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Owners Acceptance Letter 130A-336.2 (L) Authorization to Operate an Onsite Wastewater system Date: q--L? :00d. d To Whom it may Concern: As the owner of the property located at L1 `— 7(o iPa7'n)_iU Q gin 19 ni 511c RT J 1 Fa • I understand that the Onsite Wastewater System was instated.according to the GS 130A-336.2 alternative wastewater system AOWE permit. As such, II hereby acknowledge acceptance of the said system.As the owner of the wastewater system, I shall be responsible for assuring compliance with the laws, rules, an permit conditions regarding the system operation and maintenance. ' Owner Signature: P — Print Name: `1 0 '- A t y s I Phone Number:X 3 76-- ) 7--70 ? I Email address: ;R )/'. �', �,r. .a-yt if F Young Soil CONSULTING PLLC AOWE, NC Licensed Soil Scientist, • AUTHORIZATION TO OPERATE 1 Catawba PIN/Lot Identifier: 4607-19-61-6036 County: Owner: John Phillips Applicant: Same Property Address: 4276 Point Norman Drive, Sherrills Ford, NC Facility Description: House Onsite Wastewater System Relocation Number of bedrooms: 3 Number of Occupants: 6 Other: Design Daily Flow: 360 GPD ®New System 0 Expansion ❑Repair 0 Tank Repl cement Only if a repair,was best professional Judgement used? 0 Yes ®No If yes,please attach BPJ-23.1 form to th s Operation Permit. Type of Wastewater System Accepted 25% Reduction (Initial) TS-II Pretreated Drip (Repair) *Please Include system classification for proposed wastewater system types in accordance with Rule.1301 TablI XXXII Wastewater Strength:®Domestic 0 High Strength ❑Industrial Process Wastewater Effluent Standard: ®DSE ❑HSE ❑NSF/ANSI 40 0 TS-I ❑TS-II ❑RCW Type of Water Supply:❑Private well 0 Public well ❑Shared well ®Municipal Supply ❑Spring ❑Other: Saprolite System:❑Yes ®No Pump Required:❑Yes ®No Grease Trap Required:0 Yes ®No Additional Soil Cover Required:❑Yes g No Operator required: ❑Yes ®No If yes,minimum inspection frequency required: Installation Specifications: Wastewater System Installed: Accepted 25% Reduction Wastewater System Classification Type*: Ilig *Please include system classification for proposed wastewater system types in accordance with Rule.1301 Table XXXIi Septic Tank Size: 1000 gallons Septic Tank ID Number: STB-2071 Pump Tank Size(if applicable): gallons Pump Tank ID Number: Grease Trap Size(if applicable): gallons Grease Tank ID Number: Total Trench/Bed Length: 160 feet Trench/Bed Width: 36 inches Soil Cover: 14 inches Additional Soil Cover Checked(if applicable):❑Yes ®No Date: Trench/Bed Depths:28 inches m Measured on the downhill side of the trench Distribution Method: ®Serial 0 D-Box or Parallel ❑Pressure Manifold(s) ❑LPP ❑Other: Artificial Drainage Installed:Yes 0 No❑ If yes,please specify details: OP Conditions: The requirements of 15A NCAC 18E are incorporated by reference into this permit and shall be met. This OpLration Permit is subject to compliance with the provisions of 15A NCAC 18E,or 15A NCAC 18A.1900,as applicable,and to the condition's of this permit. AOWE Printed Name: Gene Young,AOWE, 10005E AOWE Signature: 6' 0 �-' Date:: 4/9/2024 Permit Expiration Date for Type 4 and VI Systems: *See attached site sketch* • Revised January 2024 Pr 1 ----'-'"•,,--3.....,,..h........ I 111 ‘/////$1111.11",111111111174? eli ia fk„e!_friire • .1 LTAR \ % )1' -N Pool 116111111 ew 1000 y:lion S1444004, 100foot : _ Nottir 101 C°1111e41°14/RrA, 1111111 Plastic all ' is r Septic lior 7- :84:19°'7416:77:41:67 ; 101 Niii.4041 . !,, ' "qt ,(350 ._ 4Vimiii ---,cgs liMI NSINgii 1 \ 50'Lake* - l'i• _ 11"1",,..„,,. ji0*4jIIIIIIII,Iml ju%o19--mmi"IIIIIIIIII U) • ri - _ . , , mommimiriumr4 LI . 42 , IIIIIIIIIIK111 . lig Pc7g = 1111111111,11111.611111.1 .. 2 8' ccip' 41 :§- cvi 51 1-1f Lake Nornian', -----7-.1.1114.1....All CX# Vil cl.P4 m "" co cr).... Ici w -1 ,t11 ----- MINI W. OIC = 0 *M 17 Z C2 ' at is•-, mu :I a) al * LICI 4., (A ill , 41) 0 f• B ....... 5 i Operation Permit Inspection Check List • 1. LOCATION AND SEPARATION DISTANCES .5�/ 2 A. System installed in proper area 1./ B. House location in proper area t,/ INSTALLER:LLER: New A*E'er # C. System meets.1950 setback requirements V APPLICATION#: 3 D. Distance from septic system to any wells N A feet DATE: .- Q-- E. Distance from septic tank to foundation IS feet F. Distance from septic system to all property lines /b feed" a 2. SEPTIC TANK/PUMP TANK SEPTIC TANK PUMP TANK A. Liquid capacity of septic tank /Og) gallons gallons GRAVEL/TRENCH DEPTHS B. Tank serial number 3116-070 71 A. N. C. Date of manufacture fj 1iS7TG B. 0. D. Visually inspect the exterior walls and top of tank vr C. P. • E. Visually inspect the interior walls,baffle wall,lids,air vent, D. Q. filter,etc. t/ E. R. F. Risers present OR tank is within 6"of finished grade a/ F. S. I G. T. 3. SUPPLY LINE TO TRENCHES H. A. Supply line fall from septic tank to nitrification lines or a 0 / /57 tz'A)-- I. i distribution device at least 1/8"per foot(minimum) /0 '"F/9// J. B. Supply line is nrininiuin 3"Sch,40 PVC,PE,or ABS a/ K. ' C. Length of supply line to trench 15 feet Do 1 S L. M. 4. NITRIFICATION FIELD Pt' .v e 1 OYV A. Type of nitrification field eGG 'l°R'� 9b GRADE SHOTS B. Manufacturer and model# .TA,)F-FL3Rti'TO A 3 C. Nitrification trench does not exceed'/a"fall in 10 feet F/ P4f1 6 7-' 4 1. 1.S 19. D. Trench depth 2.g inches 2. W.S 20. E. Trench width 3(o inches 3. Li. S 21. i F. Aggregate depth -inches 4. 22. G. Aggregate size(3,4,5,57,or 6 of ASTM D-448) -_ - 5. 6. oL 23. H. Distance between trenches 9 feet 6. (e,d. 24. I. Length of nitrification lines `3 a feet ,,xJG j f- 7. &i s)- 25. • J. Step downs:(if applicable) /6o-ro-ril I 8. . -3,iu E 1. Minimum of 2'undisturbed soil 9. 1.,a-S`�01 J-e t 2. Proper rise over step down 10. TN 1 3. Solid pipe used 11. �-e"3-e 4. Elevations of stepdowns 12. J. Distribution Devices:(if applicable) 13. 1. Type of distribution device p I?o t' b N/-e G� 14. 2. Device is watertight and of sound construction ,/' 15. 3. Device is on level foundation of soil or concrete ✓ 16. 4. Does the device perform as designed ✓ 17. 18. County: 1i414WU4 • CONSTRUCTION AUTHORIZATION: •- PIN/Lot Identifier: 4607-19-61-6036 issued To: John Phillips Property Location: 4276 Point Norman Drive AOWE/PE Plans/Evaluations Provided: Yes E]J No❑ if yes,name and license number of AOWE/PE: Genet oung,AOWE, 10005E Facility Type: House ❑New 0 Expansion ❑Repair 0 System Relocation Basement? ❑Yes 0 No Basement Fixtures? 0 Yes 0✓ No Type of Wastewater System** Accepted/Conventional (Initial) TS-II Drip (Repair) Design Daily Flow: 360 GPD Wastewater Strength:0 domestic 0 high strength ❑industrial process Session Law 2014-120 Section 53,Engineering Design Utilizing Low-flow Fixtures and Low-flow Technologies? El Yes No Installation Requirements/Conditions Septic Tank Size: 1000 gallons Total Trench/Bed Length: 160 feet Trench/Bed Spacing: 9 feet on center Drainfield square footage: 1200-total adding 480 Stint Trench/Bed Width: 36 inches LTAR: •3 gpd/ft2 Soil Cover: 16 inches Slope Adjusted Maximum Trench/Bed Depth: 28 low side inches Aggregate Depth: inches above pipe inches below pipe 6 inches total Pump Tank Size(if applicable): gallons Requires more than 1 pump? ❑Yes 0 No Pump Requirements: ft.TDH vs. GPM Grease Trap Size(if applicable): • gallons Distribution Method: 0 Serial ❑D-Box or Parallel 0 Pressure Manifold(s) 0 LPP 0 Other: Artificial Drainage Required: Yes❑ No E✓ 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)]: 0 Yes No Easement,Right-of-Way,or Encroachment Agreement Required[.1938(j)]: 0 Yes El No Declaration of Restrictive Covenants: 0 Yes Q✓ No • **If applicable: I 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 ✓D No❑ Conditions: Adding-2-80 foot Accepted Chamber lines to replace the 2 conventional lines being taken out in pool construction, See installer information sheet for additional conditions • . clivcg LTA)E 3 FOC f 6,er-i, f. )°- 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 installed in accordance with the attached system layout. AOWE/PE Print Name: C e�u•e Yocir a AOWE/PE Signature: � 5 �• . /9 OW ii . Dap:'''''''''' This AOWE/PE su ittal is pursuant to and meets the requireme ii ..1 }• 3 3 *See attached site sketch*; • • �y.; ~ j Ce4?10(S 1 rn r L UATOR F ; ; Catawba county Geospatial Real Estat Search MAKING.LIY1110.trtsex. information Services k. 0 11.17 " 288.12 co o` ri G3 co cd M V C zn at' �- {•}Ai o 11.38 4 � -t6Sb 9.52 2 : . . ---lc* 284.85 c 1 +. N I ' p f� ji�in� lnJ .. cts i Q. , 1.. M ,a!_ .. N 10 FM,'u-� V. zo 282.85 ..,_.. ..... o, 5,,,, • _ . Jo, ., , :8.44 .}..i�y _... J 1....s.. . ......s7 z .� 0 I f 0) co oi to "`�! Y l� 13,96 .... 8.66 11.73 " 1 in=60ft W+E . s Parcel:460719616036, 4276 POINTE NORMAN DR SHERRiLLS FORD, 28673 Owners: PHiLLiPS JOHN E, PHILLIPS DEBRA W Owner Address: 4276 POINTE NORMAN DR Values- Building(s): $717,700, Land: $206,500, Total: $924,200 This map/report product was prepared from the Catawba County,NC Geospatial 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 2021 Catawba County NC 02/07/2023 1 , F Management Program Know the location of the septic tank end drainfield location. Keep a copy of the Onsite wastewater system permit in your home files for reference. Keep the drainfield system seeded with proper vegetation and maintained. Have the septic tank (both tank compartments) pumped every 5 to 7 years and the effluent filter cleaned and reinstalled. Divert all surface water and gutter drains away from the Onsite wastewater system area. Do not install lawn sprinkler systems, decks, out buildings, or paving or concrete over the Onsite wastewater system area. No parking of vehicles on the Onsite wastewater system area. G.S. 130A-336.2(f) states that: "The Department, the Department's authorized agents, and local health departments shall have no liability for wastewater systems developed by the Authorized On-Site Wastewater Evaluator; however, nothing in this section shall relieve the Department, the Department's authorized agents and local health • departments from any of their other obligations under State law o administrative rules." The AOWE is fully responsible for the on-site wastewater system siting, design, and construction, as well as for development of an appropriate management plan. Thus,the Owner attests that the information required by Statute and Rule has been provided. LHD review is limited to a review of information provide. by the Owner and AOWE on the form irn,t) o 4')O)3 -� ,.Y �, Alpg. 119• )003 -y55)) .0.STA1'b,y., .,,� ,w�..,,Ho0,. ROY COOPER•Governor y,4 NC DEPARTMENT OF KODY H.KINSLEY•Secretary if, HEALTH AND tp7t, PUink Nor of e; HUMAN SERVICES HELEN WOLSTENHOLME• Interim Deputy Secretary for Health . 4.a "; 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: al- .) -'1 3 by _t_ Date Inrrrals PART 1:Notice of Intent to Construct(NOI)-Please check all that apply Single System or ❑Multiple Systems AND 0 New ❑Expansion Relocation of all or part of the Existing System 0 Relocation of Repair Area ❑ Repair—LHD Permit Number ❑Repair—EOP/LSS COVID 19/AOWE Permit Number 1. Facility Owner's name:(Owner,Company Name,Utility,Partnership,Individual,etc.): ',ORAL f 1f X1/rr's Mailing address:30H JAM-4'3 'LO AY City: / b UA'NC a State?7006zip: /U G Telephone number: 33( /- �/ 703 YE-mall Address:ss^ 3 I.E.Pit ill I•.1- C ,/1714 . I .CO V' 2. Authorized On-Site Wastewater Evaluator(AOWE)name: ff/) 2. Yo L4 A3 Qj ,qot E /606 sE- LSS License number: /O SO AOWE Certification number: /00 6JS E Mailing address: 22 9 k ST Y Ees C d 1lty: C/-em MO/US State:/GC_ Zip: 76/Z- Telephonenumber:_3&-- ('0 Of— 9.2 b {c' E-mail Address: yQUNGgpN . /4 s-4 ,4191/pC'tl�"'t 3. Licensed Geologist(LG)(if applicable)name: License Number: V . Mailing address: City: State: Zip: Telephone number: E-mall 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): Li ova 7 /9- 0 /•-- 6 63 C.- County Name: C,4 f ..t,,i NC DEPARTMENT OF HEALTH AND HUMAN SERVICES • DIVISION OF PUBLIC HEALTH RECEIVED LOCATION:5605 Six Forks Road,Raleigh,NC 27609 MAILING ADDRESS:1642 Mail Service Center,Raleigh,NC 27699-1642 CC nn www.ncdhha.gov • TEL:919-707-5874 • FAX:919-845-3972 S P J 21,23 AN EQUAL OPPORTUNITY/AFFIRMATIVE ACTION EMPLOYER Environmental Health . AOWE Common Form LHD Reference:/D LA-o - 910)3 - )C .)YY 6. Type of facility: Qg Place of residence No.Bedrooms: 3 No.Occupants: 0 Place of business Basis for flow calculation: ❑Place of public assembly Basis for flow calculation: 7. Factors that would affect the wastewater load: "C.)0 71)E. 8. Type and location of proposed wastewater system:_..al 3 ' fiV-toRT Y fie19fi, 9. Design wastewater flow: - 0 gpd Design wastewater strength: ►: .omestic ❑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 o A site plan as defined in G.S.130A-334(13a)is attached: 1XI 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: ❑Yes This is a saprolite system. ❑Yes 1No 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 W,NA 14. Proposed landscape,site,drainage,or soil modifications are attached: ❑Yes X NA Attestation by AOWE pursuant to G.S.130A-336.2 I, G'e4)-e- !Q(41'13( /Q w.)F hereby attest that the information required to be included with Authorized On Site Wastewater'&thluator(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 thak.tfk 51T E {y proposed system does not require a Professional Engineer, licensed in accordance with G.S.89C,an/18 fcetl'rilanc@•••.,TF with 15A NCAC 18A.1938 and activities determined to be engineering as determined by the NortlyC#9lp a Board of E iners for Engineer and Surveyors. I " i 4`'4'�':i�ilr46, `'t ram„ i ASPn / 7D OW O- 7- ()A , l ' , Signature of Authorized n to Wo oter Evaluator Date `'•,,, i q`•UAT OR ,..../ Owner self-submittal of NOI: .......... I, hereby submit this NOl prepared by Print Name of Owner Print Name of Licensed PE pursuant to G.S.130A-336.1. Signature of Owner Date DHHS/EHS/O5WP—AOWE COMMON FORM Updated April 2022 Page 2 of 6 • AOWE Common Form LHD Reference:I}U -6-)0)3_?O52Nf 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:ADW&'d ' 2'3--)bSD 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 deportment 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 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 department foils 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 Name of Authorized Agent of the LHD Signature of Authorized Agent of the LHO 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 via Date Email,FAX,USPS,hand-delivered A copy of this NOI and tracking information was sent to the State on via Dote Email,FAX.USPS,hand-delivered Print Name of Authorised Agent of the LHD Signature of Authorized Agent of the LHD Date DHHS/EHS/OSWP—AOWE COMMON FORM Updated April2022 Page 4 of 6 AOWE Common Form LHD Reference:] iA)D I')0)3' 7p3)/u1 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. Resubmlttais must be accompanied by a cover letter from the AOWE. LHD USE ONLY: This NOI resubmittal received: by Date initials Item q 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 Nome) 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. CND 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 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,USPS,hand-delivered Print name of authorized Agent of the LHD Signature of authorized Agent of the LHD Dote DHHS/EHS/OSWP—AOWE COMMON FORM Updated April 2022 Page 5 of 6 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 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 El 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 Dote This section for LHD Use Only. LHD Review of required Information for the ATO El 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 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 Date Emil,FAX,LISPS Hand-deNveted Print name of authorized Agent of the LHD Signature of authorized Agent of the LHD Date ISSUANCE OF CERTIFICATE OF OCCUPANCY: Once the LHO determines completeness based upon the A TO 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 G.S.130A-339. DHHS/EHS/OSWP—AOWE COMMON FORM Updated April 2022 Page 6 of 6 County: Catawba CONSTRUCTION AUTHORIZATION , ' - ' PIN/Lot Identifier: 4607-19-61-6036 Issued To: John Phillips Property Location: 4276 Point Norman Drive AOWE/PE Plans/Evaluations Provided: Yes 0No 0 If yes,name and license number of AOWE/PE: Gene Young,AOWE, 10005E Facility Type: House 0 New 0 Expansion ❑Repair ❑J System Relocation Basement? ❑Yes ❑✓ No Basement Fixtures? 0 Yes ❑✓ No Type of Wastewater System** Accepted/Conventional (Initial) TS-II Drip (Repair) Design Daily Flow: 360 GPD Wastewater Strength:0 domestic 0 high strength 0 Industrial process Session Law 2014-120 Section 53,Engineering Design Utilizing Low-flow Fixtures and Low-flow Technologies? ❑Yes YQ1 No Installation Requirements/Conditions �` Septic Tank Size: 1000 gallons Total Trench/Bed Length: 160 feet Trench/Bed Spacing: 9 feet on center Drainfleld square footage: tzontoi.iaaainaaeosyn Trench/Bed Width: 36 inches LIAR: •3 gpd/ft2 Soil Cover: 16 inches Slope Adjusted Maximum Trench/Bed Depth: 28 low side Inches Aggregate Depth: Inches above pipe Inches below pipe 6 inches total Pump Tank Size(If applicable): gallons Requires more than 1 pump? El Yes ❑✓ No Pump Requirements: ft.TDH vs. GPM Grease Trap Size(If applicable): gallons Distribution Method: 0 Serial ❑D-Box or Parallel ❑ Pressure Manifold(s) ❑LPP ❑Other: Artificial Drainage Required: Yes❑ No Q If yes,please specify details: Leval Agreements(lf the answer is"Yes"to arty type of legal agreements,please attach a copy of the agreement.) Multi-party Agreement Required(.1937(h)): ❑Yes Q No Easement,Right-of-Way,or Encroachment Agreement Required(.19380)): ❑Yes p No Declaration of Restrictive Covenants: 0 Yes 0 No "If aoallcable: i 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 No❑ Conditions: Adding-2-60 foot Accepted Chamber lines to replace the 2 conventional lines being taken out in pool construction, See Installer information sheet for additional conditions C/kcJL LTA)E .� rat ( p/LG/U r. r'- - 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 installed In accordance with the attached system layout. AOWE/PE Print Name: G e/U YOL./N5 ffOcco AOWE/PE Signature: /r 0W E- Date:........., This AOWE/PE su ittai Is pursuant to and meets the requiremelti c .1344, "See attached site sketch"/. . , s 1 ► i Giv...('/ r.,.,I 1 1OO ^(li''II li '. 'I ,. 4/UATOR '1f • ei catawba county Geospatial Real Estate Search sAr�„c. uvixc. unr„. Information Services N. L`, J- N op' 11,17 m`" ._ _-•-- 288.12 w() co � I ( ai a - _.-J 1-1 A o G 11.38 2 2 ..... 284.8g" "` 2 w o I t� 3 3' - 4 'g hb,$O�v.4. V• gal Lit'124 oo � o . � o / / t: IN ten,,,,,,,,, ,,, ,�, .. I - f--...., � .tn 4 41� N La 1 Lr 00 0 275.61 ` v°j ..f. i r 13.96 11.73 - r -- i 8.66 N W E 1 in=60ft S Parcel: 460719616036, 4276 POINTE NORMAN DR SHERRILLS FORD, 28673 Owners: PHILLIPS JOHN E, PHILLIPS DEBRA W Owner Address: 4276 POINTE NORMAN DR Values - Building(s): $717,700, Land: $206,500, Total: $924,200 This map/report product was prepared from the Catawba County,NC Geospatial 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 end all damages,loss or liability,whether direct,Indirect or consequential which arises ar may arise from this map/report product or the use thereof by any person or entity. Copyright 2021 Catawba County NC 02/07/2023 COUNTY:6A 1A Wt4 SOIL/SITE EVALUATION for ON-SITE WASTEWATER SYSTEM pp (Complete all fields in full) OWNER: Oti/u fr T/ll,T e_S APPLICATION DATE c — e 3 ADDRESS: 3 0 Li^ QA PI-e-5 t-U 0 Y OA AVf XE 4 C. 4 7 664rt EVALUATED: ,p PROPOSED FACILITY: �?U-6a PROPOSED DESIGN FLOW(.1949): , 36 ( PROPERTY SIZE: 6, L 7/1(- LOCATION OF SITE: 1.-/'-/'270 eO.rA}7 ApArn/1A) 10 ez PROPERTY RECORDED: WATER SUPPLY: . Private ublic . Web Spring , Other EVALUATION METHOD: .huger Borinc . Pit . TYPE OF WASTEWATE . . Sewage Industrial Process . Mixed 4 Boring 1 2 3 4 _ S 6 7 8 Landscape Position (1940) 2-. L. L Slpoe% /a / 5 5 (o H 1 Depth(1943) b _l a . d_/o 0 _a H1 texture 1941 C 1 C 1 G / C J , , H1 Structure 1941 _A/y be y .ery tf V H1 Consistance 1941 -vg.if .v57) 9t fi2��-f-' H1 Mineralogy 1941 < .-e. 4,-c___ G i.e.. H 2 Depth(1943) la -1/O , /a'Li! /O 310 /4-'i ._____ H2 texture 1941 if G H2 Structure 1941 4/ / _ .i// itAY /�1c / H2 Consistance 1941 V ' -j 1 q4_P - , I _-P H2 Mineralogy 1941 -‘' 9 H 3 Depth(1943) 4/5_gq '1/_s '.347fi /4e-1- H3 texture 1941 97 W 416) H3 Structure 1941 H3 Consistance 1941 H3 Mineralogy 1941 H 4 Depth(1943) H4 texture 1941 H4 Structure 1941 H4 Consistance 1941 � � S �'� ,�� H4 Mineralogy 1941 , • t,�t'E•Y�U :�• �, Soil Wettnessa' •.4 Saprolite / S- , Ii'l ,"`.;„,1...ii,r! . .) LIAR 3 , 1 Description Initial System Repair Other Factors 1946 10E ;," `' System Type �.e P' '' ^- 4',Nara"I'll" ., f 1-PL) \ 002.--P Site Classification i "*i ,wwrr Evaluated By 6—e/v-e °b(-f,v\, &o Lc)E/463 (;:.162 YE'z9 576Q1 T F- S st)E 11/1)1 / / ss catawba county Geospatial Real Estate Search µix,„G. „,,. ,,,,,Q. Information Services .1 8' 11.17 CV 288.12 CO J N J o J 1 co 1 `cri " 4 _ II z 11.38 g """�,., .. .,,,, .„ 9.52 te 2 e t: 284.8 ~ 5 .,"•�9m.,.,••,,, l r�-........._.._._- r'us.'nwvrouwrry o I • a. i J N ` ,_I z... /1 28 2.85 ^^s,,,x. �. o`' ;8.44 �` �.`""""�,,� `� �. ro � N `' h [-.._... 275.61 co 1 I 13.96 11.73 l r 8.66 N w+E 1 in=60ft s Parcel: 460719616036, 4276 POINTE NORMAN DR SHERRILLS FORD, 28673 Owners: PHILLIPS JOHN E, PHILLIPS DEBRA W Owner Address: 4276 POINTE NORMAN DR Values - Building(s): $717,700, Land: $206,500, Total: $924,200 This map/report product was prepared from the Catawba County,NC Geospatial 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 hold liable for any and all damages,lose 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 2021 Catawba County NC 02/07/2023 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. POLICY CHANGES Policy Change Number POLICY NUMBER POLICY CHANGES COMPANY EFFECTIVE MEO1174-04 04-05-2022 Markel Insurance Company NAMED INSURED AUTHORIZED REPRESENTATIVE Ley Soil&Onsite Wastewater Consulting PLLC 04/05/202204/05/2022 Wade Associates,LLC. -New Bern • PO Box 1209 Davidson, NC,28036 COVERAGE PARTS AFFECTED: Miscellaneous Errors&Omissions CHANGES Amend Named Insured Insured Name: Ley Soil&Onsite Wastewater Consulting PLLC Annual gross sales: 120,000 All other terms and conditions remain unchanged. y,„„ coJe____ Authorized Representative Signature MEIL 1250 07 17 Page 1 of 1 Installer Information The following details must be considered along with all other considerations: Preconstruction Conference required with the installer, contractor, and AOWE before installation. 'Installation inspections by the AOWE (designer) must be scheduled 5 weekdays in advance • Infiltrator Plastic Tank shall be used an approved by NC DHHS, See attached installation instructions •All tanks shall be properly back filled and compacted to prevent slump in the future .The installer is responsible for final grades and returning that grade to original, with the exception of added structural features •The supply trench shall be compacted to eliminate any cavities left during initial fill placement continuous fall of 1/8 inches per foot required or sewage effluent pump will be required +Installation of the system shall be completed during dry conditions in order to protect the soil structure "All joints shall be cleaned with PVC pipe cleaner and a heavy bodied glue applied to weld all joints "Trenches shall be carefully excavated so the bottom has no more than 1/4"fall in 10 feet, with no high or low areas within. Do not over excavate trenches! Any fine grading should be completed by hand with a rake and shovel, leaving no loose material. •All pipe openings in the tanks shall be properly grouted. This also applies to the joints around the rise. •Earth dams, constructed of relatively impervious material, shall be installed at the beginning and end of each lateral to prevent unwanted lateral water movement. •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 pin flag locations should be checked by the installer prior to beginning trenches to ensure accuracy •If septic tank risers are used, they should be a minimum of 6" above finished grade or within 6" of final grade if buried See Design Specification Sheet for Onsite Wastewater System information. •If site grading is needed, do not grade/create greater than 2 feet of elevation difference within 15 feet of any component of the septic or repair. If back filling, do not backfill over any initial or repair septic line. Onsite Wastewater Initial System is specified as an Accepted 25% Reduction Gravity Chamber with #4, #5, or#6 gravel to be installed 6 inches deep on each side of the chambers. Replacement System is a TS II Drip in the front yard. All Onsite Wastewater System components shall be 25' upslope, 15' side slope, and 10' downslope from any foundation drain and swimming pool 15 feet Divert all surface water from system area, and seed and landscape. JANUARY 2022 Infiltrator IM- and CM-Series Septic Tank General Installation Instructions �FILTRATOR' BEFORE YOU BEGIN tanks Infiltrator Water Technologies'tanks must be Installed according to state and/or 1.Inspect the tank for damage before installation. local regulations and approvals,which supersede the manufacturer's Installation 2.if the tank Inlet and outlet penetrations are not drilled,drill holes using the drill Instructions.If unsure of the installation requirements fore specific site,contact points provided at each of the inlet and outlet ports according to Table 3 In the the health department or permitting authority,The IM-and CM-Series models Inlet and Outlet Hole Locations section.The inlet and outlet may be drilled on referred to in this document include the IM-540,IM-1060,CM-1060,and IM-1530. either the aides or ends of the tank,as required based on applicable codes and site conditions.' AWARNING:IMPLOSIONS MAY CAUSE SERIOUS INJURY 'Kentucky and West Virginia tanks are factory-drilled.Florida and Follow Infiltrator Water Technologies'vacuum test Instructions Orgegon tanks must be factory-or distributor-drilled. MATERIALS AND EQUIPMENT NEEDED 3.The gaskets supplied with the tank are compatible with Schedule 40 and SDR 35 pipe using a 6-Inch-diameter(125 mm)hole sew. ❑IM-or CM-Series tank 0 Excavator 4.Install the rubber gaskets at the Inlet and outlet. ' ❑Access port lid(s)' ❑Shovel 5.Using all four of the tank's Integral lifting lugs,lower tank Into excavation. ❑10 screws per lid' 0 Level 6.Slide the Inlet and outlet pipes'through the gaskets.Soapy lubricant may ❑2 inlet/outlet gaskets ❑5-Inch-diameter(125 mm) be used to slide the pipe in, (included) hole saw 'For North Carolina,the inlet pipe shall be a straight pipe with no tee. 0 outlet tees' ❑Utility knife 7.Horizontally position the tee 114.inches(38 mm)from the access port rim, ❑Tape measure ❑PVC pipe glue with primer allowing the tee to fit into the recess in the access port lid(see detail), 6.Install lids and risers(see Installing Risers section)as necessary.Rotate lid ❑Pipe,risers,etc. lee and lid Inclusion varies by over access opening until it Indexes to tank and drops Into position. ❑Socket wrench state/province INSTALLATION SITE SELECTION 1 Pp�ITIONORTETRMAE t.5•(38 nun) 1.Do not install the tank in vehicular traffic areas.The tank Is designed for ACCESS PORT RIM FROM P non-traffic applications. GASKET _.,` 2.The allowable soil cover depth Is 6 to 48'Inches(150 to 1,200 mm). sx - " ._�`�� '18-Inch(450 mm)max.In Florida for Cat.3 tanks;48-inch(1,200 mm)max.In ACCESS Florida for Cat.4 tanks;and 36-inch(900 mrn)max.In Massachusetts,New OPENING Hampshire,North Carolina,end Oregon. TANK L1D NK 3.The tank shall not be Installed where the subsurface water level outside the tank (cM.lwwao SHOWN) INTERIOR Niel'TEE (TYPICAL) exceeds the height of the outlet pipe saddle.See page 4 illustration,See note on page 4 for Indiana installations. EXCAVATING AND PREPARING THE SITE a+sto,rol•Ioeo,cM•,oso,AND lal ISso:85 In(I,375 mm1 1.Unless buoyancy control measures are required,the excavation width and """` ` ';''' ,•i>lk;>t6k: ..............�,r.,,"+•.+n-r-_�:_ry..,'r,._.,t+-,..+-i.-.•w..�1 ;'ktSi!?iri'i7.`Y, length should be 18 to 36 Inches(450 to 900 mm)larger than the tank on each .`J; �. side or sized as necessary to ensure proper backfill compaction,as outlined r:: c1.410{D TANK r in Steps 5-10 of"BackfillIng the Tank'in this document,See Infiltrator IM-andStrO I4POOI' H r sr: CM-Series Tank Buoyancy Control Guidance document,available online at nereRE x kiy www.inflitratorwater.com,for specific excavation requirements when Installing �..g% „0::; ', ,,-.:r=w. '• ;ta p- w; ??{..4•;•,. with buoyancy control measures. ,',}}w,.<G,r ;:.\C:4;•vY,",•: ::.: �" ,, .. c;,,,,' 2.Excavation depth shall account for the 55-Inch(1,375 mm)tank height.Also •.•.h'.;>:: ..,••,,:�.•• .'•?'.r' ;.:'7%%';•&o. %z'"yr;%�' account for 4 inches(100 mm)of bedding(if required)and cover depth BACKFILLING THE TANK (permissible cover depth Is 0.5 to 4 feet(150 to 1,200 mm)of sod). Note:Infiltrator tanks do not require filling with water prior to backlit! Note:If the water level outside the tank exceeds the height of the outlet placement.Water filling and backfilling to the tank mid-height Is required pipe saddle,tank structural integrity may be compromised.See page 4 for if the tank is left in either an open or baokfitied excavation that may fill maximum allowable subsurface water elevation guidelines.See page 4 note, with water from rain or other sources. Indiana installations:If the depth of the uninterrupted saturated soil 1.Backfill with suitable native soil(max.3-inch(75-mm)stone diameter).If native conditions cannot be determined from the site soil evaluation report soil is unsuitable,replace unsuitable fraction with suitable soil,if suitable soil Is or other site-related data and other information indicates the possible not locally available,contact Infiltrator for assistance. presence of a perched ground water table,tank Installation Is permissible. 2.Suitable soil shall Include soil textural classes defined in the United States See page 4 note. Department of Agriculture soil triangle. 3.Inspect bottom of excavation to verity suitability of native soil for tank installation, a)For a tank soli cover depth of 0.5 to 2.0 feet(150 to 600 mm),suitable soil Soils with large,protruding,or sharp stones or other similar objects that may textures include: damage the tank are not suitable. 4.The tank may be installed either In suitable native soil(see Back0111ng the Tank 1D waAT Mt section)ore minimum 4-Inch(100 mm)layer of welt-graded granular soil having n,„,,,A.W, particles less than 3 Inches(75 mm)In diameter,or maximum 0.5-Inch(13 mm) . a =-1 NA" Waldo II ecru diameter crushed stone. AVA, :....._....__....,._..._,.... A/YDnrnr ante 5,Create a uniform,compacted,level surface to ensure that the bottom of the tankArm eD w .anpoMor uNx you ns w is evenly supported.Verify that the installation surface is flat. >e '°1'°'6001tl6"'"'"' P'"' W ®�S®.�,.of*Ater`''"' sew,AVM IRiNA b I•IR MNr. INSTALLING THE TANK .R�Dur 46"rAlrAnk AVAISFAV® ..—ELT ew.-amor s 1; A M a Mr Mltl,Y DtlRq.M , tl �v,,, e, ®� re armor. D,r"ir,WW ® -rileFA�A �®®�•Ma fNpb W.WM OD.9N0 100%Ar fYy 4. Os le lb lb DO II/ - 10 NI N.5.. MYIMOl _ rl„" W Abu.. rern 5/ND ,IPT QT ra.lure to comply with therm lontollation Innlructlonu will Invalidate the womanly.Contact Inflllrator Water TCchnologie i Technical Services Department for asrIctanco at 1400-221.44130. b}For a tank soil cover depth that Is greater than 2.0 feet and up to 4.0 feet and Interceptor trenches may be sensible I1 the site is amenable to construction (600 to 1,200 mm),suitable soil textures Include; of a control system and such systems are not prohibited by regulation or law,and the tank location Is not subject to flooding.Properly installed underdralns and tNPLO — — groundwater interceptor trenches may prevent the need for tank buoyancy control . «ems . . . . n0% measures. M..,x e.;,4Y EIe.IN ro.. VA — INSTALLING UNDER SHALLOW GROUNDWATER CONDITIONS FaTilli okhyww Pan ale%MIS ®-:.-- .w..x P.m,o.Eb..a. w.v Buoyancy control measures may be required if the tank Is to be installed with less :tor on epkv H ..voidR MG a i , R,.,ew aA than 12 Inches(300 mm)of soil backfill cover,and where the water level outside hN.n RAY.ATV' A„ .......wr the tank(See Table 1,Note 4)has the potential to rise 30 inches(760 mm)or e®®®Y`���', more above the elevation of the tank bottom.Otherwise,no control measures AavAirmw ;e►weilliNimidik are required(see Table 1).The need for buoyancy control measures must be AFnr determined based on backfill cover depth and height of water outside of tank C t ®rAVATAVA above the tank bottom according to Table 1.Refer to Infiltrator IM-and CM-Series 4TrAVITAT®WAVA . Tank Buoyancy Control Guidance document for more Information. 0p ON � ra ® ®•AVAM Natant Table is Tank models'end conditions requiring buoyancy control' °°" aaM Sol cover depth above tank' Subsurface water height above tank bottom" 12 in(160 mm)to 12 in(300 mm)or greeter 3. Backfill should not have stones greater than 3 inches(76 mm)In diameter or 12 In(300 mm) excessive clods that do not break apart during placement and compaction. Above outlet pipe saddle Do not Install tank Do not Install tank Backfill must be capable of occupying the spaces between the tank ribs and 36 In(900 mm)to beneath the haunches. outlet pipe saddle All models None Note:Rounded screened aggregate(e.g.,pea gravel)Is not a suitable 30 In(750 mm)to 36 In(900 mm) IM-1530 None backfill, less than 30 In(750 mm) None None 4. Standard field soil classification methods shall be used to determine the soil 1.IM-s40,IM-10a0,CM-10e0 and IM-1530. textural class. 2.See Infiltrator IM-end CM-Series Tank Buoyancy Control Guidance document for detailed Note:Under most circumstances,the determination of soil diatancy will Information on the use of controls. 3.No controls are required for sot cover depths exceeding 12 in(300 mm). not be required.Dilatancy shall be determined in the field using a teat 4.The tank shall not be Installed where uninterrupted saturated soil condlUons could be present that does not require specialized equipment,per ASTM D2488,Section from the tank bottom to a height above that of the outlet pipe saddle.See page 4 Illustration. 14.3. For Indiana installations,II the depth of the uninterrupted saturated soil conditions cannot be determined from the site sot evaluation report or other site-related data end other Information 6. Place and compact soil by walking-in beneath the haunches of the tank. Indicates the possible presence o1 a perched ground water table,no buoyancy controls era Note:Compacting soil beneath the haunches is critical for tank required.Sea page 4 note. structural integrity. 8. Place backflll around the four sidewalls in an alternating manner,so that the INSTALLING RISERS backfill height along the four sidewalls Is maintained within a 12-Inch(300-mm) 1.Compatible risers Include 24-Inch(600 mm)diameter products such as the tolerance. Do not backfill top of tank before sidewalls are completely backillled. Infiltrator EZsnap,TW-Riser,and EZset by Infiltrator,PolyLok®,Inc.,and Tuf- 7. Tite®Corporation,In addition to 24-Inch(600 mm)diameter corrugated HDPE 8. Continue to place backfill along the sldewalls in 12-inch(300-mm)lifts.Place and IPEX Ultra Rib®PVC pipe.Follow infiltrator's IM-and CM-Series Tank Riser backfill between the ribs on the aidewalls such that the space between the Connection Guidance Document. ribs Is completely filled with soli. 2.In Oregon only,watertightness testing shall Include filling with water at least 2 9. Compact backfill material either by walking-in,hand tamping or mechanical inches above riser connection,with no more than 1 gallon leakage per 24 hours, compaction(Includes backhoe bucket).If mechanical compaction is used,such per OAR 340-073-0025(3), as a walk-behind temper or backhoe bucket,a single pass Is recommended. Compact each lift prior to placement of next lift.Compact backfill from tank INSTALLING PUMPS AND RELATED EQUIPMENT walla to excavation sidewalls. Pumps may be supported on a.stable,level 16x18-Inch(400)(400-mm)platform 10,Complete backbiting and grade the area, positioned on the bottom of the tank.One 16x16-inch block or two 8x16-inch(200 11.A minimum 6-Inch(150-mm)depth of suitable soil must be placed over the -mm x 400-mm)side-by-aide blocks may be used.Limit block height to account for lop of the tank.The balance of backfill placed to finish grade above the tank pump height and liquid levels during pump cycles.Block(s)should be placed below may be either suitable or unsuitable soil. an access opening and level upon the tank bottom.For two blocks,orient them 12.Establish a strong stand of erosion-resistant vegetation, perpendicular to ribs on the tank bottom,If present,for stability. Grade to prevent the backfilled excavation from filling with surface Installation of products such as electrical conduit and wiring,pumps,water level runoff.If the subsurface water level In the backfllled excavation exceeds control equipment,valves,siphon equipment,etc.shall be In accordance with the the height of the outlet pipe saddle,tank structural Integrity may be product manufacturer's Instructions and compliant with applicable state or local compromised,See page 4 for Illustration, rules and regulations.Appurtenances shall be fastened to the tank riser system and not the tank body or access opening rim.Where possible,appurtenances shall be MOUND SACRFlII.FOR—••• -MINIMUM r SOS.COVER Pas rrvsawNAoe I installed to facilitate maintenance and repair access via the tank access openings. Note;Prefabricated pump vaults may be Installed. )y1 . ` ''' GENERAL SPECIFICATIONS BOWMEN Ries , ,,.:'' "f1)+'r 1 i ii. r.<- ins ., 'Failure to comply with installation Instructions will void warranty. ...c ....• r 4 ` MA%IUU {4 ky G. s# ' " ' AART,CL6 size •Prior to ground disturbance,check for subsurface obstructions and utilities In COMPACTS°- .y"rt•. E C ..,. ,�I t l, ,:lib.,;;`i..:': -,�• PLACE SOP.IN conformance with applicable requirements. !RATABLE NArrvs : �:,•..•: 4 �, it'rj I2 05o mml Soil wcKFxt .! .T -•,•- t u' ; ' '= •. OPT'S AND •Operating water temperature shall be less than 100'F(40°C). c(°". !`zzv; ht:,<....w,•*•,..:::.•:•,!.:>:::.;,.%:' COMPACT •.t< '''' f'rr '<�t' • in cold conditions,handle and backfill tank with care to prevent Impact damage. cM ISs0Hq q .r.Unc """'SOIL BEE NO COMPACT •Tanks are not fire resistant.Store away from Ignition sources, ,a•35•I+O.eeonw, '�—'•'•4••I SOIL EENEATH PACT ES OR 61tEo AS R6cESaARa •Removal of structural bulkheads Isprohibited:removal of lockingclips on the tank TO ENSURE PROPER BACAPIu.Mq PROCEDURE p mid-seam connection Is also prohibited. SHORT AND LONG-TERM GROUNDWATER CONTROL •Only suitable for potable applications if the tank bears the NSF/ANSI 61 certification mark.Otherwise,tank is recommended for use In septic,rainwater/ It may be necessary to implement groundwater control measures during tank Installation.Maintain dry conditions by expanding the excavation to create a stormwater storage,holding,and pump applications,or other non-potable uses. 'Infiltrator tanks shall not be installed above ground.Contact Infiltrator(f the 6-inch short-term groundwater collection sump for temporary placement of a dewatering pump if needed.Long-term groundwater control measures such as underdralns (150-mm)minimum soil cover depth cannot be met. Failure to comply with those installation Instructions will Invatldatn limo warranty.Contact InOUrntor Water Technologies'Technical Services Department for assiHnnen at 1•603-221.443h. INLET AND OUTLET HOLE LOCATIONS Drill height marks are provided on all Infiltrator tank models to guide inlet for the hole saw.The pilot drill bit on the hole saw should be positioned and outlet hole drilling.A single drill height mark Is provided at each end at the center of the drill height mark to align the hole saw properly.Table or side port on tanks(example Illustrated below).Holes may be drilled 3 provides drilling end Invert information by regulatory Jurisdiction for the at the end or side inlet and outlet locations,as allowed by state end/or Installation of 4-inch-diameter(100 mm)pipe. local regulations.The drill height mark Indicates the center point location Table 3:Inlet and Outlet Hole Locations' a Inlet Drill Outlet Drill Invert Drop Inlet Invert Height(in)[mm] Outlets Invert Jurisdiction Location Location (in)[mm] Above Inside Above Height and Liquid Bottom of Tanke Excavation Base' Level(in)[mm] IM-540 and IM-1530 All All All 3.00[76] 47.00[1,194] 47.20[1,199) 44.00[1,118] CM-1060 All Except Florida All All 3.00[76] 47.00[1,194] 47,20[1,199] 44,00[1,118] Florida End End 2,00[51] 46.00[1,168] 46.20[1,174] 44.00[1,118] IM-1060 End End 3.00[76] 47.00[1,194] 47.20(1,199] 44,00[1,118] All Side Side 3.00[76] 47.50[1,207] 47.70[1,212] 44.50[1,130] Side End 3.50[89] 47.50[1,207] 47.70[1,212] 44.00[1,118] End Side 2.50[641 47.00[1,1941 47.20 11.1991 44.50 f1,1301 1.State,provincial,and local regulatory requirements supersede Table 3 Information. Installation terminology notes: 2.Kentucky and West Virginia tanks are factory-drilled.Florida and Oregon tanks must be factory-or distributor-drilled. 1 "Subsurface water"refers to a water- 3.Invert heights are measured from the lowest Interior surface at the bottom of the tank to the Invert, saturated zone of soil. Do not install if 4.Invert heights are measured from the base of the excavation to the invert. subsurface water Is continuous from the tank Limitations When Subsurface Water Is Present Above the Tank Bottom p a en to any point above the outlet pipe pe s cadddieie elevation. Tank top 2. "Uninterrupted saturated soil"refers to wa- ter-saturated soil with no gaps In the saturated 13" ,r condition. An example of a gap In the saturated )°:°0ttn8teuhh1u Outlet pipe saddle Invert location- condition is a perched water table,when two (300 mrn) 4f''�) IIC Corresponds to the maximum allowable water-saturated soil zones are interrupted by an I � 4 subsurface water eleveton outside the tank unsaturated soli zone. Do not Install If uninterc rbsurrece water ruptad saturated soil is present from the tank 43" elevation outside the tank bottom elevation to any point above the outlet (1,075 mm) xceeds the outlet pipe saddle pipe saddle elevation. evation 3. A perched water table Is allowable above the outlet pipe saddle elevation only if unsaturated J soil is present between the perched water table and tank bottom elevation. Tank bottom • Infiltrator Water Technologies,LLC("Infiltrator") INFILTRATOR°SEPTIC TANK LIMITED WARRANTY FIVE(5)YEAR MATERIALS AND WORKMANSHIP LIMITED WARRANTY (e)Dais limited warranty Is extended to the end user of an'agitator Teri A Tank manufactured by Infiltrator,when Installed end operated In eccardance with Infiltrators Installation Instructions and local regulation by a person or company that is property quailed to Install the Infiltrator Tank In accordance with applicable state end/ar local requirements,Is warranted to you:(I)against defective materials and workmanship for eve (5)years after Installation.Infiltrator wIll,at Its option,(I)repair the defective product or Of)replace the defective materials.Inftrator's)liability epeoecnlly excludes the coat of removal and/or Installation of Ile Tank. (b)In order to exercise t s warranty rights,you must notify infiltrator In writing et Its corporate Iraadquurtere In Old Saybrook,Conneotlout within lateen(15)doye of the alleged defeat. (c)YOUR EXCLUSIVE REMEDY WITH RESPECT TO ANY AND ALL LOSSES OR DAMAGES RESULTING FROM ANY CAUSE WHATSOEVER SHALL 8E SPECIFIED IN SUBPARAGRAPH(a)ABOVE.INFILTRATOR SHALL IN NO EVENT SE LIABLE FOR ANY CONSEQUENTIAL OR INCIDENTAL DAMAGES OF ANY KIND,HOWEVER OCCASIONED,WHETHER BY NEGLIGENCE OR OTHERWISE.SOME STATES DO NOT ALLOW THE EXCLUSION 04a LIMITATION OF INCIDENTAL OR CONSEQUENTIAL DAMAGES,S0 THIS LIMITATION OR EXCLUSION MAY NOT APPLY TO YOU.THIS WARRANTY GIVES YOU SPECIFIC LEGAL RIGHTS AND YOU MAY ALSO HAVE OTHER RIGHTS WHICH VARY FROM STATE TO STATE. (d)This LIMITED WARRANTY IS THE EXCLUSIVE WARRANTY GIVEN BY INFILTRATOR AND SUPERSEDES ANY PRIOR,CONTRARY,ADOmmONAL,OR SUBSEQUENT REPRESENTATIONS,WHETHER ORAL OR WRITTEN.INFILTRATOR DISCLAIMS AND EXCLUDES TOTHE GREATEST EXTENT ALLOWED BY LAW ALL OTHER WARRANTIES,WHETHER EXPRESS OR IMPLIED,OR STATUTORY,INCLUDING ANY WARRANTY OF MERCHANTABILITY,FINESSE FOR A PARTICULAR PURPOSE AND ANY IMPLIED WARRANTIES OTHERWISE ARISING FROM COURSE OF DEALING,COURSE OF PERFORMANCE,OR USAGE OF TRADE.NO PERSON(INCUJDING ANY EMPLOYEE,AGENT,DEALER,Oft REPRESENTATIVE)I8 AUTHORIZED MAKE ANY REPRESENTATION OR WARRANTY CONCERNING THIS PRODUCT,EXCEPT TO REFER YOU TO THIS UNITED WARRANTY.EXCEPT AS EXPRESSLY SET FORTH HEREIN,THIS WARRANTY IS NOT A WARRANTY OF FUTURE PERFORMANCE,BUT ONLY A WARRANTY TO REPAIR OR REPLACE. le)YOU MAY ASSIGN THIS LIMBED WARRANTY TO A SUBSEQUENT PURCHASER OF YOUR HOME. (f) NO REPRESENTATIVE OF INFILTRATOR HAS THE AUTHORITY TO CHANGE THIS LIMITED WARRANTY IN ANY MANNER WHATSOEVER,OR TO EXTEND THIS LIMITED WARRANTY. (9)NO WARRANTY OF ANY KING IS MADE WITH REGARD TO ANY PRODUCT,COMPONENTS,DEVICES,MEDIA OR TREATMENT UNITS WHICH ARE MANUFACTURED BY OTHERS AND ARE INSTALLED IN AN INFILTRATOR TANK USE OF THESE PRODUCTS ARE AT YOUR OWN RISK. (h)THE INFLTRATOR TANK I3 DESIGNED TO BE BURIED UNDERGROUND,NO WARRANTY OF ANY KIND IS MADE IF YOUR TANK IS NOT BURIED UNDERGROUND AS SPECIFIED IN THE PRODUCT'S INSTALLATION INSTRUCTIONS. CONDITIONS AND EXCLUSIONS There are certekt aondalons or applications over which Intltretor has no control.Defects or problems es a result of such conditions a'application era not the reaponaiblllly of Infiltrator and are NOT covered under Ile warranty.They include failure to Install the Tank In aocordance wllh Instructions or applicable regulatory requirements or guidance,allotting the Tank contrary to rho Installation hauuotiena and dleposing of chemicals or other materials contrary to normal tank usage. The above represents the Standard Limited Warranty offered by infiltrator.A limited number of regulatory jurisdiction',hove different warranty requlremenls.My purchaser of a Tank should contact infnrator's corporal,heed)/oo/Mara In Old Saybrook,Connecticut,prior to such purchase to obtain a Dopy of the applicable warranty,end should uaraNlly read that warranty Our ur to the purchase of a Table �!♦ 4 Business Park Road '/ P.O.Rex 708 O8 0 577-7000'FT 06476 Distributed By; rdeo-sTr-Taco�Fnx 800.577-7001 1400.221.4438 INFILTRATOR www,inratratorwator.com water technologies Inloelnriltratorwetercom Note:Please visit www.infiltratorwater.com for updated and/or amended Instructional material. U.S.Patents:0322e4Q each t0;8297880;7914290;700Bim.Other patents pending.Infiltrator,QuIck4 and EZaow are registered trademarks of Infiltrator Water Technologies.Infiltrator Water Technologies is a wholly- owned subeldtary of Advanced Drainage Systems,Inc(ADS). 0 20221nfiltralrx Water technologies,LLC.Nol responsible for any typoaraplltc errors.Waled in U.S.A TANK01 0122 Assessment Report - Catawba County NC as of January current year Property Assessment Information: Revaluation Date:January 1,2022 Card:1 of 1 Class R Next Previous Card Parcel Information: Owner Information: Parcel ID:460719616036 Name:HARRIS RANDY L Property Address:4276 POINTE NORMAN DR Name2:HARRIS LINDA L LRK(REID):e00190 Address:4270 POINTE NORMAN DR City/State/Zip:SHERRILLS FORD,NC 28673-8356 Assessment Information: Market Building(s)Value:$411,100 Market Land Value:6183,600 Total Market Value:$594,700 Use Total Value:$0 Sales Data: Date Type Price Source Validity 1996-07.01 LAND&BLDG $277,000 BUYER VALID SALE Property Factors: Topography Utilities Street or Road ROLLING Utility Contacts PAVED Building Permit Data: Issue Date Number Amount Purpose 1996-02-01 9629592 $4,900 NEW DOCK 1995-07-01 9526430 $122,307 NEW HSE Notes: Note1: Dwelling data Style:CONVENTIONAL Story Height:1.0 Upper Level:NONE Basement:CRAWL SPACE Bedrooms:3 Total Rooms:8 Full Baths:2 Halt Baths:1 Year Built:1996 Year Remodeled: Exterior Walls:MASONRY/FRAME Ground Floor LNIng Area:2540 • Total Living Area:2540 Fin.Basement Living Area; Basement Recreation Area: Fireplace Stacks/Openings:1/1 Metal Fireplace Stacks Openings: /0 Heating:CENTRAL/AC Heating System:HEAT PUMP Fuel Type:ELECTRIC Total OBY Value:2830 Last Update:2021-03-25 See an issue?Request a change. Card:1 of 1 Next Previous Card n 7 ***Op. Permit and/or Cert. Op. Required lt4ust'be completed.prigt to final) Nc I I 8 6 6 4 .� . CATAWBA• COUNTY HEALTH DEPARTMENV / (704) 465-8270 Lot Eval. c.eImprove. Permit(repair Permit Cert. of Comp. Permit Oper. Permit Owner/Agent ) 1- c M 6,.6 Phone � Address Ifs,J Pol/y!j5 /VOiar�/sti Pa?, Subdivision PO/ i�IQ2/n33A �19f./612.146,S I:: dt47 f IV i C. Section/Block/Phase Lot as Lot Size E Directions: _, 04/ /S' e' /A PAmifir 07r1- rSr-7— 7a'6- Lei 7- ` .mod n J Facility: House ( ,,..- Mobile Home Business . Other: Tax Ma /.2. ){— l-2 Multi-family Other . Zoning Approval( Bedrooms 2/ Seats Employees . Application Rate GPD Flow witp Hot Tub or Basement yes/ es�SpeciBasementrPlumbing yes, . Repair 030 DAYS OR NOTICE: OR Water Supply: Private Public --- . DAYS FROM DATE OF PERMIT., Type of System: Trench (/Bed Pump Pump/Panel Panel,____LPP Other Tank Size: Septic Tank /O Pump Tank Nitrification Field: Total Square Feet / rf Depth of Stone mil Bed Size Trench Width 3 ' Total Length of All Trenches 4 )4 Number of Trenches . ,' Individual Trench Length t 'O /e0 /�`'d /tSU /LfV Feet on,Center i Maximum Trench,DBptki -• Distance of Nearest :Well --r-r-- ' Lot Even: Approve... ,�j'.o (Void After 24l months) k*iFilrik *4****41w.0.11 *** ***.********vYr ....yrM***....+r*'IMii***..*'i;***** "' Too 6--..: Slope Sketch of lot Evaluation Site - System Design - Final , . Texture ''64;/+}y' D `p- •Nt,51), i NSTAL structure cj WHEN..WET Clay M4.n _ I.� Soil•'Wetnese, C"PrxTrZ r�.e.r • Soil vept2i - fe.2- , Restrie. Hoz;: at! '..2 " -- Availablespace: no 1 -� , • Overall Chase S Comments: • •-- =�' V J J ��11/�J G�--A ouN y° ff5S'essrn-eA sq - A- t T : '}iDws e fo-T -r ok P d-()o"71 Septic Tank Contractors Fk�n " Ue�M j e ne Q - ! v MUST contact the 1 Sanitarian BEFORE 4)4_ 3 froka0nS changing permit. *yNn nr:aaanTrm nr w PERMIT** ** * ** ** Permit Date 4 j � /? /957 (Improvement Permit void after 60 months) Owner/Agent I &mAj .., Q w . L .+-L Sanitarian ,_n, /:r� c (r^Installed By C �lt��f� llJr-�C,(S, Date � - 2.�-,j� Sanitarian ley -1 (Note any changes/information in red or by sketch o ba )•,• *******IF A PERMIT HAS TO BE REDESIGNED AND/OR RETRIPS MADE TO THE PROPERTY, THERE IS AN ADDITIONAL $25 CHARGE. • r Parcel Report - Catawba County NC Parcel Information: Owner Information: Parcel ID: 460719616036 Owner: PHILLIPS JOHN E Parcel Address: 4276 POINTE NORMAN DR Owner2: PHILLIPS DEBRA W City: SHERRILLS FORD, 28673 Address: 4276 POINTE NORMAN DR LRK(REID): 800190 Address2: Deed Book/Page: 3772/0540 City: SHERRILLS FORD Subdivision: POINTE NORMAN State/Zip: NC 28673-8356 Lots/Block: 20/ School Information: Last Valid Sale: $975,000 on 2022-09-30 School District: COUNTY Plat Book/Page: 35/148 Legal: LOT 20 PLAT 35-148 Elementary School: SHERRILLS FORD Middle School: MILL CREEK Calculated Acreage: .670 High School: BANDYS Tax Map: 012FX 01020 School Map Township: MOUNTAIN CREEK State Road #: 2768 TaxNalue Information: Tax Rates Zoning Information: City Tax District: All in County Zoning District: COUNTY County Fire District: SHERRILLS FORD Zoning1: R-30 Building(s) Value: $717,700 Zoning2: Land Value: $206,500 Zoning3: Assessed Total Value: $924,200 Zoning Overlay: CRC-O,WP-O,FPM-O Year Built/Remodeled: 1996/ Small Area: SHERRILLS FORD Tax Revaluation 2023: Info, COMPER Split Zoning Districts: / Online Appeals Zoning Agency Phone Numbers Valid Sales (COMPER) for this parcel Contact Tax Dept. at 828-465-8436 Current Tax Bill Miscellaneous: Firm Panel Date: 2007-09-05 Building Permit Address Search for this parcel. Firm Panel #: 3710460700J If available, Building Permits for this parcel. Septic 2010 Census Block: 4001 links are not permits. 2010 Census Tract: 011504 Septic Final Permits prior to 08/2018, contact Agricultural District: Environmental Health. )OIL . S�p c.. f t \oc,Xo- Building Details WaterShed: WS-IV Critical Area �J oor`� 0 �j } Voter Precinct: P41/ Voting Map 31S.00 Parcel Report Data Descriptions List all Owners Deed History Report Assessment Report This map/report product was prepared from the Catawba County,NC Geospatial 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 I 17 i * I 7 ***Op. Permit and/or Cert. Op. Required (Must'be completed.vrigr to final) N_ 8 6 6 4 A CATAWBA COUNTY HEALTH DEPARTMENT (704) 465-8270 Lot Eval. t.. rove. Permit repair Permit Cert. of Comp. Permit Oper. Permit Owner/Agent ►))/7 11-0/y,g'S Phone Address liA 7c P6//v725 rYO&ry2,4,J P#L. Subdivision o/,ijrt- A/O My S ilc3.t f-nit,o,44/,C. car4'6 ..1 Section/Block/Phase J Lot# al) Lot Size 6 66 i' Directions: i(/ 0 /S- No 7A-A1 C ,cr- ?e Facility: Houses.— Mobile Home Business . Other: Tax Ma - Multi-family Other . Zoning Approval() Z 5 a 3-7 -7 Bedrooms 4 Seats Employees . Application Rate GPD Flow lap Hot Tub or Spa es1Special Fixtures . 100% Repair Area f o REPAIR NOTICE: Basement yes/.) Basement Plumbing yes, . REPAIRS MUST BE WITHIN 30 DAYS OR Water Supply: Private Public t - . DAYS FROM DATE OF PERMIT. Type of System: Trench C.....--fled Pump Pump/Panel Panel LPP Other Tank Size: Septic Tank /© - Pump Tank Nitrification Field: Total Square Feet / - Depth of Stone .N Bed Size Trench Width 3 ' Total Length of All Trenches — Number of Trenches Individual Trench Length SO //80 sea / /5 Feet on Center 9 ' Maximum Trench Depth I Distance of Nearest Well ------- Lot Ev en: Approve• 1.o (Void After 24 months) **** Topo vr':;' % Slope Sketch of lot Evaluation Site - Sys em esign - Final Texture GL/}yey 106=105T- NSTALL Structure .6c.pc cJ ' /-'` WHEN WET Clay Min. /.. / Soil Wetness / f'ifFi7z. /ry�r70 Soil Depth VZ " ) Restric. Hoz. at44.2 " — _ Available space no - Overall Class 40 . Comments: •- -- ` "S`— / 4't--1VOGrJ d Ix 3 ,! _ _ - - u , t- iious e Septic Tank Contractors F441,0- MUST contact the n Sanitarian BEFORE changing permit. **un r_Ukpa rrn'w no W PD TY Sc Mar 7t'D QfI`I L)I� ,TgeSUANCD or TIIIO PERMIT** Permit Date /�,c.(,,,,,,,,Q &� /95s- (Improvement Permit void after 60 months) Owner/Agent l�1 &n. ''. . 0. L Sanitarian (. £.S' Installed By /7,Lta, /mac ('ion f' cost1S. Date / - 2,/-9t. Sanitarian ,,. (Note any changes/information in red or by sketch o bac ) IF A PERMIT HAS TO BE REDESIGNED AND/OR RETRIPS MADE TO THE PROPERTY, THERE IS AN ADDITIONAL $25 CHARGE. White-O fice Blue-Building Inspection Completion Yellow-Owner/Agent Green-Building Inspection IF'