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HomeMy WebLinkAboutIMPV-12-2023-209278.tif Authentisign ID:33014A43-C29D-EE11.8925-6045BDD68161 �vi' a CATAWBA COUNTY Case M IMPV-12.2023-209278 rj� -t- Public Health Department Subdivision r Environmental Health Division � � PINH 366602859041 +\ •# Po Box 389,25 Government Drive,Newton,NC 28658 LOTH 2 faltSlteAddress: 3924 E MAIDEN RD, MAIDEN NC 28650 Name on Permit: MARIA GONZALEZ Property Size: Acres 1.23 Directions: NC 16, right onto Buffalo Shoals Rd, bear left onto Laney Rd, right onto E Maiden Rd, property is on the left ,, Owner/Authorized Representative Acknowledgement of Permit Receipt �a I certify that I am the owner or authorized agent(owner's authorization required)representing the owner of the property described above. •,[6 s the property owner or authorized representative, I have received the above referenced permit(s)as requested in the application for service EHPR-11-2023-46126,by the following method(s): Received in Person Facsimile Transmittal (Return form with signature required) .1 Electronic Image Transmittal/E-mail (Return receipt required) ?(1 11; j jl i s 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: 12/0112023 A ,t ,t Owner/Authorized Representative Signature brakAhtohla�lnA4�Ohip�Qt r Date 12/18/23 Documentation of Permit(s)Transmittal (permit transmitted by electronic or other means) Permit transmitted by (name of person sending permit) Signature () c Date/Time f )171)3 Method: Fax J 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 yolPlease ttake a few momentts tto complette our custtomer service survey att http://www.surveymonkey.com/s/EHCusttomerservice jhoselind, rticl hit d. q . ari chpc,„,i 12/072023 06:53 Permit#:1-Arv-11-'2011-1'?27,/ ROY COOPER•Governor ' NC DEPARTMENT OF KODY H.KINSLEY•Secretary HUMAN SERVICES MARK BENTON•Deputy Secretary for Health SUSAN KANSAGRA•Assistant Secretary for Public Health Division of Public Health Submittal Includes: IZr(a2)Improvement Permit ❑(a2)Construction Authorization El Fee$ IMPROVEMENT PERMIT FOR G.S. 130A-335(a2) County:lW PIN/Lot identifier Qjp420cA.5't 04' Issued To: LLAA. 11:*1-\'iC\o Property Location: a:11,49 t, i r 1D 14,1Yl (n'0"i gn 14(.. 3 Subdivision(If applicable) Lot#: 2 Block: Section: LSS Report Provided: Yes[a- No 0 If yes,name and license number of LSS:FsCA{yxti,p\..hibMt�, PO, i �11 New Expansion ❑ '"� System Relocation 0 Change of Use 0 Proposed Structure: C Si,r-•t`rt ,YYi& Number of bedrooms: 3 Number of Occupants:( Other: Design Wastewater Strength:EK-rnestic ❑high strength ❑industrial process Proposed Design Daily Flow: U GPD Proposed LiAR;Initial): C.2 Proposed LTAR(Repair): 0 3 Proposed Wastewater System Type*: 1 �/ ic�tC">rL,,Vk\t/_(Initial) Pump Required: 0 Yes 0 No El May be required Proposed Wastewater System Types: a c31.1 AC-C.ftplits4 C ICCA.A1 (Repair) Pump Required; 0 Yes ❑No 0 May be required *Please include system classification for proposed wastewater system types in accordance with 15A NCAC18A.1961 Table V(a) Saprolite System(initial):0 Yes Ga1Vo Saprolite System(repair):0 Yes 9'NNo Fill System(Initial):❑Yes [ 'No If yes,specify:0 New 0 Existing (when adding more than 6 inches of fill to system area provide a fill plan) Fill System(repair):❑Yes F2No If yes,specify:0 New 0 Existing (when adding more than 6 inches of fill to system area provide a fill plan) Usable Soil Depth(Initial): 50 Usable Soil Depth(Repair): 5-'c' Max.Trench Depth(Initial)*: - Max.Trench Depth(Repair)*: 3J iMeasured on the downhill side of the trench Artificial Drainage Required: ❑Yes allo If yes,please specify details: Type of Water Supply:['Private well [0 Public well 0 Shared well 0 Municipal Supply ❑Spring 0 Other: Drainfleld location meets requirements of Rule.1945: Yes Q. No 0 Drainfleld location meets requirements of Rule.1950: Yes a- No❑ Permit valid for:['Five years[site plan submitted pursuant to GS 130A-334(13a)] 0 No expiration[plat submitted pursuant to GS 130A-334(7a)] Permit conditions: ee1V Licensed Soil Scientist Print Name: , Qin11.._ Licensed Soil Scientist Signature: .r_, - " -' , 72 -1 Date: /� 2-C/ The LSS evaluation Is being submitted pursuant to and meets the requirements of G.S.130A-33S(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 I AFFIRMATIVE ACTION EMPLOYER Permit#: IMPV-12-2023-209278 3924 E Maiden Rd This Section for Local Health Department Use Only Initial submittal received: 11/27/2023 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(a2)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 deportment 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: "i!�4 - / jj Date: 12/1/2023 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: 12/1/2028 *See attached site sketch* G.S. 130A-335(a2)Common Form 2 V.2023.07 SOIL Ft FORESTRY SERVICES OF THE EARDLINALi, HA www.soilandforestryservices.com Project#: 23-0026 June 14`h, 2023 Luis Dionicio Attn:Luis Dionicio Email:techntire@gmail.com RE: Soil&Site Evaluation for a 3 Bedroom Residence on Lot 2,1.23 ac Parcel,PIN# 366602859041, 3916 E Maiden Rd,NC 28650. Mr. Dionicio: At your request Soil& Forestry Services of the Carolinas(S&FS) has performed soil/site evaluations on parcel noted above. The Lot size is noted on the attached survey map&soil evaluation form.The purpose of our work was to identify soil areas with potential to support subsurface wastewater disposal systems and provide design details for Session Law submittal to Iredell County Health Department. Site Conditions At the time of our evaluation land cover on the property was mostly clear open land.Topography within the evaluated area was gently slope near the house site and proposed drainfield area. Property lines and corners were marked at the time of the evaluation by Honeycutt Land Surveying. The client provided an Autocad File of a survey as a basemap. The proposed septic layout was located via Trimble Submeter GPS/tape measures and used to produce the attached Site Plan.The house envelope was located via Survey by Honeycutt Land Surveying. Methodology We evaluated soil areas through the use of backhoe pits. Soil morphological conditions including color, texture,structure,etc.were reviewed in the field with nine pit locations on the property flagged and located via GPS. Five of the nine backhoe pits are located in or adjacent to the proposed septic layout. Soil suitability was determined by referencing 15A NCAC 18A.1900"Laws and Rules for Sewage Treatment and Disposal Systems". Soil&Site Evaluation Forms were utilized to record the soil morphological data for each pit. The house envelope was located via survey.An on-ground layout of system and repair was performed using a laser level. Pin flag locations of the layout were also located by GPS and tape measures. Detailed system& repair information is summarized in the following paragraph for this Lot. 3916 E. Maiden Rd-Lot 2 (See Attached Design) The septic layout for this lot(9'centers)yielded a total of 756 linear feet of line.The primary system is proposed as 300 linear feet of Accepted (25%Reduction) drainfield with gravity distribution.Trench depth is specified at 30 inches.The repair system is proposed as 300 linear feet of Accepted (25% Reduction)drainfield with gravity distribution.There is 461 linear feet available for repair.Trench depth is specified at 30 inches. Session Law Requirements All information needed to issue the IP must be submitted with the application.The application shall include all information described in 15A NCAC 18A.1937(d) and be accompanied by a signed and dated statement from the applicant(owner or owner's legal representative)that reads as follows: "The LSS/LG evaluation(s)attached to this application is to be used to issue an Improvement Permit in accordance with G.S. 130A-335(a2)and(a3)." Owner Date Print Name ttllV LOOM(10 Signature U4 f!_22 - �3 The LSS ev uation shall include a statement bearing the LSS seal and signature that reads as follows: "The LSS evaluation is being submitted pursuant to and meets the requirements of G.S. 130A- 335(a2)." Disclaimer This report reflects the findings of S&FS, PA. This LSS evaluation is being submitted pursuant to and meets the requirements of G.S. 130A-335(a2)."Any site modifications that impact the proposed septic areas on the site may nullify this design for 3916 E Maiden Rd, Maiden NC 28650.System design requirements and site requirements shall be adhered to for installation and Operations Permits to be issued by the local Health Department. If you have questions regarding these requirements a Pre- Construction meeting should be scheduled to discuss. Please contact S&FS if you have any questions regarding this report or the attached inforr. . r. S&FS also offers septic system inspection, wetland delineation and forestry services. /�6 5JIC s Sincerely, F' �` f - • 0L A. Po r<c. —. v� ! \s' 0 / i 1 f r i S.Ashley Rollans, LSS '.,^"'' Attachment: Septic Design 0 1 31cl NORTH a � FORESTRY SERVICES � r Iii r:nraor. irons. ran www.soilandforestryservices.corn Attached is a proposed design for an Accepted Septic System with gravity dist for a 3 bedroom single family residence on Lot 2 3916 E Maiden Rd,Maiden 28650,Catawba County,NC. PIN#:366602859041 Contents: Pate Information for the Installer 1 Design Information Design Specifications • 2-3 Layout Specifications - 4 Site Plan/System Plan------ 5-7 Calculations • 8 Profile Descriptions Zoning Permit& Receipt2 � -� Client " C.Y`Y,. i! 4Provided --- Application---- �, y , - � --• Client ' -rovided IP .44.41.4e'� 10 404"-A Pity CA Form ��.► -.-_,- �`'- f2 3 11 NO 6/14/2023 Project#:23-0026 Design By: Soil& Forestry Services of the Carolinas,PA I INFORMATION FOR THE INSTALLER: The permit should be read very carefully prior to bidding. The following are details that must be considered along with all other considerations. - Tanks shall be approved by NC DHHS, and certification supplied by the manufacturer. - Tanks shall be water tested prior to installation. - The installer shall be responsible to the owner for placement of the tanks and to insure that final grades are returned to the original natural grade, with exception of added structural features. - The supply trench shall be compacted to eliminate cavities left during initial fill placement. - Installation of the system shall be during dry conditions in order to protect the soil structure. - All fittings shall be pressure rated fittings. - All joints shall be cleaned with PVC pipe cleaner and a heavy bodied glue applied to weld all joints. - Where required by the county health department, post installation inspections by the designer must be scheduled 5 week days in advance. - Trenches shall be carefully excavated so the bottom is within 2" from the highest to . the lowest points of elevation within the trench. If the bottom elevation needs adjusting after it has been trenched, it will be done by removing high points rather than filling low points. It is extremely important to insure that trenches are not over excavated during initial trenching. All fine grading within the trench will be hand done with a shovel. No loose material will be left in the trench - All pipe openings in the tanks shall be properly grouted. This also applies to the joints around the riser. - All tanks shall be properly back filled and compacted to prevent slump at a later date. - Earth dams, constructed of relatively impervious material, shall be installed at the beginning and end of each lateral. - 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 pintlag locations should be checked by the installer prior to beginning trenches. - Septic tank riser shall be a minimum of 6" above finished grade. - System is specified as a gravity 25%reduction (Accepted) installation. - Repair is specified as a gravity 25%reduction (Accepted) installation . 2 GRAVITY ACCEPTED SYSTEM FOR WASTEWATER TREATMENT Owner/Applicant: Luis Dinico Address: 2146 l lcphzibah Church RD Bessemer City.NC 28016 Phone: 704-913-4242 County: Catawba Location: 3916 F Maiden Rd Maiden, NC 28650 Source of Wastewater Flow: 3 Bedroom Single Family Residence Estimated Gallons Per Day Flow: 360 System Flow: N/A Design Specifications Drainfield Size: 300 Loading Rate(gpolft.2): 0.3 Depth of Gravel in Trench: N/A Gravel Size: N/A Max.Trench Depth (Low Side): 30 in. Repair Trench Bottom 30 in. Trench Width: 36 in. Septic Tank Size: 1000 Estimated Supply Line Length: 22 Supply Line Diameter: 4 in. SCH 40 PVC Supply Line Volume: 14.37 Dosing Volume: N/A Supply Manifold: N/A Supply Manifold Length: N/A Supply Manifold Volume: N/A Recommended Float Controls: N/A Recommended Control Panel: N/A Pressure Head: N/A Friction Head: N/A Elevation Head: N/A Total Dynamic Head: NIA Threaded Union: N/A Gate Valves: N/A Check Valves: N/A Anti-Siphon Hole: N/A Additional Comments: Soil suitability was performed by Soil & Forestry Services of the Carolinas, PA 3 3916 E Maiden Rd ACCEPTED SYSTEM DESIGN FLOW(gpd): 360 SOIL APPLICATION RATE(gpolft.2): 0.3 TOTAL AREA TRENCH BOTTOM: 900 TOTAL LATERAL LENGTH: 300 NUMBER OF FIELDS: 1 LATERAL LENGTH REQUIRED PER FIELD: 300 SUPPLY LINE LENGTH: 22 TOTAL DYNAMIC HEAD: N/A MANIFOLD SIZE: N/A DOSING VOLUME: N/A PUMP TANK DRAW DOWN*: N/A SEPTIC TANK SIZE: 1000 I 4 Layout Specifications -3916 E Maiden Lot 2 Project#: 23-0026 LAYOUT FOR 3 BEDROOM HOME 6/14/2023 FLAG FLAGGED DESIGN LINE# COLOR BS HI FS ELEVATION LINE LENGTH LINE LENGTH TB M INSTR. I 1 ORANGE 97 94 2 RED 91 90 3 PINK 77 74 4 BLUE 72 42 5 YELLOW 67 67 6 ORANGE 73 73 7 RED 55 55 8 PINK 50 50 9 BLUE 43 43 10 YELLOW 44 44 11 ORANGE 42 47 12 RED 45 45 Total 756 719 sou. Low Side LINE STAR SYSTEM LTAR TRENCH MAX TRENCH LENGTH CPD/FT2 TYPE GPD/FT2 SYSTEM DISTRIBUTION DEPTH *System 300 0.300 ACCEPT. 0.300 25%RED GRAVITY 30" Repair 461 0.300 ACCEPT. 0.300 25%RED GRAVITY 30" Notes: **All measures in feet **Nitrification lines are demonstrated on contour via colored pin flags **Nitrification lines were located by GPS and tape measure. **House Envelope, Property corners& lines located by survey(Patterson Land Surveyors) 1 / • • /cbc) �/ f 0) /3,7 • „,/ 0) \s. 10YOI? � 9 6 /`\J �O ', J CA ���M �- , I i� / \ ar �j F .rJ r %" \ / *, a \ e/Y a I \ ,aO �`r_ ,� i ' GNo p. \-3; �� tit O Lea, ER a \ r- II NORTH \\\ \ om CP \ LI`, ... :- \Te, 7J / \•� \ \ �` / \ may \ / 4 \ =.1 -- —1_,,_/ --— \ \ \ W ,o� co \ \ o 1 \ \ n \ . . 4,_....... I. .. Z— sr 4� •aF / / ; '44rQy Iii •., /v ,. iv .\. . ,&)0400 s \ c R. $.. ; I \ mi ' ll, 47 • y ‘� MI ° I \\ \ J� \I ` Ill i NORTH \ r• \ ‘... J, N6Ci • • ice !PIP 10 1 1 1 31 11-f--- --------------, ... / ! a i Pi 1 g :1, 1 g i II �1 it it '� . i 1 ,- i ill iron 1• \ 4 PP M v�/7 47 a S g3 \ `t ‘ h 1 4 1 i 1,,.. „ 1. -Aitt lit i \ 1 PP \ IiliI , l iU ° il a 11 � o a.1' g t 1 a / i Ail '6 \\ `\ ` \ -- \ YN� — f ,\ g ; - , frI , 1 1;VA m : ik i Lai ii r�� � 1 I i l k it PA 8 s_. h R al 041fic ,:... .- ".-) : II gli% ilki L.' 1 r P i a i asiii 81 • 8 CALCULATIONS Location 3916 E Maiden RD Maiden, NC 28650 Project Number 23-0026 Lot No: 2 No. of Bedrooms 3 Design Flow 360 gal/day LTAR 0.300 galift2day PPBPS?(YES OR NO) NO Supply Line Length 22 ft. Supply Line Volume 14.366 gal. FRICTION FACTOR INTERPOLATER Required Feet of Line 300 ft. 2"SCH 40 PVC Amount of Line from Layout 300 ft. GPM f 20 0.84 Gallons per Minute N/A ° l/m,n -0.88 25 1.27 Required Septic Tank Capacity 1000 gal. -1.28 Septic Tank Size 1000 gal. 30 1.78 -1.76 Panel Volume N/A gal. 35 2.37 #of Panels N/A -2 25 Dosing Volume N/A gal. 40 3.03 43.07 3.48 45 3.77 48.14 4.28 50 4.58 57.11 5.89 60 6.42 Tank Draw Down N/A Pump Run Time Elevation Head N/A ft. Pressure Head N/A ft. Friction Factor N/A ft./100 ft. (From the intepotater.) Friction Head N/A ft. Total Dynamic Head (+15%) N/A ft. Sheet 1 of 1 PROPERTY ID it: 366602859041 COUNTY: Catawba SOIUSITE EVALUATION for ON-SITE WASTEWATER SYSTEM (complete all fields in full) OWNER: Modem Construction&Real Estate LLC APPLICATION ATED: ADDRESS: 2146 Hephzibah Church Rd Bessener City NC 2801E DATE EVALUATED: 3I212023 PROPOSED FACILITY: 3 bedroom Residence PROPERTY SIZE: 1.23 LOCATION OF SITE: 391E E.Maiden Rd Maiden NC 28650 PROPERTY RECORDED: YES WATER SUPPLY: El Private ❑ Well 0 Spring 0 Other EVALUATION METHOD: 0 Auger Boring El Pit ❑Cut TYPE OF WASTEWATER: El Sewage 0 Industrial Process 0 Mixed P 1 R O SOIL MORPHOLOGY OTHER F .1940 HORIZON (.1941) ILANDSCAPE DEPTH PROFILE FACTORS PROFILE L POSITION! (IN.) CLASS E SLOPE% .1941 .1942 &LTAR .1941 .1943 .1966 .1944 STRUCTURE! CONSISTENCE! SOIL SOIL SAPR RESTR itTEXTURE MINERALOGY WETNESS! DEPTH CLASS HORIZ 0-22 BRCWFABKISBK FRSSSP rnr nR 22-48 BRCWMSBK FRSSSP F Schist 1 U5% 48 PS-0.3 - 0-7 RBCLWFSBK FRSSSP 7-28 BRCWFABKISBK FRSSP 2 U5% 28-48 BRCWMSBK/ABK FRSSSP 48 PS-0.3 0-10 RBCLWFSBK FRSSSP 10-29 RBCWFSBK/ABK FRSSSP 3 U5% 29-49 BRCWMSBK FRSSP 49 PS-0.3 0-10 BCLWFSBK FRSSSP 10-35 BRCWFSBK/ABK FRSSSP 4 L16% 35-51 - 51 PS-0.3 0-5 BSLGR FRSSSP 5-12 RBCLWFSBK FRSSSP 5 1/5% 12-54 BRCWMSBK/ABK FRSP F-C WR/LITHO 54 PS-0.3 0-11 BCLWFSBK FRSSSP 11-32 RBCWFSBK/ABK FRSSSP - 6 1../5% 32-54 BRCWMSBK FRSSSP 54 PS-0.3 0-7 BSLGR FRSSSP 7-16 RBCLWFSBK FRSSSP F GRAVEL I 7 L/6% 16-28 RRCWMSBK/ABK FRSSSP r - r ! 26-51 BRCWFABKISBK FRSSP F WR/LITHO ,v� .�""" ""^�.,,�Cf PS-0.3 0-11 BCLWFSBK FRSSSP C' - ire. Ir 0� ‘)_ 11-54 BRCWFSBK/ABK FRSSP F WR/LITHO �\ �- ��` �� 8 U7% Li �: ri �..;' r�•$.:_ �, �� ;PS-0.3 0-17 a` ,7 ,..1,.. �7 , BCLWFSBK FRSSSP 1 - --}' y's//'./ 17-30 RBCWMSBK FRSSP 144iii - Lvv/'� 9 US% 30-51 RCWFSBK/ABK FRSSP F LITHO - 51 �- ` `' ;`��I ,PS-0.3 AC/ i"*.,.._ ' ' ..,/,,;.S5:?;/ DESCRIPTION INITIAL SYSTEM REPAIR SYSTEM OTHER FACTORS(.1946): SITE CLASSIFICATION(.1948): PS Available Space(.1946) PS PS S stem T EVALUATED BY: Ashley Rollins y ypes(s) ACCEPTED ACCEPTED OTHER(S)PRESENT: Chad Wagner&Mason Freeman Site LTAR 0.3 0.3 COMMENTS: / J