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AOWE-05-2023-196527.TIF
pr- gE -0003g CR 4Goi Ass' ned P— -{front [lacy n PEf 0000 0151 g Case -Fr) b ewpont4f4 -eec [I -I�n -Pees sr�rEa ROY COOPER•Governor A ok-t- }-- 20 23- (1 i s-Z7 41: NC DEPARTMENT OF KODY H.KINSLEY Secretary Vea HEALTH AND HUMAN SERVICES HELEN WOLSTENHOLME•Interim Deputy Secretary for Health . �• MARK T.BENTON•Assistant Secretary for Public Health Division of Public Health COMMON FORM FOR AUTHORIZED ON-SITE WASTEWATER EVALUATOR PERMIT OPTION FOR NON-ENGINEERED SYSTEMS See Instructions for Use in Appendix A Except for"Date received",this Section to be completed by the AOWE in accordance with G.S.130A-336.2 LHD USE ONLY: Initial submittal of this NOI received: 5--1y Tfr by it, Date Initials PART 1:Notice of Intent to Construct(NOI)-Please check all that apply ®Single System or 0 Multiple Systems AND New ❑Expansion ❑Relocation of all or part of the Existing System ❑Relocation of Repair Area ❑ Repair—LHD Permit Number 0 Repair—EOP/LSS COVID 19/AOWE Permit Number 1. Facility Owner's name:(Owner,Company Name,Utility,Partnership,Individual,etc.): Adams Homes-AEC, LLC Mailing address:3401 St.Vardell Lane, Suite B City:Charlotte State: NC Zip: 28217 Telephone number: 704-558-4527 E-mail Address: bcashion a(�.adamshomes.com 2. Authorized On-Site Wastewater Evaluator(AOWE)name:Jeff Vaughan LSS License number:1227 AOWE Certification number:10003E Mailing address:501 N Salem St, Suite 203 City:Apex State:NC Zip:27502 Telephone number: 919-859-0669 E-mail Address: jvauahan(a�agriwaste.com 3. Licensed Geologist(LG)(if applicable)name: 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: ®AOWE ❑ LG 5. Property location(physical address,tax parcel identification number or subdivision lot,block number of the property to be permitted Lot 70 Colchester Court, Catawba, NC. 28609(Cardiff Glyn Subdivisions County Name: Catawba LOT 69 Amended based on PLAT dated January 26,2023 RECEIVED ECE1V - NC DEPARTMENT OF HEALTH AND HUMAN SERVICES • DIVISION OF PUBLIC HEALTH OCT 1 6 2024 LOCATION:5605 Six Forks Road,Raleigh,NC 27609 MAY 9 2023 MAILING ADDRESS:1642 Mall Service Center,Raleigh,NC 27699-1642 www.ncdhhs.gov • TEL:919-707-5874 • FAX:919-845-3972 Environmental Health AN EQUAL OPPORTUNITY(AFFIRMATIVE ACTION EMPLOYER vironmental He: P �J ) AOWE Common Form LHD Reference: /T")"(' o Qol (��r17 6. Type of facility: ® Place of residence No.Bedrooms:4 No.Occupants•$ ❑Place of business Basis for flow calculation: El Place of public assembly Basis for flow calculation: 7. Factors that would affect the wastewater load:domestic strength wastewater from a single-family residence 8. Type and location of proposed wastewater system:Pressure Manifold. Low-Profile Chamber drain field product Location shown on site plan 9. Design wastewater flow:480 gpd Design wastewater strength: 0 domestic ❑high strength ❑industrial process(For high strength and Industrial process wastewater,a Professional Engineer licensed in accordance with GS.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: J Yes 0 No This is a saprolite system. ❑Yes ®No 12. Evaluation(s)of soil conditions and site features in accordance with G.S.130A-335(a1)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 AOWE pursuant to GS.130A-3362 i,Jeff Vaughan hereby attest that the information required to be included with Authorized On-Site WastewaterEvaluator(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. May 5,2023 Signature ofAuthorized On-Site WastewaterEvaluator Date Ownerself-submittal of NOi: 1, hereby submit this NOI prepared by Print Name of Owner Print Name of Licensed PE pursuantto G.S.130A-336.1. Signature of Owner RECEIVED OCT 1 6 2024 DHHS/EHS/OSWP—AOWE COMMON FORM Updated April2022 Environmental Health Page 2 of 6 AOWE Common Form LHD Reference: 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 AOWE Permit Option(G.S.130A 336.2(f f j RIGHT OF DORY:Thesubmittal 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 agencyfora permit for electrical,plumbing,heating,air conditioning or other construction,location,or relocation activity under any provision of general ors pedal law pursuant to G.S.130A-338. RECEIVED OCT 1 6 2024 Environmental Health DHHS/EHS/OSWP—AOWE COMMON FORM Updated Apri12022 Page 3 of 6 r AOWE Common Form LHD Reference:A°k v�-20-3- 116s27 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 departmentshall determine whetherthe 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 department to cure the defidencies 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 departmentfails to act within any time period set out in this subsection,the owner may treat thefailure to act as a determination of completeness. The owner shall be able to applyfor 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 AOWE 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 Name of Authorized Agent of the LHD Signature of Authorized Agent of the LHD Date 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. Copies of this signed form were sent to the AOWE and the Owner on 6107 h$via kr ! Date Email,FAX,USPS,hand-delivered A copy of this NOI and tracking information was sent to the State on via Date Email,FAX,USPS,hand-delivered . itottia gal /f Print Name of Authorized Agent of the IND Signature of Authorized Agent of the LHD Date RECEIVED OCT 1 6 2024 Environmental Health DHHS/ENS/OSWP-AOWE COMMON.FORM Updated April2022 Page 4 of 6 r AOWE Common Form LHD Reference: Re-submittal of NOI with missing items included ThlsSection is for use by owner to submit Items noted as missing during LED t:ompletenessReview above. Resutunittafs must be accompanied bya rover letter from theAOWE LHD USE ONLY: This NOI resubmittal received: by Date Initials Item f from initial NOI Resubmittal description Attestation by AOWE certified in North Carolina pursuant to G.S.130A-336.2 1, hereby attest that the information required to be included with Authorized On-Site Wastewater Evaluator(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 Authorized On-Site Wastewater Evaluator Date Thesection below is forLocal 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 AOWE 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 AOWE and the Owner on via Date Email,FAX,LISPS,Band-delivered A complete copy of this form with tracking information was sent to the State: via Dote Email,FAX,USPS,hand-delivered RECRVED Print name of authorized Agent of the LHD Signature of authorized Agent of the LHD Date OCT 1 6 2024 DHH5/EHS1DSWP—AOWE COMMON FORM Updated April 2022 Page 5 of 6 Environmental Health AOWE Common Form LHD Reference: PART 3: Authorization to Operate(ATO) Except for date received,the Section below is to be completed by the Owner. LHD USE ONLY: Initial submittal of requestfor ATO received: by Date initials Date of Post-construction Conference: T The following items are included in this submittal for an Authorization to Operate under an AOWE permit 1. Signed and sealed copy of the AOWE's report that includes the information in G.S.130A-336.2(k) ❑ Yes ❑ No 2. Operation and managementprogram ❑ Yes ❑ No 3. Fee (as applicable) ❑Yes ❑ No 4. Notarized letter documenting Owner's acceptance of the system from the AOWE ❑ 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 I, hereby attest that all items indicated above have been provided to the Print nome of Owner County LHD and the system.shall meet applicable federal,State,and local laws, regulations,rules,and ordinances. Signature ofOwner Date Thls 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 AOWE permit Copies of this signed form were sent to the AOWE and the Owner on via Date Email,FAX,USPS,Hand-delivered Print name ofauthorized Agent of the UM 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 Emaiil,FAX USPS,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 th °E.s.siTZ; h ,}�r{gr a apply to the local permitting agency for permanent electrical service to a residence,place of business or place o pu TrcIr rs a&-to 130A 339. OCT 1 6 °024 DHHS/EHS/OSWP—AOWE COMMON FORM Updated April 2022 Page 6 of 6 Environmental Heafth I iii 11 • r ---1 .-? .,. , ,....,,.9. 4I . it 1 1 Oo a S ; ,, a ct> =a� _ 1 • '" I"+y 1 lid i z" -5 aw � �i iw5°� � g �.�a�a� I � � ,, awl (£001}IS)Qi 08771LV SdV?I?!!lW 1 " 1 1 d 1 ON. p1.. 1 -7--•-__r��_ i g 4 � n '� it ter-+�:�- _=- --- _ �!�ticno, m Sg 2 11i �fifi rm".o' �,e5ac+mer mad , W n 4 ;OP e I G i _ z,an z.w MCC +e ar =sm•_IIy '' C7 a 4,11510. ag$neae a s loan!, 5 a `\ 511 \ i9 I �d-x 0o l t l gI5 1 BA III 1 a p X0t,,� j o € i ig .\ 0• a ga r rAiAg.gli t aI Noia?g'}p•qi. 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Erivirenm�nal - th N 3 c 0 / _ a m� o _ ` E3=uo , , % ro in O i-N a1 N,N a2 \ 1 % Li_� TiV t- RNA-Ds:x.)34/f 408 STATE o ROY COOPER•Governor A(1it-t-01' 20 2-3- ( / i c2-7 - P 3' NC DEPARTMENT OF ~��l ��- � H EA LT H AND KODY H. KINSLEY•Secretary •Vor HUMAN SERVICES HELEN WOLSTENHOLME•Interim Deputy Secretary for Health MARK T. BENTON•Assistant Secretary for Public Health Division of Public Health COMMON FORM FOR AUTHORIZED ON-SITE WASTEWATER EVALUATOR PERMIT OPTION FOR NON-ENGINEERED SYSTEMS See Instructions for Use in Appendix A Except for"Date received",this Section to be completed by the AOWE in accordance with G.S.130A-336.2 LHD USE ONLY: Initial submittal of this NOI received: 5-'t/-20 by K., Dote Initials PART 1: Notice of Intent to Construct(NOI)-Please check all that apply ® 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/L5S COVID 19/AOWE Permit Number 1. Facility Owner's name: (Owner, Company Name, Utility, Partnership, Individual, etc.): Adams Homes-AEC, LLC Mailing address: 3401 St. Vardell Lane, Suite B City: Charlotte State: NC Zip: 28217 Telephone number: 704-558-4527 E-mail Address: bcashion(ca7adamshomes.com 2. Authorized On-Site Wastewater Evaluator(AOWE) name: Jeff Vaughan LSS License number:1227 AOWE Certification number:10003E Mailing address:501 N Salem St, Suite 203 City:Apex State: NC Zip:27502 Telephone number: 919-859-0669 E-mail Address: ivaughan(a.agriwaste.com 3. Licensed Geologist(LG) (if applicable) name: 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: ®AOWE U LG 5. Property location (physical address,tax parcel identification number or subdivision lot, block number of the property to be permitted Lot 70 Colchester Court, Catawba, NC. 28609 (Cardiff Glyn Subdivision) County Name: Catawba RECEIVED NC DEPARTMENT OF HEALTH AND HUMAN SERVICES • DIVISION OF PUBLIC HEALTH LOCATION:5605 Six Forks Road.Raleigh,NC 27609 MAY 1 9 2023 MAILING ADDRESS:1642 Mail Service Center, Raleigh,NC 27699-1642 www.ncdhhs.gov • TEL:919-707-5874 • FAX:919-845-3972 AN EQUAL OPPORTUNITY l AFFIRMATIVE ACTION EMPLOYER Environmental Health /4w� -or-2o23- /9d 5'Z7 AOWE Common Form LHD Reference: 6. Type of facility: E' Place of residence No. Bedrooms:4 _ No. Occupants:8 ❑ Place of business Basis for flow calculation: ❑ Place of public assembly Basis for flow calculation: 7. Factors that would affect the wastewater load: domestic strength wastewater from a single-family residence 8. Type and location of proposed wastewater system: Pressure Manifold, Low-Profile Chamber drain field product Location shown on site plan 9. Design wastewater flow:480 gpd Design wastewater strength: ®domestic ❑ high strength ❑ industrial process(For high strength and industrial process wastewater,a Professional Engineer licensed in accordance with G.S.89C shall 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 1SA 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 AOWE pursuant to G.S. 130A-336.2 I,Jeff Vaughan hereby attest that the information required to be included with Authorized On-Site Wastewater Evaluator(Pont 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 Surve�y�ors./ i/ o %'� r/,/ May 5, 2023 Signature of Authorized On-Site Wastewater Evaluator Dote Owner self submittal of NO!: hereby submit this NOI prepared by Print Nome of Owner Print Nome of Licensed PE pursuant to G.S. 130A-336.1. Signature of Owner Date DHHS/£HS/OSWP-AOWE COMMON FORM Updated April 2022 Page 2 of 6 AOWE Common Form LHD Reference:/T U�r -DS 2 u2 3_ 1`S27 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 AOWE Permit Option[G.S. 130A-336.2(f)] 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—AOWE COMMON FORM Updated April 2022 Page 3 of 6 AOWE Common Form LHD Reference:Q.ow+2:�S_20? 1,6527 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 department to cure the deficiencies in the initial notice.The local health deportment 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 AOWE 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 Er 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. Copies of this signed form were sent to the AOWE and the Owner on 5J 1a�135 via 1i^4< Date Email,FAX,USPS,hand-delivered A copy of this NOI and tracking information was sent to the State on via Date Email,FAX,USPS,hand-delivered (11/4,ti;a P�.� r 4' -Z3-Z3 Print Name of Authorized Agent of the!HD Signature of Authorized Agent of the LHD Date DHHS/EHS/OSWP-AOWE COMMON FORM Updated April 2022 Page 4 of 6 AOWE Common Form LHD Reference: Re-submittal of NOI with missing items included This Section is for use by owner to submit items noted as missing during LHD Completeness Review above. Resubmlttass must be accompanied by a cover letter from the ADWE. LHD USE ONLY: This NOI resubmittal received: by Date initials Item#from initial NOI Resubmittal description Attestation by AOWE certified in North Carolina pursuant to G.S.130A-336.2 hereby attest that the information required to be included with Authorized On-Site Wastewater Evaluator(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 Authorized On-Site Wastewater Evaluator 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 AOWE and the Owner on via Dote Email,FAX,LISPS,Hand-delivered Print name of authorized Agent of the LHD Signature of authorized Agent of the LHD Dote ❑ 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 AOWE and the Owner on via Date Email,FAX,LISPS,Hand-delivered A complete copy of this form with tracking information was sent to the State: via Date Email,FAX,LISPS,hand-delivered Print name of authorized Agent of the LHD Signature of authorized Agent of the LHD Dote OHMS/ENS/OSWP—AOWE COMMON FORM Updated April2022 Page 5 of 6 AOWE Common Form LHD Reference: 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 Dote initials Date of Post-construction Conference: T The following items are included in this submittal for an Authorization to Operate under an AOWE permit: 1. Signed and sealed copy of the AOWE'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 AOWE ❑ 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 I, 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 Date This section for Elio 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 AOWE permit: Copies of this signed form were sent to the AOWE and the Owner on via Date Email,FAX,LISPS,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 Dote Emoif,FAX USPS,Hond-delivered Print name of authorized Agent of the LHD Signature of authorized Agent of the WO 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 pursuant to C.S.130A-339. DHNS/EHS/OSWP—AOWE COMMON FORM Updated April 2022 Page 6 of 6 �...14,41 AGRITEC-01 GKROHL ACORO' DATE(MMIDD/YYYY) �� CERTIFICATE OF LIABILITY INSURANCE 3/1412023 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(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 Connie Garkalns SAME: Hartsfield&Nash Agency, Inc. PHONE x 10405 Ligon Mill Rd.,Ste H (Arc,No,Eat).(919) 556-3698 ___ I(FA a lc,No):(919)5564758 Wake Forest,NC 27587 Matt Connie@hartsfield-nash.com INSURER(S)AFFORDING COVERAGE _ NAIL f_ INSURER A_Selective Insurance Company of the Southeast 39926 -_ INSURED INSURER B:ACCIDENT FUND INSURANCE COMPANY OF AMERICA 10166 Agri-Waste Technology Inc INSURER C:Evanston Insurance Company 501 N.Salem St Ste 203 INSURER 0 Apex,NC 27502 INSURER E: INSURER F: i- 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 sum' POLICY NUMBER POLICY EFT POLICY EXP LIMITS LTR *MD MD. ItAWDDIYYYYI fNMIDDtYYYYt A X COMMERCIAL GENERAL LIABILITY $ 2,000,000 EACH OCCURRENCE S 2253659 1/18/2023 1/18/2024 DAMAGE T R CLAIMS•MADE X I OCCUR PREMISES(O EaENTED ommence} S _ 300,000 MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 POLICY X JEC° LOC PRODUCTS-COMPIOPAGG _1_ 4,000,000 OTHER: $ A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 ...LEaaccidenll_ $ X ANY AUTO S 2253659 1/18/2023 1/18/2024 BODILY INJURY(Per person) $ — OWNED SCHEDULED AUTOS ONLY AUTOS BODILYBODILY INJURY(Per accident) $ AUTOS ONLY — VMS (PerR aaccident)ERTY OAMAGE _$__ S A ^X UMBRELLA LIAB X OCCUR EACH OCCURRENCE S 2,000,000 EXCESS UAB CLAIMS-MADE ,S 2253659 1/18/2023 1/18/2024 AGGREGATE $ 2,000,000 I DED RETENTION$ I $ B WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY YIN 100003072 1118/2023 1/18/2024 STATUTE ER --. 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE N NIA E.L.EACH ACCIDENT $ MFFICERfMEMBER EXCLUDED'? andatary In NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes.describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ C Prof&Pollution MKLV3ENV103400 8/22/2022 8/2212023 Each Claim 5,000,000 A Leased!Rented S 2253659 1/1812023 1/18/2024 Equipment 25,000 DESCRIPTION OF OPERATIONS I LOCATIONS!VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE ***This is ONLY For Informational Purposes THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN P ACCORDANCE WITH THE POLICY PROVISIONS. Contact Agency for Specific Holder info to be added AUTHORIZED REPRESENTATIVE . Kr514 ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AVIFT ,• mil= Engineers and Soil Scientists Agri-Waste Technology, Inc. • '-so• 501 N Salem Street, Suite 203, Apex, NC 27502 agriwaste.com I 919.859.0669 Soil Suitability for Domestic Sewage Treatment and Disposal Systems Lot 70 Colchester Court, Catawba, NC. 28609 Cardiff Glyn Subdivision (Catawba County) PREPARED FOR: Adams Homes—AEC, LLC, Client PREPARED BY: Jeff Vaughan, Senior Agronomist & Soil Scientist Trevor Hackney, Environmental Scientist DATE: May 5, 2023 Soil suitability for domestic sewage treatment and disposal systems was evaluated on October 10, 2022, for the proposed property located at Lot 70 Colchester Court, Catawba, NC. Jeff Vaughan and Trevor Hackney of Agri-Waste Technology, Inc. (AWT) conducted the soil evaluation. This evaluation was done to facilitate permitting for a septic system. This report and attached documents were prepared to meet the requirements for an Authorized On-Site Wastewater Evaluator to meet G.S. I 30A-336.2 A drawing of the site plan, septic layout, and boring locations is included in Attachment 1. Profile descriptions for each boring are included in Attachment 2. Additional documentation about the property is included in Attachment 3. This property is a subdivision of a larger property that will make up the Cardiff Glyn subdivision. This property area is approximately 1.5 acres. The property is an open grass field. The home is proposed near the front of the property with the septic system proposed upslope of the home. The proposed septic system is a pressure manifold septic system utilizing a low-profile chamber dispersal product for the primary and repair system. Soil Suitability for Domestic Sewage Treatment and Disposal Systems The drawing in Attachment 1 details the property boundaries (as proposed by Frank Craig), soil boring locations, and layout of drain field trenches (Completed by AWT). Soil borings were examined to determine soil suitability for on-site sewage disposal systems in accordance with 15A 18A .1900 Rules for Sewage Treatment and Disposal Systems. These borings were advanced with a hand auger. 1 A septic layout was performed to demonstrate available space (.1945). The layout in Attachment I indicates there is available space for a four-bedroom primary and repair system utilizing a low-profile chamber dispersal drain field product. The proposed LTAR(Long Term Acceptance Rate) by AWT is 0.25 GPD/ft2. The soils on this property are group IV soils within the distribution and treatment zone as used to define the [TAR. Since usable slope corrected soil depths meet or exceed 28" AWT is recommending the use of the low-profile chamber dispersal trench product. The maximum trench bottom should not exceed 16". With an LTAR of 0.25 GPD/ft2, 1280 linear feet of trench are necessary to support a four-bedroom home initial and repair system. The attached drawing proves that 640 linear feet of trench can be installed for the primary septic system. The attached drawing proves that 648 linear feet of trench can be installed for the repair system. Any disturbances or grading done in the usable area or within the proposed setbacks will change the potential of using the area designated for a drain field. We appreciate the opportunity to assist you in this matter. Please contact us with any questions, concerns, or comments. Sincerely, Jeff Vaughan, AOWE /40 /10 -. 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Lot#: 70 Permit#: Project Manager: Owner: Adams Homes-AEC, LLC Jeff Vaughan, PhD, LSS Address: 3401 St.Vardell Lane,Suite B Type of System: III bg jvaughan@agriwaste.com Charlotte, NC 28217 919-859-0669 Phone: 704-558-4527 Engineer: Email: bcashion@adamshomes.com PIN: 378003016801 Rodney L.Huffman, PhD, PE rhuffman@agriwaste.com EHS: Soil Parameters Soil Evaluation By: Special Conditions/Notes: LIAR: 0.25 gpd/ft2 Design Parameters Type of Establishment: Residence,5 or fewer bedrooms Unit: Bedroom #of Units: 4 Septic Tank Specifications Min.Tank Capacity: 1,000 gal Exterior Interior Actual Tank Volume: 1,250 gal Length: 125.5 119.5 in. Tank Manufacturer: Shoal Width: 65.5 59.5 in. Tank Model: TS 1250 STB Depth: 61.5 54.5 in. Primary Draintield Specitications Type of Distribution: Parallel Pressure Manifold Trench Bottom Area: 1920 ft' Trench Media: Low-profile Chambers Minimum Drain Line: 640 ft Trench Width: 3 ft Actual Drain Line: 640 ft Trench Depth: in. Number of Lines: 4 (or as specified on permit) Minimum Line Spacing: 9 ft O.C. Wastewater Treatment System Design Calculations Project: Cardiff Glyn - Lot 70 Location: 5064 Throneburg Rd Catawba, NC 28609 County: Catawba Septic Tank Sizing Daily Flow Estimate: Unit #of Units Flow/Unit _ Flow/Day Bedroom 4 120 480 • Q= 480 gpd Septic Tank Minimum Capacity: Per NCAC T15A:18A.1952(b)(1): For individual residences with 4 bedrooms, Minimum Liquid Capacity(V)= 1,000 gal Septic Tank Specs: Manufacturer: Shoat Model: TS 1250STB Volume: 1,250 gal Weight: 11,000 lbs Exterior Interior Length: 125.5 119.5 in. Width: 65.5 59.5 in. Depth: 61.5 54.5 in. Shape of Risers: Circular Diameter: 2.00 ft Pump Tank Storage & Float Settings Project: Cardiff Glyn -Lot 70 Location: 5064 Throneburg Rd Catawba, NC 28609 County: Catawba Tank Manufacturer Shoaf -_ Tank Model TS 1275 PT Interior Height(in.) 60.5 in. Avg. Storage 21.07 gal/in. Primary System Elevations, measured from bottom towards top(0 = Interior Bottom of Tank): Top of pump(including 4"block) 16.1 in. (Pump height= 12 1/8") Pump Off 18.0 in. Pump On 31.5 in. (set for dose volume) Alarm On 37.5 in. (6 in. above On Float) Emergency Storage Available Pump Tank 485 gal Days of Storage 1.01 days (determined from"Interior top of tank"-"High Water Alarm") Repair System Elevations, measured from bottom towards top(0= Interior Bottom of Tank): Top of pump (including 4"block) 16.1 in. (Pump height= 12 1/8") Pump Off 18.0 in. Pump On 31.5 in. (set for dose volume) Alarm On 37.5 in. (6 in. above On Float) Emergency Storage Available Pump Tank 485 gal Days of Storage 1.01 days (determined from"interior top of tank"-"High Water Alarm") ELEVATIONS Project: Cardiff Glyn-Lot 70 Location: 5064 Throneburg Rd Catawba,NC 28609 County: Catawba Benchmark IP SW corner Lot 70 BM Elev 1017 ft Septic Tank 1,250 gal Ground Surface ft Depth of Soil Cover 23 in. 1.92 ft Overall Ht of Tank 61.5 in. 5.13 ft Elev.Base of Tank 1009.96 ft Ht to 4"Inlet Invert 50 in. 4.17 ft Elev,4"Inlet Invert 1014.13 ft Ht to 4"Outlet Invert 48 In. 4.00 ft Elev,4"Outlet Invert 1013.96 ft Gravel Base Olin, 0.50 ft Elev,Bot of Excavation 1009.46 ft Pump Tank 1287 gal Ground Surface { t y 1 ft Depth of Soil Cover 18 in. 1.50 ft Overall Ht of Tank 67.5 in, 5.63 ft Elev,Base of Tank 1009.08 ft Ht to 4"Inlet Invert 57 in. 4.75 ft Elev,4"Inlet Invert 1013.83 ft Ht to 2"Outlet Invert 58 in. 4.83 ft Elev,2"Outlet Invert 1013.91 ft Gravel Base in. 0.50 ft Elev,Bot of Excavation 1008.58 ft ST Inlet Pipe Grade @ Stub-out 1016.3 ft Depth of Stub-out,top 1,.5 ft Elev.Stub-out Invert 1014.45 ft Elev @ ST Inlet Invert 1014.13 ft Length [ 151ft Slope 2.1 % Pipe,ST to PT ID 4 in. 0.33 ft OD 45 in. 0.38 ft Elev,ST Outlet Invert 1013.96 ft Elev,PT Inlet Invert 1013.83 ft Length :r::: ft Slope 1.2 % Cover over inlet pipe 2.52 ft Pump Regmt. Floor Thickness 4 in. 0.33 ft Elev,Pump Tank Floor 1009.41 ft Pump Block Ht. _g z j In. 0.33 ft Elev,Pump Intake 1009.74 ft Grade @ Primary Manifold ,..,., ft Grade @ Repair Manifold ft Min.Cover , +_;in. 1.50 ft Max Elev,Primary 1018.85 ft Max Elev,Repair 1021.50 ft Elev Duff,Primary 9.11 ft Elev Duff,Repair 11.76 ft Drainfield Design Project Cardiff Glyn-Lot 70 location 5064 Throneburg Rd Catawba,NC 28609 County Catawba Drainfield Sizing Primary LIAR 0.25 gpd/ft2 Daily Design Flow 480 gpd Type of Drainfield Media Low-profile Chambers Req.Drainfield Area 1,920 ft2 Required Drainline Trench Width,Eff. 3 ft After 0%Reduction 640 ft Required Drainline 640 ft Minimum Line Spacing 9 ft(O.C.) Repair LIAR 0.25 gpd/ft2 Daily Design Flow 480 gpd Type of Drainfield Media Low-profile Chambers Req.Drainfield Area 1,920 ft2 Required Drainline Trench Width,Eff. 3 ft After 0%Reduction 640 ft Required Drainline 640 ft Minimum Line Spacing 9 ft(O.C.) Drainfield Layout Elevation Line Length Used as UI!d#s Use Flag Color (ft) (ft) Primary(ft) R_ (ft)' 1 Layout Line red _1017.9 171 138.0 2 Layout Line blue 1018.5 139 138.0 3 Layout Line purple 1019.1 210 182.0 4 Layout Line white 1019.9 200 182.0 5 Layout Line red 1020.8 192 162.0 6 Layout Line blue 1021.3 185 162.0 7 Layout Line purple 1022.1 180 162.0 8 Layout Line white 1022.7 174 162.0 lot,il 1451 640 648 Count 8 4 4 Note:Line length totals are shown to the nearest foot. For Chambers or Low-profile Chambers: Effective trench lengths are shown.Add 1'for total installation length. PRESSURE MANIFOLD DESIGN (Primary) Site Information Project: Cardiff Glyn-Lot 70 Location: 5064 Throneburg Rd Catawba,NC 28609 County: Catawba Design information Estimated Daily Flow 480 gal/day L.T.A.R.(from Catawba Co.) 0.25 gal/day/ft2 L.T.A.R.+5% 0.263 gal/day/ft2 Trench Width 3 ft. Line Length Required 640 ft. Length after 0%Reduction 640 ft L.T.A.R.Reduced 0.250 gal/day/ft2 L.T.A.R.Reduced+ 5% 0.263 gal/day/ft2 DRAINFIELD INFO.- Primary Proposed Type of System/Distribution: to Autisttnemongot using Low-profile Chambers Flag Line Flow Flow/Foot Line Line No. Color Length(ft) Tap ..m (gpm/ft) L.T.A.R. 1 red 138 1/2in SCH 80 ,;: _.' 0.040 0.252 2 blue 138 1/2in SCH 80 ` 0.040 0.252 3 purple 182 1/2in SCH 40 . 0.039 0.248 4 white 182 1/2in SCH 40 7,11 0.039 0.248 Total 640 Total 25.18 Avg. 0.25 Note:Line lengths are calculated in 4'increments to reflect use of Low-profile Chambers product.2'added for endcaps. Total Run Time 19.06 min. Drainfield Capacity 417.9 gal %of Drainfield Cap (Req. Range 66-75%) Dose Volume 284.4 gal/dose Run Time/Dose 11.3 minutes Range 5-7 minutes unless uphill,checked Volume/depth 21.07 gal/in. (Per tank manufacturer's specifications) Estimated Drawdown 13.50 in. Manifold Box Number of Taps 4 with 0 Split(s) Manifold Length 3.5 ft. (approximate) PRESSURE MANIFOLD SYSTEM DESIGN (Repair) Site Information Project: Cardiff Glyn-Lot 70 Location: 5064 Throneburg Rd Catawba,NC 28609 County: Catawba Design Information Estimated Daily Flow 480 gal/day L.T.A.R.(from Catawba Co.) 0.25 gal/day/ft2 L.T.A.R. +5% 0.263 gal/day/ft2 Trench Width 3 ft. Line Length Required 640 ft. Length after 0%Reduction 640 ft L.T.A.R.Reduced 0.250 gal/day/ft2 L.T.A.R.Reduced+5% 0.263 gal/day/ft2 DRAINFIELD INFO.- Repair Proposed Type of System/Distribution: Pump to Pressure Manifold using Low-profile Chambers Flag Line Flow Flow/Foot Line Line No. Color Length(ft.) (9gm) (gpm/f1) L.T.A.R. 5 red 162 1/2in SCH 40 7.11 0.044 0.247 6 blue 162 1/2in SCH 40 7.11. 0.044 0.247 7 purple 162 1/2in SCH 40 741 0.044 0.247 8 white 162 1/2in SCH 40 7.11 0,044 0.247 Total 648 Total 28.44 Avg. 0.25 Note.Line lengths are calculated in 4'increments to reflect use of Low-profile Chambers product.2'added for endcaps Total Run Time 16.88 min. Drainfield Capacity 423.1 gal %of Drainfield Cap 67.2* (Req. Range 66-75%) Dose Volume 284.4 gal/dose Run Time/Dose 10.0 minutes Range 5-7 minutes unless uphill,checked Volume/depth 21.07 gal/in. (Per tank manufacturer's specifications) Estimated Drawdown 13.50 in. Manifold Box Number of Taps 4 with 0 Split(s) Manifold Length 3.5 ft. (approximate) PUMP DESIGN System(initial/repair): Primary Project: Cardiff Glyn•Lot 70 Location: 5064 Throneburg Rd Catawba,NC 28609 County: Catawba Friction Losses Suction Head, .;_. , ..:OJft (submersible 0) Elev.Difference(highest point from pump) 9.11 ft Design Pressure At Outlet.. , ::21 ft Supply Line-1.5"Schedule 40 PVC Pipe Diameter,Nominal " '_;''in. Pipe Diameter(ID) 1.59 in. Flow 25.18 gpm Pipe Length )ft Velocity 4.07 ft/sec Pipe Length for Fittings 16.4 ft Meets requirement that 2 ft/s<v<5 ft/s. Equivalent Length 180.4 ft Estimated Friction Loss in Supply Line 7.29 ft Pressure Filter Friction Loss '�';;F. [`.: ft (from manufacturer) Friction Loss-Taps/Special Fittings,`- _,ft TOTAL 22.23 ft Flow for Anti-Siphon Hole Hole Diameter 11101M1 in. Hole Flowrate 1.95 gpm Pump Efficiency illalgril(assumed,typical) Motor Efficiency minin(assumed for electric pumps) Flow 27.13 gpm Required Horsepower 0.24 hp TDH 22.23 ft Pump Selection Manufacturer: Zoeller Model:,. N151 Horsepower: 0.4 1 i PUMP PERFORMANCE CURVE MODEL 151/152/153 m 14- , 153 - i a n 1 10- 30 1- 26 1I" Operating 0 e- 2u i Point . 16 • 10 2 6 , .\\\*\\\‘1%\\* ' ' 0 : ' : i N 20 10 100 GALLONS LRfl18 0 M i 1i0 1l0 260 240 tin 3i0 310 FLOW RP 114141112 PAW PUMP DESIGN System(initial/repair): Repair Project: Cardiff Glyn-Lot 70 Location: 5064 Throneburg Rd Catawba,NC 28609 County: Catawba Friction Losses Suction Head ft (submersible 0) Elev.Difference(highest point from pump) 11.76 ft Design Pressure At Outlet MOW ft Supply Line-1.5"Schedule 40 PVC Pipe Diameter,Nominal' 151in. Pipe Diameter(ID) 1.59 in. Flow 28.44 gpm Pipe Length "'- ft Velocity 4.60 ft/s Pipe Length for Fittings 20.9 ft Meets requirement that 2 ft/s<v<5 fUs. Equivalent Length 229.9 ft Estimated Friction Loss in Supply Line 11.63 ft Pressure Filter Friction Loss ift (from manufacturer) Friction Loss-Taps/Special Fittings 3s ft TOTAL 29.12 ft. Flow for Anti-Siphon Hole Hole Diameter itA6 in. Hole Flowrate 2.24 gpm Pump Efficiency r 4(assumed,typical) Motor Efficiency (assumed for electric pumps) Flow 30.68 gpm Required Horsepower 0.36 hp TDH 29.12 ft. Pump Selection Manufacturer: Zoeller Model: 14133 Horsepower: 0.5 PUMP PERFORMANCE CURVE MODEL 1511152/153 e too 1210- 36. W 152 J0 Opelatmy�... = 25 151 r 5� 20 . 15 10 2 0 r r 10 21 50 02 d0 70 A 10 1 10 p tjO tbo a6u 2io 2)o 40 AD FLOW PERM UM nws Attachment 2: Soil Boring Description Sheets COUNTY:Catawba Co. SOIL/SITE EVALUATION for ON-SITE WASTEWATER SYSTEM (Complete all fields in full) CLIENT: Adams Homes APPLICATION DATE ADDRESS: Lot 70 Colchester Court.Catawba,NC 28609 DATE EVALUATED: 8/09/22 PROPOSED FACILITY: Single Family Residence PROPOSED DESIGN FLOW(.1949): 480 GPD PROPERTY SIZE: 1.5 ac. LOCATION OF SITE:Lot 70 Colchester Court.Catawba,NC 28609 PROPERTY RECORDED: WATER SUPPLY: ❑Private tA Public ❑ Well ❑ Spring 0 Other EVALUATION METHOD: X Auer Boring ❑Pit ❑Cut TYPE OF WASTEWATER: X Sewage (I Industrial Process \• SOIL MORPHOLOGY OTHER F (.1941) PROFILE FACTORS .1940 LANDSCAPE HORIZON POSITION/ DEPTH 1942 PROFILE a SLOPE% (IN.) .1941 .1941 SOIL .1943 .1956 .1944 CLASS STRUCTURE/ CONSISTENCE/ WETNESS/ SOIL SAPR RESTR <AR TEXTURE MINERALOGY COLOR DEPTH 0 HORIZ CLASS 0-10" SCL;GR SS;SP;FR - 36" - Provisionally 3% Suitable 10-36" C;SBK SS;SP;Fl 0.25 0-8" SCL;GR SS;SP;FR 34- Saprolite Provisionally 8-34" C;SBK SS;SP;Fl Suitable 34+" CL;MA SS;SP;FR 0.25 Saprolite 0-6" SCL;GR SS;SP;FR 33" Provisionally Suitable �Il 6 C:SRK SS;SP;FI S:CL:MA 0.3 SS:SP:FR Saprolite S13 o u-t' SCL.;GR SS;SP;FR - Provisionally 3/o 4 8 32„ Suitable C;arK SS;SP;F] 32+" 0.3 CL;ma SS;SF;Fr DESCRIPTION INITIAL SYSTEM REPAIR SYSTEM OTHER FACTORS(.1946): SITE CLASSIFICATION(.1948): __ Available Space(.1945) Provisionally Provisionally Suitable Suitable EVALUATED BY: Jeff Vaughan Low-Profile Low-Profile OTHER(S)PRESENT: Trevor Hackney System Type(s) Chamber Chamber Pressure Manifold Pressure Manifold Site LTAR 0.25 GPD/Ft2 0.25 GPD/Ft2 COMMENTS Updated February 2014 LEGEND use the following standard abbreviations SOIL CONVENTIONAL LPP MINERALOGY/ LANDSCAPE POSITION GROUP TEXTURE .1955 LTAR* .1957 LTAR* CONSISTENCE STRUCTURE CC(Concave Slope) I S(Sand) 1.2-0.8 0.6-0.4 SEX?(Slightly Expansive) G(Single Grain) CV(Convex Slope) LS(Loamy Sand) EXP(Expansive) M(Massive) D(Drainage Way) CR(Crumb) DS(Debris Slump) II SL(Sandy Loam) 0.8-0.6 0.4-0.3 GR(Granular) FP(Flood Plain) L(Loam) SBK(Subangular Blocky) FS(Foot Slope) ABK(Angular Blocky) H(Head Slope) III Si(Silt) 0.6-0.3 0.3-0.15 PL(Platy) L(Linear Slope) SiCL(Silty Clay Loam) PR(Prismatic) N(Nose Slope) CL(Clay Loam) R(Ridge) SCL(Sandy Clay Loam) MOIST WET S(Shoulder Slope) SiL(Silt Loam) T(Terrace) VFR(Very Friable) NS(Non-sticky) IV SC(Sandy Clay) 0.4-0.1 0.2-0.05 FR(Friable) SS(Slightly Sticky) SiC(Silty Clay) FI(Firm) S(Sticky) C(Clay) VFI(Very Firm v.Very Sticky) VS(Very Sticky) 0(Organic) None None EFI(Extremely Firm) NP(Non-plastic) SP(Slightly Plastic) *Adjust LTAR due to depth,consistence,structure,soil wetness,landscape,position,wastewater flow and quality. P(Plastic) NOTES VP(Very Plastic) HORIZON DEPTH In inches below natural soil surface DEPTH OF FILL In inches from land surface RESTRICTIVE HORIZON Thickness and depth from land surface SAPROLITE S(suitable)or U(unsuitable) SOIL WETNESS Inches from land surface to free water or inches from land surface to soil colors with chroma 2 or less-record Munsell color chip designation CLASSIFICATION S(Suitable),PS(Provisionally Suitable),or U(Unsuitable) Evaluation of saprolite shall be by pits. Long-term Acceptance Rate(LTAR):gal/day/ft2 Show profile locations and other site features(dimensions,reference or benchmark,and North). —........— —t—.. ..—...,_..._ ..._.. _F.—_ —_ — ll I -{ i I . ■ -. _.1 1 ■_ '._- __-__ - T . ..._ .._..._ . ___ 1 I I--- _ _ II 1 ■-- -- ----1_ i .. ■ , . ,—i t I 1 l Updated February 2014 SOIL/SITE EVALUATION Sheet 3_ of_3_ (Continuation Sheet-Complete all field in full) PROPERTY ID#: DATE OF EVALUATION: COUNTY: Catawba Co, P R SOIL MORPHOLOGY OTHER 0 1 (.1941) PROFILE FACTORS .I940 E LANDSCAP HORIZ .1942 E .1941 .1941 SOIL .1943 .1956 .1944 PROFILE k DEPTH POSITION! ON STRUCTURE! CONSISTENCE/ WETNESS/ SOIL SAPRO RESTR CLASS (IN.) SLOPE% TEXTURE MINERALOGY COLOR DEPTH CLASS HORIZ <AR 0-4" SCL;OR SS; SP;FR 30" - Sanrolite Provisionally 4-30" C;SBK SS; SP;Fl Suitable SB 5 30+" CL;WSBK SS; SP;FR 0.3 COMMENTS: Updated February 2014 Attachment 3: Additional Documentation „. 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