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Home My WebLink AboutEOP-10-2023-205828.tif 1 3?57 Vj{ak- e)Ln. Terre iI d,"STATFO'Y' • ROY COOPER •Governor RECEIVED m.,,, a4T • ', NC DEPARTMENT OF KODY H. KINSLEY•Secretary � 1 HEALTH AND SEP 1 5 2023 i+a�/ HUMAN SERVICES MARK BENTON • Deputy Secretary for Health •Qa.,,o', SUSAN KANSAGRA•Assistant Secretary for Public Health Division of Public Health Environmental Health COMMON FORM FOR ENGINEERED OPTION PERMIT Eop-/0•)Q13-)os Q)g See Instructions for Use in Appendix A K6PR- v -X)3 .•'Slab I LHD USE ONLY: Initial submittal of this NOI received: 1--1.4-217 by p Date Initials PART 1: Notice of Intent to Construct(NOI)-Please check all that apply ❑X Single System or ❑ Multiple Systems AND X❑ New ❑ Expansion X❑ Relocation of all or part of the Existing System ❑ 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.): Tap Realty, LLC(Anthony Pariti) Mailing address: 43 Casey Lane City: Mt. Sinai State: NY Zip: 11766 Telephone number: (631)882-3567 E-mail Address: anthonypariti@gmail.com 2. Professional Engineer(PE) name: Donald Munday, PE License number: 17327 Mailing address: 125 East Plaza Drive, Suite 101 City: Mooresville State: NC Zip: 28115 Telephone number: (704)664-7888 E-mail Address: dmunday@pdapa.com 3. Licensed Soil Scientist(LSS)name: Jeff Vaughn License number: 1227 Mailing address: 501 N. Salem Street, Suite 203 City: Apex State: NC Zip: 27502 Telephone number: (919)859-0669 E-mail Address: jvaughan@agriwaste.com 4. Licensed Geologist(LG)(if applicable) name: License number: Mailing address: City: State: Zip: Telephone number: E-mail Address: 5. On-Site Wastewater Contractor name: AQWA License number: 57240 Mailing address: 2604 Willis Court City: Wilson State: NC Zip: 27896 Telephone number: (252)243-7693 E-mail Address: mclayton@aqwa.net 6. 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: X❑ PE ❑X LSS ❑ LG X❑ On-site Wastewater Contractor NC DEPARTMENT OF HEALTH AND HUMAN SERVICES•DIVISION OF PUBLIC HEALTH LOCATION:5605 SIX FORKS RD,RALEIGH NC 27609 MAILING ADDRESS: 1642 MAIL SERVICE CENTER, RALEIGH NC 27699-1642 www.ncdhhs.gov•TEL:919-707-5874•FAX.919-845-3972 AN EQUAL OPPORTUNITY/AFFIRMATIVE ACTION EMPLOYER -- Engineer Option Permit Common Form LHD Reference: EDP- !C-X)3-)D5 y� 7. Property location(physical address,tax parcel identification number or subdivision lot, block number of the property to be permitted): 3757 Waterview Lane, Sherrills Ford, NC PID:4627-0135-7996 County Name: Catawba 8. Type of facility: ❑x Place of residence No. Bedrooms: 4 No.Occupants: 8 Maximum(2 per Bedroom) ❑ Place of business Basis for flow calculation: ❑ Place of public assembly Basis for flow calculation: 9. Factors that would affect the wastewater load: No more than 6 persons in residence, use of garbage disposal is not recommended, no water softener or HVAC discharge, or pharmaceuticals into waste stream, utilized as short term rental. 10. Type and location of proposed wastewater system: Type Va. TS-II LP PPBPS (Primary and Repair) 11. Design wastewater flow: 480 gpd(For flow>3,000 gpd and industrial process,duplicate plans shall be sent to the State.) Design wastewater strength: n domestic ❑ high strength ❑industrial process 12. A plat as defined in G.S. 130A-334(7a)is attached: E Yes ❑ No 13. 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: E Yes ❑ No This is a saprolite system. ❑Yes x❑ No 14. Evaluation(s)of soil conditions and site features in accordance with G.S. 130A-335(a1)signed and sealed by a LSS is attached: x❑Yes ❑No 15. Evaluation of geologic and hydrogeologic conditions signed and sealed by a LG is attached ❑Yes ❑x NA 16. Proposed landscape,site,drainage,or soil modifications are attached: ❑Yes ❑x NA Attestation by Professional Engineer licensed in North Carolina pursuant to G.S.89C Donald Munday, PE hereby attest that the information required to be included wit,1011i,1'lt1/i,� Registered Professional Engineer(Print Name) `♦♦♦ /i�� this Notice of Intent to Construct is accurate and complete to the best of my knowledge and that the proposed of ..,% system shall meet applicable federal,State,and local laws,regulations, rules,and ordinances in accordanczwith• G.S. 130A-336-.1(e)(6). _ • SEAL 01(� ly dgnml GY Uonald L.AIui�Jay 17327 IpN:(,=U5.E=dmun yaGdape Donald L.Mundy� gaNM^ csotlaes,PA" 09/07/20263 O:;i Z027,080y I1 SY:11-0100' .1, w '•.,I .•.` O Signature of Licensed Professional Engineer Date * "Q Designation of Registered Professional Engineer as legal representative of Owner for this Notice of Intent: '//,, M� ♦ hereby designate Print Nome of Owner Print Name of Registered Professional Engineer as my legal representative for purposes of this Notice of Intent pursuant to G.S. 130A-336.1. Signature of Owner Date Owner self-submittal of NOI: Anthony Pariti hereby submit this NOI prepared by Donald Munday, PE Print Name of Owner Print Name of Licensed PE pursuant to G.S. 130A-336.1. Signature of Owner Date DHHS/EHS/OSWP—EOP COMMON FORM Updated July 2023 Page 2 of 3 Engineer Option Permit Common Form LHD Reference: PART 3: Authorization to Operate(ATO) LHD USE ONLY: Initial submittal of request for ATO received: by Date Initials The following items are included in this Authorization to Operate for an EOP: 1. Signed and sealed copy of the Engineer's report that includes the information in G.S. 130A-336.1(k)(1)and 15A NCAC 18A.1971(f) ❑Yes ❑ No 2. Operation and management program and ORC contract,if applicable ❑Yes ❑ No 3. Letter documenting Owner's acceptance of the system from the PE ❑Yes ❑ No 4. Owner meets requirements of ownership or control of the system per 15A NCAC 18A.1938(j) ❑Yes ❑ No 6. Easement, right of way,or encroachment agreement required per 15A NCAC 18A.1938(j) ['Yes ❑ No 7. Multi-party agreements required,as applicable, pursuant to 15A NCAC 18A. .1937(h) ❑Yes ❑ No If yes,agreements filed in County Register of Deeds in Deed Book Page Attestation by the Owner or the PE for Authorization to Operate I, hereby attest that all items indicated above have been provided Print name of Owner or Professional Engineer and the system meets applicable federal,State,and local laws, regulations,rules,and ordinances in accordance with G.S.130A-336-.1(e)(6). Signature of Owner or Professional Engineer Date 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 Engineer Option Permit[G.S.130A-336.1(f)J DHHS/EHS/OSWP—EOP COMMON FORM Updated July 2023 Page 3 of 3 L-OP- IQ- Q - a� AQWA The clear leader. AQWA Inc. 2604 Willis Court,Wilson,NC 27896 Phone:252-243-7693—Email:aqwatammysanders@gmail.com i Customer Name: Tap Realty LLC Date of Inspection: 11/21/2025 I Address: Tap Realty LLC-3757 Waterview Lane Terrell,NC 28682 Arrival Time: 12:27:00 PM System AX ID: AX-159649 Departure Time: 2:05:00 PM County: Catawba Permit No. Inspection and Maintenance Checklist-AX-RT with LPP or P-Manifold or D-BOX Septic Tank Inspection Tank At Site Tank 1 Tank 1 Inlet Readings Tank 2 Inlet Readings 0 Scum 6 Sludge Scum Sludge Tank 1 Outlet Readings Tank 1 Outlet Readings 0 Scum 4 Sludge Scum Sludge Tank Inspection Questions Tank 1 Tank 2 Clean Effluent Filter: _ Cleaned Check for Influent or Effluent Blockages: No Blockage Inspect Tank/Riser for Leaks: None Seen Control-Panel Inspection Check Pump Operates In Manual Mode: Yes Recirculation Pumps Recirculation Pump 1 . Pump 1 Timer Settings Pump 1-Counters and Elapsed Time Meters 0.8 Dose 10 Rest 51253 CT 680.3 ETM Dose Pumps Pump 1 Timer Settings Pump 1-Counters and Elapsed Time Meters Demand Dose Demand Rest 529 CT 81.7 ETM Verify Conduit Seal: Verified AX-RT Treatment Pod inspection. Pod Inspection Pod 1 Inspect for Ponding or Bridging: _ None— Check and Record PSI: Verify Orifice Position and Assess for Clogging: Ok Check for Odors: None Clean,Brush,Flush Lateral: Done Recheck and Record PSI Flush Pod Throroughly: Done Inspect and Clean Vents: Vents Clear Inspection and Maintenance Checklist-AX-RT with LPP or P-Manifold or DBOX Recirculation Chamber-Inspection Verify Inlet Flow: No Inflow I Inspect Liquid: Normal Level I Record Scum/Sludge Levels: Inlet Readings: Outlet Readings: 0 Scum 0 Sludge 0 Scum 0 Sludge Inspect Tank/Riser for Leakage: None Seen Verify All Floats Work: Operating Properly Pump Sludge to Septic Tank: Not Needed Verify Audible Alarm Works for High Water float: Works Properly Pull Pump and Clean Screen: Cleaned Verify Neat Wrap of Float and Pump Cords: Checked Verify No Leaking In Piping or Flex Hoses: None Seen Verify Conduit Seal: Added Ultraviolet Disinfection Unit Inspection Does System Have a UV? Yes How Many UV Disinfectant Units Present? UV 1 UV Disinfectant Unit Inspection UV 1 UV2 After Disconnecting Power,.Clean or Replace Bulb As Needed: Cleaned T Flush Housing Thoroughly: Flushed Return Power and Verify Proper Function: Verified Dosing Chamber Inspection Inspect for Tank/Riser Leakage: None Seen Turbidity Reading: 0.00 Inspect Liquid: Normal Level Record Scum/Sludge Levels: Inlet Readings: Outlet Readings: Scum Sludge 0 Scum 0 Sludge Visually Check Liquid Level: Normal Verify Audible Alarm Works for High Water float: Works Properly Verify No Leaks In Piping or Flex Hoses: None Seen Verify Neat Wrap of Float and Pump Cords: Checked Inspect Pump Intake: Ok Delivery Rate at Start Up: 26.4 Verify All Floats Work: Operating Properly Verify Conduit Seal: Verified LPP or P-Manifold or DBOX Inspection Areas Mowed and Clear of Obstruction: Yes Flush Laterals:,Flushed Area Free of Ponding or Surface Effluent: Yes Set and Record Head Pressure: 3 ft Curtain Drains,Ditches,Swales Functioning Properly: Yes Check Hardware: Functioning Properly Current Delivery Rate: 22 Pump Efficiency: 83 Return Valves and Control Panel to proper settings Done Panel did not call in.No Internet service on the ethernet line in the Control Panel Communication Checked: panel.The line is black. Inspection Notes 41.5-5025=11 x4.4=44+2=22 Paul Smith Operator Operators Signature