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HomeMy WebLinkAboutIMPV-10-2023-207364.tif 8 CATAWBA COUNTY Case# .� •� IMPV-10-2023-207364 .t. ,y Public Health Department Subdivision Environmental Health Division PIN# 374502858054 (...._ PO Box 389,25 Government Drive,Newton,NC 28658 I O"[# 1 8 w Site Address: 6460 ST PETERS CHURCH RD, CONOVER NC 28613 Name on Permit: GIANCARLO RAMOS Property Size: Acres.485 Directions: NC 16, left onto St Peters Church Rd, left onto Naked Creek Rd, property on the right Owner/Authorized Representative Acknowledgement of Permit Receipt K _I certify that I 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 EHPR-10-2023-45835, by the following method(s): Received in Person Facsimile Transmittal (Return form with signature required) 1 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: 10/27/2023 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 Date/Time j___11° � 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 youPlease ttake a few momentts tto complette our custtomer service survey att http://www.surveymonkey.com/s/EHCusttomerService je 1i4An stipsagaAto,614 ehpennit 10/27/2023 16:10 Permit t#; t fv-14 LOl- ?D/3(• t{ e# ;'' , ROY COOPER•Governor .1 NC DEPARTMENT OF n pram' HEALTH AND KODY H.KINSLEY•secretery it,; l/f '. HUMAN SERVICES MARK BENTON•Deputy Secretary for Health .!-inN` SUSAN KANSAGRA•Assistant Secretary for Public Health Division of Public Health Submittal Includes: (a2)Improvement Permit ❑(a2)Construction Authorixation ❑Fes$ IMPROVEMENT PERMIT FOR G.S.130A-335(a2) County: CcriQ-11J b 0-• PIN/Lot Identifier:37 yfo a 8 f fIO .ram Issued To: Bruno RtlLMpS Property Location: St Peel's C..:ku r.)1 Po Subdivision(If applicable) 4///9 Lot it: Block: Section: L55 Report Provided: Yes No❑ —t• �1 1 if yes,name and license number of LS5: JOB fr? B Ct New® Res Expansion ❑ System Relocation ❑ Change of Use El proposed ►derlee. Number of bedrooms: 3 Number of Occupants: Other: Design Wastewater Strength:01 domestic ❑high strength ❑Industrial process Proposed Design Daily Flow: 340 GPD Proposed LTAR(Initial): .2/5- Proposed LTAR(Repair): a.215 Proposed Wastewater System Type*: r P 41/$ -i T. rt�"01Po.1]ei (Initial) Pump Required: In Yes 0 No ❑May be required Proposed Wastewater System Type':p 7 .8 PS 1 1'Jpxyle , (Repair) Pump Required: 2]Yes 0 No 0 May be required 'Please include system classifrcotion for proposed wostewarersystem types in accordance with I5A NCAC 18A.1961 Table Vfa) Saprolite System(initial):❑Yes X No Saprolite System(repair):❑Yes In No Fill System(Initial):❑Yes J No If yes,specify:❑New 0 Existing (when adding more than 6 Inches of fill to system area provide a fill plan) Fill System(repair):0 Yes Rvii No If yes,specify:❑New ❑Existing (when adding more than 6 inches of fill to system area provide atilt plan) Usable Solt Depth(Initial): 117 rt Usable Soil Depth(Repair): at7 i t Max.Trench Depth(Initial(':AO° Q8' Max.Trench Depth(Repair)':y2O •40 'Measured on the downhilIside of the trench Artificial Drainage Required: ❑Yes [D No If yes,please specify details: Type of Water Suppiq:,M Private well ❑Public well 0 Shared well 0 Municipal Supply ❑Spring ❑Other: Drainfleld location meets requirements of Rule.1945: Yes(XI No❑ Drainfield location meets requirements of Rule.195D: Yes 0 No❑ Permit valid for:2j)Five years(site plan submitted pursuant to GS 130A-334(13a)) 0 No expiration(plat submitted pursuant tit GS 130A•334(7a)) Permit conditions: J.1 et-Q.4st r.,4/0;11. %AY dAA:cer.., fry jeft:-.12.g fr Licensed Soil Scientist Print Name: .S Gt. V. I_V 411) Tr .) Licensed Soil Scientist Signature: p Date:lbi'.?q IRDa3 The 155 evaluation Is being submitted pursuant to and meets the requirements of GS.130A-335(a2), ''See attached site sketch* NC DEPARTMENT OF HEALTH AND HUMAN SERVICES • DIVISION OF PUBUC HEALTH Lo0ATtori:5605 Six Forks Road,Building 3,Raleigh,NC 27809 MAILING Mail Service Center.Raleigh,NC 27699-.1632 www.rtcdhh`gov • TEL:919.707-5854 • FAX 919-54S-3972 AN EQUAL OPPORTUNITY f ArrIRMAT1vt ACTION chestovtf 6460 St Peters Church Rd Permit#: IMPV-10-2023-207364 This Section for Local Health Department Use Only Initial submittal received: 10/23/2023 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(02)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: ©Complete State Authorized Agent: Date: 10/27/2023 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: 10/27/2028 *See attached site sketch* G.S. 130A-335(a2)Common Form 2 V.2023.07 . . • . ' I { 1 , • ; i ' , iL t ' , . ; . . , .t I, i i . . \ / t . / ... ' ., ..... .„. • . / , , ..',... ......, it7 1 k.. 1 / • I'S q .tr1 4.v ' •-, 0 I - ,-..,.........4",, 0 , ....,- --f• c) 9.• I 7... . 1 — ... . • --- I. , 1 `"P,,, , ... i, 1 tit t ....,A ea , 4 . l...- trt,R ,. ,, -....... ; 1 s .,. . . , 1, 't14 - •[ .... i, . •4 I.,. .. ..- ,i ,.,,, -,./.---- , , :_..,,,..,0.''',4„3,A bl— ,,,,__ "I „ ..., et. °I... a ..,..,..A.' . 16 1 ...• ...- ) ,•„ ...---- ...; rip- , _,-.7..----." '...) •• ! ..,......e.. I I . • , - • MT ...,,,-...',.+•"".- ..• 1111,....„....e. .."' ........'- -' iz-pa-6 _ • . • •: '. 1 ' I i ,• 1 ' • , . ....----- - • . . -, — . • •• i, . .. ... 1.-- l• • ' t : ' ' .. , „ , , . • 11 l' • SOIL/SITE EVALUATION FOR ON-SITE WASTEWATER SYSTEM Owner/Applicant: Bruno Ramos Date Evaluated: 3/29, 4/18, & 4/21/2023 Address/Phone #: County/ PIN #: Catawba Facility: Residence Design Flow: 360 gpd Property Size: .485 acres Location/Road: St. Peters Church Road Subdivision/Lot #: Water Supply Public _ Private Well X TCommun y well Evaluation Method Auger Boring Pit X Cut Type of Wastewater Sewage X IPWW Mixed Profile Landscape Horizon Texture Structure Consistency Saprolite Soil Soil Profile I # Position& Depth Mineralogy Wetness depth classification Slope in. Color & LTAR 1 L 0-37 C SBK/ABK Fl mica some rock 37-47 CL SBK/ABK Fl mica some 47 PS .275 rock 2 L 0-17/18 CL SBK _ Fl 17/18- C SBK/ABK Sticky 40/42 plastic 40/42- C SBK/ABK Fl mica some 48 Ps .275 48 rock _ 3 FS 0-12/15 CL SBK FR 12/15- C SBK/ABK Fl mica 47 Ps .275 47 _ rock _ PRESENT USE: FIELD OTHER FACTORS: New lot cut out of parcel 374502858054 EVALUATED BY: Joe Lynn OTHER(S) PRESENT: Britt, Bruno COMMENTS: Power line right of way along front of lot , Landscape Texture Structure Mineralogy 1 Mineralogy Position consistency consistency Ridge Sand Crumb Moist Moist R S CR Shoulder slope Loamy sand Granular Slightly expansive Expansive S LS GR Nose slope 'Sandy loam Block like loose Very firm N SL VF Head slope Loam Subangular Very friable Extremely firm H L SBK VFR EF Foot slope Silt loam Angular Friable FS SIL ABK FR Flood plain Silt 1 Platy Firm FP SI PL Fl Drainage way Sandy clay loam Prismatic D SCL PR I Terrace Silty clay loam Absence 'Wet Wet T SICL A Debris slope Clay loam Slightly sticky Very sticky DS CL SS VS Sandy clay Sticky SC S Concave slope Silty clay Non plastic I Very plastic CC SIC NP VP Convex slope Clay Slightly plastic CV 'C SP Plastic P 1 1 s I I • • • • r' CT , ... 8 jt . , . , ,'7-..',,P,v,:•., . : • • .. ...q . . „ ., . , • . ... . . . , . .. .4..,, , t:..• : .. . . 1 • i i • • I . 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Giancarlo Bruno Ramos •'r 0ae .. — Jennifer Noel Ramos 8420 St.Men C6.FH•Lwow,AC 26614 ,"' °a.a.,, xrw..r.rw.rn• Cirri Torna6/ry Coror0o C, b.AC i..orr.......w.._r Imsf* +ars•n.1•444 ..•.,'.•••• cw n awwxc• a._ PP O.m W..r.m1...........e_.r. ranr ac....q.r...v...r•► m PPM q w•• .R.• W' ry. 4F41_•r_y. ...Y•.Y..s,.__•.r_ ,°`_•.!•...ands 0. — PPP Pvt.PO 2024 .n..rWi•iFY._.•1.4•la$rrl66—. 1.1WWwwWW ...w1...4r, IN 0 is OP OW • .•tY.MYn✓—.IOiR.Mw.111•11+Iiiim..t.r/.r4..•W..r..Y.wr GROW WALK-PUT ▪rnr. .0.>s,�.., '/-s r/i �s aa+mrwa`o0ro.e+esw.t r._.�r..ar arr ro.w•a.s..n r•w.rl.rr+.r•+. — aads • David S. Clark Ir "`-" 11.6.6 .rrW.errrr.......wr•••rr_r.r�...• %• ili. 11.1.011. .•-•J•..../ rd....40-,A 49. ..e. .....,a .« 9 .. Y. , Surveyor. PA ... ., . .F ...••:..••r..r W00. f910 J2r4 St AC .rr ,'NC 26661 r_v.cl•110,1.6.67.cam 828 826_256-6400 D-195 t