner or authorized representative, I have received the above referenced permit(s)as requested in the application for service RBPR-04-2023-44056, by the following method(s): Received in Person _ Facsimile Transmittal (Return form with signature required) I Electronic Image Transmittal/E-mail (Return receipt required) 1 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: 05/12/2023 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) Signatureq€-- .--- r Date/Time ./ 73 Method: Fax i 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 1 fr 0 L iA 6SItaJA (re ehpennit 05/15/2023 08:36 8527 Fieldstone Dr County: Ga'tC,ae CONSTRUCTION AUTHORIZATION FOR G.S.130A-335(a2)/SL2022-11 PIN/Lot Identifier: 4(a 1c. o 2SGl"s'3So Issued To: LuX CVSfo Viate•Gc 1—( C, Property Locatio 're...lcVSIronG Or (_a t 2 i 7-erre I j 1Vc- ").t(afs2 AOWE/PE Plans/Evaluations Provided: Yes El No❑ If yes,name and license number ofAOWE/PE: SOY••vCl 11,[,1 I )1(G0c 4410071 E Facility Type: S:s j%CG C-(rrv.i`�l (Z-C.S(d(,nc�-- tt New 0 Expansion \❑Repair System Relocation ❑ Basement? ❑Yes ®No Basement Fixtures? 0 Yes ❑No Type of Wastewater System** PAPS Low QrgS CC... (Initial) PINWS low P rtsurL (Repair) Design Daily Flow: w 66 GPO Wastewater Strength:El domestic 0 high strength 0 industrial process Session Law 2014-120 Section 53,Engineering Design Utilizing Low-flow Fixtures and Low-flow Technologies? 0 Yes 0 No Installation Requirements/Conditions Septic Tank Size: 1000 gallons Total Trench/Bed Length: 'L?O feet Trench/Bed Spacing: $ feet on center Drainfield square footage: 5IiO Trench/Bed Width: 2 li inches LIAR: O.'3 gpd/ft2 Soil Cover II" .N Depth: nches Slope Adjusted Maximum Trench/Bed �j� �� inches 6_.).' .`-, 1 L(r) Aggregate Depth: inches above pipe inches below pipe inches total Pump Tank Size(if applicable): ]coo gallons Requires more than 1 pump? ❑Yes 3 No Pump Requirements:23.4 ft.TDH vs. 2S.23GPM Grease Trap Size(if applicable): gallons Distribution Method: ❑Serial ❑D-Box or Parallel 0 Pressure Manifold(s) tll LPP ❑Other: Artificial Drainage Required: Yes 0 No IN If yes,please specify details: Legal Agreements(If the answer is"Yes"to any type of legal agreements,please attach a copy of the agreement.) Multi-party Agreement Required(.1937(h)): Yes❑ No El Easement,Right-of-Way,or Encroachment Agreement Required[.1938(j)]: 0 Yes IN No Declaration of Restrictive Covenants: ❑Yes ISNo "If applicable: 1 understand the system type specified is different from the type specified on the application. I accept the specifications of this permit. Owner/Legal Representative Print Name: Owner/Legal Representative Signature: Date: Pre-Construction Conference Required: Yes 0 No f I / / r y L Conditions: Se.` C.JC, y1 , CA 10 be '5Svi'o( lApQkx firla( , . f? (.oi(JQ110 ... The construction and installation requirements of Rules.1950,.1952,.1954,.1955,.1956,.1957,.1958,and.1959 are incorporated by reference into this permit and shall be met. Systems shall be inst?Iled in accordance with the attached system layout. AOWE/PE Print Name: SJ JI UV. l A p!/ 4, it S AOWE/PE Signature: ��� 1 7/11s 4 z i Date: / This AOWE/PE submittal is pursuant to and meets the requirements of G.S.130A-335(a2)and(a5). *See attached site sketch* Ar SOIL & FORES'IRY SERVICES CIF TI1[ CAROLIN Ari, PA www.soilandforestryservices.com Attached is a proposed design for an PPBPS Septic System w/Low Pressure distribution for a 4 bedroom single family residence on Fieldstone Drive,Proposed Lot#2,(PID#461602593350),Terrell NC,28682. Contents: Page Information for the Installer 1 Design Information Design Specifications _ 2-3 Layout Specifications 4 System Tapsheet---------- -- 5 Site Plan/System Plan 6 Calculations 7 Profile Descriptions 8 Septic Application -� ,:..,,,; client provide 4 Improvements Permit Form9 4 • "" 'r Construction Authorization Form ------ ---_ y � Minor Subdivision Survey d.G Ak ‘ April 3,2023 Project#:23-0030 Design Bs': Soil& Forestry Services of the Carolinas,PA 1 INFORMATION FOR THE INSTALLER: The permit should be read very carefully prior to bidding. The following are details that must be considered along with all other considerations. - Tanks shall be approved by NC DIMS, and certification supplied by the manufacturer. - Tanks shall be water tested prior to installation. - The installer shall be responsible to the owner for placement of the tanks and to insure that final grades are returned to the original natural grade, with exception of added structural features. - The supply trench shall be compacted to eliminate cavities during initial fill placement. - Installation of the system shall be during dry conditions in order to protect the soil structure. - All fittings shall be pressure rated fittings. - All joints shall be cleaned with PVC pipe cleaner and a heavy bodied glue applied to weld all joints. - Where required by the county health department,post installation inspections by the designer must be scheduled 5 week days in advance. - Trenches shall be carefully excavated so the bottom is within 2"from the highest to . the lowest points of elevation within the trench. If the bottom elevation needs adjusting after it has been trenched, it will be done by removing high points rather than filling low points. It is extremely important to insure that trenches are not over excavated during initial trenching. Alt fine grading within the trench will be hand done with a shovel. No loose material will be left in the trench - All pipe openings in the tanks shall be properly grouted. This also applies to the joints around the riser. - All tanks shall be properly back filled and compacted to prevent slump at a later date. - Earth dams,constructed of relatively impervious material, shall be installed at the beginning and end of each lateral. - No heavy equipment shall be used on the field during or after installation. The use of a small loader(i.e. Bobcat)or a trencher(i.e. Ditch Witch 2300/2310) may be used for installation. - Elevations at pinflag locations should be checked by the installer prior to excavation - Pumptank riser should be 6"above grade, control panel should be 12"above grade. - Septic tank riser shall be a minimum of 6" above finished grade. - System is specified as an PPBPS installation with low pressure distribution. - Repair is specified as an PPBPS installation with low pressure distribution. - Backfill• /y " of material (County Approved)over panels, rake trench walls, lime side- walls,install trenches 24."wide and have no more than 1/4" fall in 10 feet. - Septic Lines must be 15' from poweriine. • • LP HPPBPS SYSTEM FOR WASTEWATER TREATMENT Owner/Applicant: Vlid t3aloiu Current Address: 198 Montiveilo 1)ri‘ Mooresville.NC 28117 Phone: n02.332.872.8 County: Catawba Location: Fieldstone Dr. Derrell.NC 28682 Source of Wastewater Flow: 4 Bedroom Single Family Residence Estimated Gallons Per Day Flow: 480 gpd System Flow: 25.83 gpm Design Specifications Drainfield Size: 270 Loading Rate(gpd/ft.2): 0.3 Depth of Gravel in Trench: NA(PPBPS ) Gravel Size: NA(PPBPS ) Trench Depth (LOW SIDE): 36 in., Repair 36 in. Trench Width: 24 in. Septic Tank Size: 1000 Pump Tank Size: 1000 Estimated Supply Line Length: 177 Supply Line Diameter: 2 in. SCH 40 PVC Supply Line Volume: 30.80 Dosing Volume: 226.80 Supply Manifold: NIA Supply Manifold Length: N/A Supply Manifold Volume: N/A Recommended Float Controls: SJE Sensor Float Control Switches as Required for Control Panel or County Approved Equivalents Recommended Control Panel: SJE-Rhombus Model 112 (NEMA 4x) Control Panel or County Approved Control Panel. Pressure Head: 2 ft. Friction Head: 3.15 Elevation Head: 15 40 Total Dynamic Head: 23.63 Threaded Union: In Tank Gate Valves: 1 in Tank 1 per lateral Check Valves: In Tank Anti-Siphon Hole: NA Additional Comments: Soil suitability was performed by Soil & Forestry Services of the Carolinas, PA 3 Fieldstone Dr. LP HPPBPS DESIGN FLOW(gpd): 480 SOIL APPLICATION RATE (gpd/ft.2): 0.3 TOTAL AREA TRENCH BOTTOM: 540 TOTAL LATERAL LENGTH: 270 NUMBER OF FIELDS: 1 LATERAL LENGTH REQUIRED PER FIELD: 266.6666667 SUPPLY LINE LENGTH: 177 TOTAL DYNAMIC HEAD: 23.63 MANIFOLD SIZE: N/A DOSING VOLUME: 226.80 PUMP TANK DRAW DOWN": 10.8 SEPTIC TANK SIZE: 1000 PUMP TANK SIZE: 1000 'Pump tank draw down based on a volume basis of 27 gallons per inch. Draw down may vary among pump tank manufacturers. 4 Fieldstone Dr.-Lot 2 Project#:23-0030 LAYOUT FOR 4 BEDROOM HOME April 3,2023 FLAG FLAGGED DESIGN LINE# COLOR ilk HI n ELEVATION LINE LENGTH LINE LENGTIIi IBM Right Front 2.70 100.00 INSTR. 1 102.70 HOUSE CNR (LEF!WONT) 8.00 94.70 P.TANK 13.10 89.60 1 RED 2.90 99.80 106 90 2 ORANGE 3.40 99.30 110 90 3 YELLOW 4.10 98.60 110 90 4 BLUE 4.80 97.90 110 110 5 PINK 5.50 97.20 110 110 6 RED 6.00 96.70 100 50 Total 646 540 SOIL LINE LTAR SYSTEM LTAR TRENCH TRENclI l GTtl GPD/FT' TYPI;; GPDJFT2 SYSTEM J ISTRIi}ITION DEPTH(IOW SIDE1 *System 270 0.300 MOD. 0.300 PPBPS LOW 36" COAT'y PRESSURE Repair 270 0.300 MOD. 0.300 PPBPS LOW 36" CON V. PRESSURE Notes: **AII septic lines and borings located via CPS and tape measures **Ali measures in feet **Nitrification lines are demonstrated on contour via colored pin flags 5 LP PPBPS TAPSHEET-Fieldstone Dr.-Lot 2 SYSTEM Line# Color I kvation icnth Ifole Si-iv Fl '#rule "I rench Area Number of Panels 1 RED 91k80 90 0.156 0.41 270 21 2 OR.4!VGE 99.30 90 0.156 0.41 270 21 3 FELLOW 98-60 90 0.156 0.41 2711 21 total feet .. 270 gal/min= 25.83 63 Des.How 480 Pomp Run 8.78 soil LIAR 0.3 I.TAR+5% 0.315 LIAR with mod. 0,6 LIAR with mod..+5% 0.63 .156 equals 6/32 Inch hole • • CALCULATIONS Location Fieldstone Dr. -Lot 2 Terrell, NC 28682 Project Number 23-0030 Lot No: 2 No. of Bedrooms 4 Design Flow 480 gal/day LTAR 0.3 gaI/n2day PPBPS?(YES OR NO) YES Supply Line Length 177 ft. Supply Line Volume 30.798 gal. FRICTION FACTOR INTERPOLATER Required Feet of Line 266.6667 ft. 2"SCH 40 PVC Amount of Line from Layout 270 ft. GPM �r 20 0.84 Gallons per Minute 25.83 gal/min -0.88 25 1.27 Required Septic Tank Capacity 1000 gal. -1.28 Pump Tank Capacity 1000 gal. 30 1.78 -1.76 Panel Volume 3.6 gal. 35 2.37 #of Panels 63 -2 25 Dosing Volume 226.80 gal. 40 3.03 Note: Dosing Volume based on 100%of#of 43.07 3.48 panels times 3.6 gal/panel 45 3.77 48.14 4.28 50 4.58 57.11 5.89 60 6.42 Tank Draw Down 10.8 Generic Draw Down of 21 gal per in. Pump Run Time 8.78 minutes Elevation Head 15.4 ft. Pressure Head 2 ft. Friction Factor 1.78 ft./100 ft. (From the interpolator.) Friction Head 3.15 ft. Total Dynamic Head (+15%) 23.63 ft. 8527 Fieldstone Dr County: Catawba This Section for Local Health Department Use Only Initial submittal received:4/18/23 by RP Date Initials Permit Number: Auth-05-2023-195413 G.S. 130A-335(a6)states the following: 'If a local health department fails to act on an application for a construction authorization submitted pursuant to subsection(a5)of the section within 10 business days of receipt of a complete application, the local health department shall issue the construction authorization.' In accordance with G.S. 130A-335(a5)the construction authorization application is: ❑ Incomplete(If box is checked,information in this section is required.) The following items are missing: Copies of this were sent to the AOWE/PE and the Owner on Date State Authorized Agent: Date: ❑ Denied (See attached report.) Copies of this were sent to the AOWE/PE and the Owner on Date State Authorized Agent: Date: © Complete State Authorized Agent: —2-1/1/ 1 � Date of Issuance: 5/10/28 This Construction Authorization is issued pursuant to G.S.130A-335(a2),(a5),and(a6)using the signed and sealed plans or evaluations attached here.This Construction Authorization is subject to revocation if the site plan,plat,or the intended use changes,or if information submitted in the application was falsified,inaccurate or misleading. The Construction Authorization shall not be affected by a change in ownership of the site. This Construction Authorization is subject to compliance with the provisions of the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit. The location and identification of all property lines,easements,water lines, and other appropriate utilities shall be the responsibility of the owner. Final landscaping shall be constructed to divert water and establish vegetative cover. The Department,the Department's authorized agents,and the local health departments shall be discharged and released from any liabilities,duties,and responsibilities imposed by statute or in common law from any claim arising out of or attributed to plans,evaluations,preconstruction conference findings,submittals,or actions from a person licensed pursuant to Chapter 89C of the General Statutes as a licensed engineer or a person certified pursuant to Article 5 of Chapter 90A of the General Statutes as an Authorized On-Site Wastewater Evaluator in GS 130A-335(a2),(a5),and(a7).The Department,the Department's authorized agents,and the local health departments shall be responsible and bear liability for their actions and evaluations and other obligations under State law or rule, including the issuance of the operations permit pursuant to GS 130A-337. Construction Authorization Expiration Date: 5/2/28 *See attached site sketch* -• • . . . .... _,• ___., _...,.___,,____. 35.68) • ----N.- co C=A 1-- C.0 c.C3 t•—• Awt, • : ;:a• rk., • t-4 C, C) DRAINAGEWA, W , . . n cji ,-1 dOei 1 • • m ..... 1,,.., c) \ ....... ,....... . f 1 " s. i•-4 = • Oa CO }....... \ • • , ;I:i.:1 1 ' .,.... .-- , A- \ P ---,; '......) (-• cv• ‘(P' ':.":›\('' ....) .„... '0. •7-; i : = • CX) -3 •, .4.--.1,; tm ..... g -- zio :N. \ ' \ , '.. ...I!: ,•; ‘(CIJ(...C),/I I ' \,.._.. \ .......,,, i .1 \ \ •, I, •-1 \ fri,::• ' 1......4 \ 0.. i ; 1 (A I •;• .. \ 00 jr- 3-0!lull i Ft'•- re-1,_ : c5 . C/D co t.TA j ; )-3 co ,; ' P Ti !'1 , L.,, ri°,•;;IN---i• ci ',1 I.;-.: •-,,.._____, (=I . I : CZ ZC::::' c:".. .:. , • C=' t til c1> ' ,... 1 , c...4 CZ) • ..... • . - ^.1 • ' : •:::::) , ,... 1 I i (... 1 • '• i ' ; --...... ....._____. ....., I , - .......,,....... -. =• 1 , 1 ;• 1 1 .--N\ i, .›... .c-) 1 i : f---t----- .. ... . .... . 1 i RIvt- ! t\D --,, ,.., L. ....,2 6..; I ! • I...., oNO c-, ..-----, -.,...:'. • I ,..Lii TrtN, ( 5-1)) NO 1 • ' i,.., , . 6 R. ,-.• . . .. . I r t 70 : "t) ; NORTH ------------------..._ \ ( a2 ;_,* I rl ,.. ,..... • . ,, . ..7) i , - .rri \\\ ... -' inSt,-,/: .,,,.., rri k -1-''''4. '. i 1, '''''''''+q, .." 73)0 ..• '14?< 4r} /4-•-••... 'CO c:7 \,...„," 5.; 1 I '4.... , ,,,,,,..,,,,... „),4 4 4 , ',.''.1 r '.\...rri 1 xi : ---.---1..: ....... .+7,....>, _ I 1 0 itatrt n.„-,-r-,,,Z•.•.„ .70 • . cza , . 1 I `4` L ' r"\'73,. ,,' ''''''.4::4;,;.;;;Z.:;;;„'...,,,*. ..,v,),-,......-......,--I rrt -\-- -I,' ao , i i , N R / 9 liori ----..-- .-- -0›. •- . t.)s,toff 90' -0 ..:, ./. c;" m ! ; -.7-. :...., I : ..../ . ... , m/a 135.00 S 02 00P 0,0 • II '•• W 135 00 Cs) -.................,. . —— ...... .., — - ..--- .---z — SR.11 1 RA 1 . 'Mti. . LAKE NORMAN -SE áEPTIc Contract for Inspections of On-Site Wastewater Systems (Type IV & V) This Contract is entered into this 3`d day of NOVEMBER 2023 by and between Lake Norman Sewer and Septic Services, LLC, a full service provider and a North Carolina company of Lincoln County, North Carolina (hereinafter the "ORC" or Operator in Responsible Charge) and LUX CUSTOM HOMES (hereinafter "The Owner"). Preamble The ORC 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 NC Admin. Code 18A.1900 et seq.; and 15A NC Admin. Code 18A.1961 requires that a condition of the Operation Permit for Type IV &V 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.The ORC is a management entity which employs certified operators of a type authorized by 15A NC 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 the Agreement, it is hereby agreed by and between the Owner and the ORC as stipulated below. Conditions of the Contract A. The ORC, 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 the Maintenance Agreement, then the Owner may request the ORC to provide an estimate. At the authorization of the Owner the ORC will perform the necessary repairs at the ORC's then-prevailing charges for services and materials. 4. If the ORC's services are terminated, the ORC will notify the local environmental regulatory agency within 48 hours. B. The Owner, in consideration of the services performed, agrees: 1. To pay the ORC for its services according to the schedule of charges as set out in the Maintenance Agreement. 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 the ORC to complete the needed repairs. 3. To notify the ORC 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 system as is reasonably necessary for the ORC to comply with its obligations under this Agreement. Terms of the Agreement 1. This Agreement shall be effective for one year from the date of this contract. This contract will have to be renewed each year. 2. The real property to be serviced under this contract is listed on the Maintenance Agreement. 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 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. Limited Warranty THE ORC'S SOLE DUTIES AND RESPONSIBILITIES UNDER THIS AGREEMENT IS TO PROVDE INSPECTION AND ROUTINE MAINTENANCE ONLY AS SPECIFIED IN THIS AGREEMETN. INSPECTIONS WILL COMPLY WITH APPLICABLE CODES, LAWS AND REGULATIONS IN FORCE AT THE TIME OF THE INPSECTION 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 REAIR OR REPLACEMENT AND CONSEQUENTIAL DAMAGE OR DAMAGES FOR DELAY ARE LIMITED TO THE TOTAL SUMS PAID THE ORC UNDER THIS AGREEMETN 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 SYTSMS COVERED BY THIS AGREEMETN WITHOUT PRIOR NOTICE TO THE ORC OR ACCEPTANCE OF THE WORK BY THE ORC DURING THE TERM OF THIS AGREEMETN VOIDS ANY WARRANTY GRANTED HERIN AS TO THE ORC. 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. The ORC may perform its duties and responsibilities by subcontract but the ORC 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: LUX CUSTOM HOMES 8527 FIELDSTONE DRIVE TERRELL, NC 28166 Lake Norman Sewer and Septic Services, LLC Po box 889 Denver, NC 28037 Environmental Regulatory Agency: Catawba County Environmental Health Department 100 A SW Boulevard Newton, NC 28658 A party may change its address by giving notice in the manner provided above. 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. OWNER: Lake Norman Sewer and Septic Services, LLC ATTEST: By: Gr-"e-7.2 Title: Owner License number: Subsurface Water Pollution Control System Operator#995940 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: LUX CUSTOM HOMES 8527 FIELDSTONE DRIVE TERRELL, NC 28166 Lake Norman Sewer and Septic Services, LLC Po box 889 Denver, NC 28037 Environmental Regulatory Agency: Catawba County Environmental Health Department 100 A SW Boulevard Newton, NC 28658 A party may change its address by giving notice in the manner provided above. 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 i igns, heirs and personal representatives, on the date first above written. / /', '--- OWNER: 1./, . I ,..,) Lake Norman Sewer and Septic Services, LLC ATTEST: . t��ts,,/,� "G„�d r..,. By: V4.,,� _4 `� Title: Owner License number: Subsurface Water Pollution Control System Operator#995940 )o 3- 15'5y David Currier Date of Inspection: Owner of: LAKE NORMAN 11/11/25 LAKE NORMAN SEWER AND SEPTIC PO BOX 889 ❑X Initial ❑6 Months Denver, NC 28037 p� (704)-483-5125 O� Field location: License Number:995940 SEPTIC ®Onsite ❑ Offsite Subsurface Wastewater Inspection Form Offsitesepticlot#: Name & Address of Owner: Control_panel: Liane & Uwe Czychy VPE OF SYSTEM: 8527 Fieldstone Drive Conduit sealed: ®YES ❑ NO ❑Polystyrene Terrell, NC 28166 Alarm operating: EYES ❑ NO ❑Chamber Panel location: ❑Panel ®LPPBS SEPTIC TANK: ❑Wall ®Post 18"inches High Size of Septic Tank: 1000 Gallons ❑Gravel ❑LPP Counter- Cycle: Hour: ❑Large diameter pipe Risers Readily Accessible: EYES ❑ NO ❑Other: Signs of Infiltration: OYES ® NO REDUCTION TYPE: PUMP Tank: Structurally Sound: ®YES ❑ NO ®Type IV(50%reduction) Size of Pump Tank: 1000 Gallons Filter(s)Cleaned: ®YES ❑ NO ❑Type III (25%reduction) Pump Model: WE0311M Surface Water Diverted: ®YES ❑ NO ❑ None Pump HP: 1/3 HP Scum Level: 0" Pump Voltage: 115V °nci Settings Sludge Level: 6" Pipework in good condition: EYES ❑NO Scum plus Sludge level: 6" ®2' ❑ 3' ❑other: Liquid Depth:49" Control floats operating: ®YES ❑ NO Distribution Set @ inspection: TANK NEEDS PUMPING: EYES ® NO Effluent free &clear of solids: DYES ❑ NO OYES E NO TANK NEEDS PUMPING: OYES ® NO Drain field: Effluent surfacing:DYES E NO Notes and/or Corrective Action Needed: Traffic Protected:EYES ❑NO We performed your 1Sr Type Iv inspection for DISTRIBUTION TYPE: Repair Area Reserved: the year. We removed and cleaned the outlet EYES El NO ❑Manifold ®Individual valves Surface Water Diverted: filter. We checked over the system at (CONTROL VALVE BOX.) EYES ❑NO everything was functioning as intended. We ❑Serial/drop boxes ❑Distribution box Line Cover Maintained: will be back out in 6 months to perform the 2' EYES ❑NO inspection. Thanks! LOW PRESSURE SYSTEM: Turn-ups and/or Valves Located/ Pump draw down: Protected:EYES ❑NO Gallons per cycle: 226 n Laterals Free of Excess solids:EYES ❑NO Draw down length: 10.8 / / ►� /�,�, w Laterals Flushed:DYES E NO Tether length if wide angle INSPECTOR SIGNATURE• U'l 1.�' ✓✓ float:6.2"