HomeMy WebLinkAboutIMPV-08-2023-201678.tif , , •
CATAWBA COUNTY
• t.1111 Public Health Department Subdivision
Environmental Health Division PINS 460712766075
PO Box 389,25 Government Drive,Newton,NC 28658 LOTS 2
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Site Address: 3670 CHEVLOT HILLS RD, SHERRILLS FORD NC 28673
Name on Permit: PAMELA BETHEA
Property Size: Acres 1.21
Directions: Hwy 150, Left onto Cheviot Hills, Lot is on the Right.
Owner/Authorized Representative Acknowledgement of Permit Receipt
XI certify that 1 am the owner or authorized agent(owner's authorization required)representing the owner of
the property described above.
As the property owner or authorized representative, I have received the above referenced
permit(s)as requested in the application for service RBPR-07-2023-45002,by the following method(s):
Received in Person
Facsimile Transmittal (Return form with signature required)
"Electronic Image Transmittal/E-mail (Return receipt required)
As the property owner or authorized representative I have reviewed and understand the specific conditions
of the permit issued, and further understand that all applicable regulatory requirements specified under the
North Carolina Laws and Rules for Sewage Treatment and Disposal Systems(15A NCAC 18A.1900),
and/or Well Construction Standards(15A NCAC 2C.0100), shall apply to the issuance of this permit and
the construction of the wastewater system and/or water supply well permitted.
Permit Issue Date: 11/02/2023
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)
Signature ! f L Date/Time 1 a/7/)3
Method: Fax -( Email US Mail Other
Owner's request to send by the above indicated method of transmittal in lieu of signature
We wantt tto hear from yoaPlease ttake a few momentts tto complette our custtomer service survey att
http://www.surveymonkey.com/s/EHCusttomerService
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IPermit 4=:'11/✓-D-2013-20l67g
"NP.ST^tt Q
Pia 4cy� ROY COOKER Ap, '� ?, `I J W�
-4 NC DEPARTMENT OF. �✓ "
I ` HEALTH AND KOf]Y H. KINSLEY ,
,�• HUMAN SERVICES MARK BENTON • ,,,- Pf� f� �Sld G�?�
'')>'<, . SUSAN KANSACP,
7Q Chet +I4 )ts Rd
Submittal Includes: lifj(a2)Improvement Permit ❑(a2)Construction Authorization ❑Fee$
IMPROVEMENT PERMIT FOR G.S. 130A-335(a2)
County: Catawba
PIN/Lot Identifier: 460712766075
Issued To: Ernest Nixon
Property Location: 367e68 Cheviot Hills Road Sherriils Ford. North Carolina 28673
Subdivision(if applicable) Lot#: Block: Section:
ISS Report Provided: Yes E No❑
If yes,name and license number of LSS: Steven Randal Cannon # 1291
New® Expansion ❑ System Relocation ❑ Change of Use ❑
Proposed Structure: House
Number of bedrooms: 4 Number of Occupants: Other
Design Wastewater Strength:®domestic ❑high strength ❑industrial process
Proposed Design Daily Flow: 480 GPD Proposed LTAR(Initial): .3 Proposed LTAR(Repair): .3
Proposed Wastewater System Type*: Horizontal PPBPS III-B
(Initial) Pump Required: ®Yes ❑No ❑May be required
Proposed Wastewater System Type*: Horizontal PPBPS III-
B
(Repair) Pump Required: ®Yes ❑No ❑May be required
*Please include system classification for proposed wastewater system types in accordance with 15A NCAC 18A.1961 Table V(a)
Saprolite System(initial):❑Yes ®No Saprolite System(repair):❑Yes IN No
Fill System(Initial):❑Yes ®No If yes,specify:❑New ❑Existing (when adding more than 6 inches of fill to system area provide a fill plan)
Fill System(repair):❑Yes ®No If yes,specify:❑New ❑Existing (when adding more than 6 inches of fill to system area provide a fill plan)
Usable Soil Depth(Initial): 48 Usable Soil Depth(Repair): 48
Max.Trench Depth(Initial)': 30 Max.Trench Depth Re air `: 30
P ( P ) 'Measured on the downhill side of the trench
Artificial Drainage Required: ❑Yes ®No If yes,please specify details:
Type of Water Supply:E Private well ❑Public well O Shared well ❑Municipal Supply ❑Spring ❑Other:
Drainfield location meets requirements of Rule.1945. Yes® No❑ Drainfield location meets requirements of Rule.1950: Yes® No❑
Permit valid for:E Five years[site plan submitted pursuant to GS 130A-334(13a)] ❑No expiration[plat submitted pursuant to GS 130A-334(7a))
Permit conditions:
Licensed Soil Scientist Print Name: Steven Randal Cannon
Licensed Soil Scientist Signature: ~r —"' /1 Yff1"...- Date: 8/3/23
The LSS evaluation is being submitted pursuant to and meets the requirements of G.S.130A-335(a2).
*See attached site sketch*
NC DEPARTMENT OF HEALTH AND HUMAN SERVICES • DIVISION OF PUBLIC HEALTH
LocATIoN 5605 Six Forks Road. Building 3.Raleigh. NC 27609
MAILING ADDRESS 1632 Mail Service Center,Raleigh. NC 27699-1632
www.ncdhhs.gov • TEL 919-707-5854 • FAX 919-845-3972
AN EQUAL OPPORTUNITY/AFFIRMATIVE ACTION EMPLOYER
3670 Permit#: IMPV-08-2023-201678
.%3gCz$ Cheviot Hills Rd
This Section for Local Health Department Use Only
Initial submittal received: 7/28/2023 by RP
Date Initials
G.S. 130A-335(a3)states the following:
When an applicant for an Improvement Permit submits to a local health department an Improvement Permit application,the permit fee charged by the local health
department,the common form developed by the Department,and a soil evaluation pursuant to subsection(all of this section,the local health department shall,
within five business days of receiving the application,conduct a completeness review of the submittal.A determination of completeness means that the Improvement
Permit includes all of the required components.If the local health department determines that the Improvement Permit is incomplete,the local health department
shall notify the applicant of the components needed to complete the Improvement Permit.The applicant may submit additional information to the local health
department to cure the deficiencies in the Improvement Permit.The local health department shall make a final determination as to whether the Improvement Permit
is complete within five business days after the local health department receives the additional information from the applicant.If the local health department fails to
act within any period set out in this subsection,the applicant may treat the failure to act as a determination of completeness.The Department shall develop a
common form for use as the Improvement Permit.
The review for completeness of this Improvement Permit was conducted in accordance with G.S. 130A-335(a3). This Improvement
Permit is determined to be:
❑Incomplete(If box is checked,information in this section is required.)
The following items are missing:
Copies of this were sent to the LSS and the Applicant on
Date
State Authorized Agent: Date:
El Complete
State Authorized Agent: /� f'1' /72kiti Date: 8/3/2023
This Improvement Permit is issued pursuant to G.S.130A-335(a2)and(a3)using the signed and sealed LSS/LG evaluation(s)
attached here. The issuance of this permit by the Health Department in no way guarantees the issuance of other permits.The
permit holder is responsible for checking with appropriate governing bodies in meeting their requirements.This permit is subject
to revocation if the site plan,plat,or the intended use changes. The Improvement Permit shall not be affected by a change in
ownership of the site. This permit 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 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
evaluations,submittals,or actions from a licensed soil scientist or licensed geologist pursuant to GS 130A-335(a2).
Improvement Permit Expiration Date: 8/3/2028
*See attached site sketch*
G.S. 130A-335(a2)Common Form 2 V.2023.07
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Design Specifications for Proposed Wastewater Systems
Applicant: Ernest Nixon
Physical Address: 966 CThevlot Hills Road
Sherrills Ford, North Carolina 28673
Pin #46071276607.5
Site 1
Acres: 1.21
Catawba County, North Carolina
Source of Water Flow 4 Bedroom House
Wastewater Treatment Systems II.PPBPS/I I.PPBPS
Septic Tank 1,000 gallons
Pump Tank 1,000 gallons
Estimated Daily How 480 per day
Wastewater Treatment: Initial II.PPBPS
Loading Rate .3 g/d/sq.ft.
Irainfield Size 267 feet
Number of Panels 62 panels on 8'centers
Distribution Device Pressure Maifold
Slope 8 percent
Slope Correction 3 inches
Trench Bottom Depth 30"on lowside
Wastewater Treatment: Repair H.PPBPS
Loading Rate .3 g/d/sq.ft.
Drainfield Size 267 feet
Number of Panels 62 panels on 8'centers
Distribution I,PP
Slope 8 percent
Slope Correction 3 inches
Trench Bottom Depth 30"on lowside
1
, f
Nitrification Lines Elevation and Length
Applicant : ErnGeti
66 Nixon
Physical Address: 3 Cheviot Hills Road
Sherrills Ford, North Carolina 28673
Pin #460712766075
Site 1
Acres: 1.21
Initial
Line Flag Line Elevation Flagged Length Number of Panels
Color
1 White 6.93' 67' 16
2 Orange 7.83' 67' 15
3 Red 8.87' 66' 15
4 Pink 9.75' 67' 16
Total 267' Total 62
Repair
Line Flag Line Elevation Flagged Length Number of Panels
Color
1 Blue 10.68' 64' 15
2 Yellow 6.16' 82' 19
3 Green 5.0' 82' 19
4 White 4.0' 39' 9
Total 267' Total 62
2
•
Design Calculations for Wastewater System
Applicant: �r6n��ebost Nixon
Physical Address:3�Chevlot Hills Road
Sherrills Ford, North Carolina 28673
Pin #460712766075
Site 1
Acres: 1.21
Catawba County,North Carolina
Source of Wastewater Flow 4 Bedroom House
Estimated Daily Flow 480 gallons/day
Wastewater Treatment System Horizontal PPBPS
Supply Line Diameter 2 inch Sch 40 PVC
Estimated Supply Length 100 feet
Supply Line Volume 17.4 gallons
Dosing per Panel 4.0 gallons
Number of Panels 62 Panels
Dosing Volume 248 gallons
Distribution Pressure Manifold
Pressure Head 2 feet
Friction Head 1.52 feet
Elevation Head 17 feet
Total Dynamic Head 20.52 feet
Pump Tank Drawdown (may vary) 20.16 gallons per inch
Check Valve In tank
Gate Valves (1) in tank(1)at Pressure Manifold
Threaded Union In tank
Anti-Siphon Hole Yes 3/16"
1
Design Calculations for Wastewater System
Manifold Taps (4)3/4"Sch 80 taps @ 10.1 g/m
Total Flow Through Taps 40.4 g/m
Pump Time to Dose 248 gallons 6m 7s
Pump Time to Dose 480 gallons l 1 m 52s
Pump Block 4 inches
Pump Height 12 inches
Approximate Gallons at 16 322.56 gallons
inches in Pump Tank
Total Gallons per Dose 248 gallons
Gallons between float on 120.96 gallons
and alarm on
Total Gallons in Tank When Alarm Sounds 691.52 gallons
Pump Drawdown 12.3" or 12 5/16"off tank bottom
Pump Float On 28 5/16"off tank bottom
Alarm On 34 5/16 off tank bottom
Storage After Alarm Sounds 308.48 gallons(about 16 hrs.)
2
r
e:54 PM Sun Jul 2 ... 19 -
Pam& Ernest v U 0, F--
Done
1 to, Trimble Conned Ernest Nixon 0
.
J _• 1
ta) 1
Scale: 1"= 50'
3 1 99.88.
Initial System:Horizontal PPBPS 10.
White 67' 16 Panels
Orange 67' 15 Panels
Red 66' 15 Panels
T Pink 67' 16 Panels
267' 62 Panels •
(4)3/4"Sch 60 taps at 10.1 g/m Install Horizontal PPBPS on
(40.1 g/m total) ti grade and level at 30"trench
( - bottom on lowside
6 minutes 7 seconds to dose _co.
248 gallons it -.
986 0 Do not cut or grade soils
when clearing lot
Do not bury stumps and
1,09 SOU( S+ debris on septic location
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f 4 it/Y":41-9P-.,° �` ',
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cr; ; ' r • �� ' Well Sites P.
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Ernest: Site 1
1
2 26 PM SCn Jul 16 ' ' L.c"79%Oil
Ernest Boring locations U Q i•••I 0 Done
, 1 IMF 1 ; , 41,
99 88,
10'
Scale: 1" = 50'
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�Sc�O Stilt Stilts et/ Boring Locations
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Sheet of
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PROPERTY ID#.
.. . COUNTY.Cal4,40....i
SOIL/SITE EVALUATION
for ON-SITE WASTEWATER SYSTEM
(Complete all fields in HI)
OWNER: cillf,e$4, igem-..., ic, / . . . • APPLICATION DATE______
ADDRESS: 45_4 61 Q4'ha .3A'Id' r"P'....,...,.1 USO DATE EVALUATED:--VA_
PROPOSED FACILITY: ‘2LA,44._ -PROW)SED I)ES iN.FLOW (.1949): ,5vgre... i PROPERTY SIZE:..._,Z 2/
LOCATION OF SITE: 364:8 (444,,/at-imi , 54 ,(vp21.1Ahrle it.JC, PROPERTY RECORDED. ---
.. ....._
WATER SUPPLY: PICrivate Public :Well Spring I Other
EVALUATION METHOD: Lil4t-iger Boring Pit Cut 1 YPE OF WAS I I:WA 11 l 1..-s-ewage H Industrial Process 7 N11w)I
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SOIL/SITE EVALUATION Sheet_ of__
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PROPERTY ID#:
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