HomeMy WebLinkAboutAUTH-10-2014-054509.TIF /1 - t b9
.., MAINTENANCE REPORT FORM
A� � Name and Location of System Date of Inspection
4: ,�. �� ;,' 1 f Cameron Hatcher 19 Jul 2016
8777 Bass Dr Permit Number
Effill4r'.n ent` I Services Terrell, NC 28682 PIN#:461604729104
Operators Responsible for Care (0.R.C.'s): System Classification
Jack Moore - Certified Operator #985357 Phone (704) 904-7538 Type IV-A
Phone
David Lynch - Certified Operator #996383 Alternate Mailing Address
J.C. Moore Phone (704) 873-2171 Subdivision
1227 Troutman Drive Fax (704) 873-9928 Kiser Sunset Keys 1
Statesville, NC 28625 Mobile(704) 902-1122 County Phone
Catawba Phone
SEPTIC TANK AND PUMP TANK LOW PRESSURE PIPE SYSTEM
Risers accessible? [S] Satisfactory Turnups,cleanouts,valves
Signs of infiltration? [S] Satisfactory located and protected?
[S] Satisfactory
Structurally sound? [S1 Satisfactory Laterals free of excess solids? [S] Satisfactory
Landscape position? [5] Satisfactory Laterals flushed? YES
Septic tank filter cleaned? YES
Pump tank filter cleaned? [N/A] Not Applicable
PRESSURE HEADS
SOLIDS ACCUMULATION DESIGN HEAD ADJUSTED HEAD
Line 1 2 2
Approximate Quantity of Solid Waste in Septic Tank Line 2 2 2
Line 3 2 2
INLET Scum: — I in. Sludge: — 3 in. Line 4 2 2
OUTLET Scum: — 0 in. Sludge: — 4 in.
Approximate Percentage of Solids to Liquid Waste in Tank RECEIVED
8 %
AUG 0 4 2016
DRAIN FIELD
No effluent surfacing? [5] Satisfactory CA TAW AUJ HA COUNTY
Surface water diverted? [S] Satisfactory ENVIRONMENTAL HEALTH
Line cover maintained properly? [S] Satisfactory
Protected from traffic? [S] Satisfactory COMMENTS
Distribution devices operating properly? [S] Satisfactory
Repair area reserved? [5] Satisfactory
PUMP
Pump present and operating?
Design GPM 27
Actual GPM 35
Efficiency 129%
High water alarm operating properly? [5] Satisfactory
Pipework in good condition? [5] Satisfactory
Control panel in good condition? [5] Satisfactory
Control floats operating properly? Es] Satisfactory
Straps/float tree in good condition? [5] Satisfactory
Effluent free and clear of solids? [S] Satisfactory
MAINTENANCE REPORT FORM
L�4M 1
0 . Name and Location ofS stem
Y Date of Inspection
),,II Cameron Hatcher
8777 Bass Dr 12 Jan 2022
aEPIIV RAI►P IPlrfft/'il SPniir, .S Permit Number
lik, Terrell, NC 28682 PIN#:461604729104
Operators Responsible for Care (O.R.C.'s): System Classification
Jack Moore - Certified Operator #985357 Phone (704) 904-7538 Type IV-A
Phone
David Lynch - Certified Operator #996383 Alternate Mailing Address
J.C. Moore Phone (704) 873-2171 Subdivision
1227 Troutman Drive Fax (704) 873-9928 Kiser Sunset Keys 1
Statesville, NC 28625 Mobile(704) 902-1122 County Phone
Catawba Phone
SEPTIC TANK AND PUMP TANK LOW PRESSURE PIPE SYSTEM
Risers accessible? [S] Satisfactory Turnups,cleanouts,valves
Signs of infiltration? [5 I Satisfactory located and protected? [S] Satisfactory
Structurally sound? [S] Satisfactory Laterals free of excess solids? [SI Satisfactory
Landscape position? [5] Satisfactory Laterals flushed? YES
Septic tank filter cleaned? YES
Pump tank filter cleaned? [N/A] Not Applicable
PRESSURE HEADS
SOLIDS ACCUMULATION DESIGN HEAD ADJUSTED HEAD
Line 1 2 2
Approximate Quantity of Solid Waste in Septic Tank Line 2 2 2
Line 3 2 2
INLET Scum: — 1 in. Sludge: 8 in. Line 4 2 2
OUTLET Scum: — 0 in. Sludge: — 9 in.
Approximate Percentage of Solids to Liquid Waste in Tank
18 i
DRAIN FIELD
No effluent surfacing? [5] Satisfactory -_-
Surface water diverted? [5 I Satisfactory
Line cover maintained properly? [S] Satisfactory
Protected from traffic? [5] satisfactory COMMENTS
Distribution devices operating properly? ES] Satisfactory
Repair area reserved? [S j Satisfactory
PUMP
Pump present and operating?
Design GPM 27 s.
Actual GPM 27 it.. : r)
Efficiency 100% .1...""
High water alarm operating properly? [S] Satisfactory A��
Pipework in good condition? [S] Satisfactory 5 2022
Control panel in good condition? [5] Satisfactory
Control floats operating properly? [S] Satisfactory
Straps/float tree in good condition? [S I Satisfactory Ef1Yiltif; 6ttiaj IE-_3ftil
Effluent free and clear of solids? [S] Satisfactory
OHf o
MAINTENANCE REPORT FORM
m ;
Name and Location of System Date of Inspection
i�f�� Cameron Hatcher 15 Jul 2022
16
8777 Bass Dr
FrivO mini '�?A,R oirli' SPrvir`Pc Permit Number
' Terrell, NC 28682 PIN#:461604729104
Operators Responsible for Care (O.R.C.'s): System Classification
Jack Moore - Certified Operator #985357 Phone (704) 904-7538 Type IV-A
Phone
David Lynch - Certified Operator #996383 Alternate Mailing Address
J.C. Moore Phone (704) 873-2171 Subdivision
1227 Troutman Drive Fax (704) 873-9928 Kiser Sunset Keys 1
Statesville, NC 28625 Mobile(704) 902-1122 County Phone
Catawba Phone
SEPTIC TANK AND PUMP TANK LOW PRESSURE PIPE SYSTEM
Risers accessible? [5] Satisfactory Turnups,cleanouts,valves
Signs of infiltration? [5] Satisfactory located and protected? [5] Satisfactory
Structurally sound? [5] Satisfactory Laterals free of excess solids? (5] Satisfactory
Landscape position? [S] Satisfactory Laterals flushed? YES
Septic tank filter cleaned? YES
Pump tank filter cleaned? [N/A] Not Applicable
PRESSURE HEADS
SOLIDS ACCUMULATION DESIGN HEAD ADJUSTED HEAD
Line 1 2 2
Approximate Quantity of Solid Waste in Septic Tank Line 2 2 2
Line 3 2 2
INLET Scum: — 1 in. Sludge: — 9 in. Line 4 2 2
OUTLET Scum: — 0 in. Sludge: — 9 in.
Approximate Percentage of Solids to Liquid Waste in Tank
" 20 %
DRAIN FIELD
No effluent surfacing? [S] Satisfactory _
Surface water diverted? [S] Satisfactory
Line cover maintained properly? [5] Satisfactory
Protected from traffic? [S] Satisfactory COMMENTS
Distribution devices operating properly? [5] Satisfactory
Repair area reserved? [5 I Satisfactory
PUMP
Pump present and operating?
Design GPM 27
Actual GPM 27
Efficiency 100%
High water alarm operating properly? [5] Satisfactory
Pipework in good condition? [S] Satisfactory
Control panel in good condition? [S] Satisfactory
Control floats operating properly? [S] Satisfactory
Straps/float tree in good condition? [5] Satisfactory
Effluent free and clear of solids? IS] Satisfactory
4( -rvi OS 1 D I
MAINTENANCE REPORT FORM
M } Name and Location of System Date of Inspection
d Cameron Hatcher 11 Jan 2023
F,wironmenfrlI SPr1Ai!`PS 8777 Bass Dr Permit Number
�" Terrell, NC 28682 PIN#:461604729104
Operators Responsible for Care (O.R.C.'s): System Classification
Jack Moore - Certified Operator #985357 Phone (704) 904-7538 Type IV-A
Phone
David Lynch - Certified Operator #996383 Alternate Mailing Address
J.C. Moore Phone (704) 873-2171 Subdivision
1227 Troutman Drive Fax (704) 873-9928 Kiser Sunset Keys 1
Statesville, NC 28625 Mobile(704) 902-1122 County Phone
Catawba Phone
SEPTIC TANK AND PUMP TANK LOW PRESSURE PIPE SYSTEM
Risers accessible? [S] Satisfactory Turnups, cleanouts, valves
Signs of infiltration? [5] Satisfactory located and protected? [5] Satisfactory
Structurally sound? [5] Satisfactory Laterals free of excess solids? [5] Satisfactory
Landscape position? [S] Satisfactory Laterals flushed? YES
Septic tank filter cleaned? YES
Pump tank filter cleaned? [N/A] Not Applicable
PRESSURE HEADS
SOLIDS ACCUMULATION DESIGN HEAD ADJUSTED HEAD
Line 1 2 2
Approximate Quantity of Solid Waste in Septic Tank Line 2 2 2
Line 3 2 2
INLET Scum: — 2 in. Sludge: — 14 in. Line 4 2 2
OUTLET Scum: — 1 in. Sludge: — 14 in.
Approximate Percentage of Solids to Liquid Waste in Tank
- 33 %
DRAIN FIELD
No effluent surfacing? [S] Satisfactory
Surface water diverted? [S] Satisfactory
Line cover maintained properly? [5] Satisfactory
Protected from traffic? [S] Satisfactory COMMENTS
Distribution devices operating properly? [5] Satisfactory
Repair area reserved? [S] Satisfactory With the placement of artificial grass over the drain lines,
I was unable to find the end cap for the lower line.
PUMP Since the solids have reached 33% of the liquid, the
Pump present and operating? septic tank should be pumped at this time.
Design GPM 27
Actual GPM 27
Efficiency 100% RECEIVED
High water alarm operating properly? Is] Satisfactory
Pipework in good condition? [S] Satisfactory
Control panel in good condition? [S] Satisfactory J A N 3
Control floats operating properly? [SI Satisfactory
Straps/float tree in good condition? [5] Satisfactory
Effluent free and clear of solids? [S] Satisfactory Environmental Health
/71 t1 N v5 i/c ffi
MAINTENANCE REPORT FORM
Name and Location of System Date of Inspection
))11EMH 0 ' ' Cameron Hatcher 11 Jul 2023
•FnyRi�n�rrrAlntnp SP/t�ir'Qc 8777 Bass Dr Permit Number
' Terrell, NC 28682 PIN#:461604729104
Operators Responsible for Care (O.R.C.'s): System Classification
Jack Moore - Certified Operator #985357 Phone (704) 904-7538 Type IV-A
Phone
David Lynch - Certified Operator #996383 Alternate Mailing Address
J.C. Moore Phone (704) 873-2171 Subdivision
1227 Troutman Drive Fax (704)873-9928 Kiser Sunset Keys 1
Statesville, NC 28625 Mobile(704) 902-1122 County Phone
Catawba Phone
SEPTIC TANK AND PUMP TANK LOW PRESSURE PIPE SYSTEM
Risers accessible? [S] Satisfactory Turnups,cleanouts,valves
Signs of infiltration? [S I Satisfactory located and protected?
[S] Satisfactory
Structurally sound? [5 I Satisfactory Laterals free of excess solids? [5] Satisfactory
Landscape position? [5] Satisfactory Laterals flushed? YES
Septic tank filter cleaned? YES
Pump tank filter cleaned? [N/A] Not Applicable
PRESSURE HEADS
SOLIDS ACCUMULATION DESIGN HEAD ADJUSTED HEAD
Line 1 2 2
Approximate Quantity of Solid Waste in Septic Tank Line 2 2 2
Line 3 2 2
INLET Scum: — 1 in. Sludge: — 8 in. Line 4 2 2
OUTLET Scum: — 0 in. Sludge: 8 in.
Approximate Percentage of Solids to Liquid Waste in Tank
- 18 °%
DRAIN FIELD
No effluent surfacing? [5] Satisfactory
Surface water diverted? [S] Satisfactory
Line cover maintained properly? [5] Satisfactory
Protected from traffic? ES] Satisfactory COMMENTS
Distribution devices operating properly? IS] Satisfactory
Repair area reserved? [S] Satisfactory
PUMP
Pump present and operating? C r'r 1\lED
Design GPM 27 ` l�- �-" +�
Actual GPM 27
Efficiency 100% )23
High water alarm operating properly? [5] Satisfactory �' 2
Pipework in good condition? [5] Satisfactory
Control panel in good condition? [5] Satisfactory
Control floats operating properly? [5] Satisfactory Environmental Health
Straps/float tree in good condition? (5] Satisfactory
Effluent free and clear of solids? [5] Satisfactory
au+h-ioit- 054509
MAINTENANCE REPORT FORM
` .1 I i'=� Name and Location of System Date of Inspection
�,` - 1),A Cameron Hatcher 19 Jul 2024
/ 8777 Bass Dr Number
46160Permit
Environmental _ �� i s Terrell, NC 28682 PIN#rmit4729104
Operators Responsible for Care (O.R.C.'s): System Classification
Jack Moore - Certified Operator #985357 Phone (704) 904-7538 Type IV-A
Phone
David Lynch - Certified Operator #996383 Alternate Mailing Address
J.C. Moore Phone (704)873-2171 Subdivision
1227 Troutman Drive Fax (704)873-9928 Kiser Sunset Keys 1
Statesville, NC 28625 Mobile(704)902-1122 County Phone
Catawba Phone
SEPTIC TANK AND PUMP TANK LOW PRESSURE PIPE SYSTEM
Risers accessible? [S] Satisfactory Turnups,cleanouts,valves
Signs of infiltration? [S] Satisfactory located and protected? [S] Satisfactory
Structurally sound? [S] Satisfactory Laterals free of excess solids? [S] Satisfactory
Landscape position? [5] Satisfactory Laterals flushed? YES
Septic tank filter cleaned? YES
Pump tank filter cleaned? [N/A] Not Applicable
PRESSURE HEADS
SOLIDS ACCUMULATION DESIGN HEAD ADJUSTED HEAD
Line 1 2 2
Approximate Quantity of Solid Waste in Septic Tank Line 2 2 2.
Line 3 2 2
INLET Scum: ^' 1 in. Sludge: "' 9 in. Line 4 2 2
OUTLET Scum: ^' 0 in. Sludge: ^' 7 in.
Approximate Percentage of Solids to Liquid Waste in Tank
20
DRAIN FIELD
No effluent surfacing? [S] Satisfactory
Surface water diverted? [S] Satisfactory
Line cover maintained properly? [S] Satisfactory
Protected from traffic? [5] Satisfactory COMMENTS
Distribution devices operating properly? [S] Satisfactory
Repair area reserved? [5] Satisfactory
PUMP
Pump present and operating? ,�.
Design GPM 27 RECEIVED
Actual GPM 27
Efficiency 100%
High water alarm operating properly? [S] Satisfactory S E P 5 2024
Pipework in good condition? [S] Satisfactory
Control panel in good condition? [S] Satisfactory
Control floats operating properly? [5] Satisfactory Environmental Health
Straps/float tree in good condition? [S] Satisfactory
Effluent free and clear of solids? [S] Satisfactory
aU.4-1-1- 10-(9.0N-00-1509
MAINTENANCE REPORT FORM
If Name and Location of System Date of Inspection
Cameron Hatcher 22 Jan 2025
8777 Bass Dr
Environmental Services Permit4 Number
Terrell, NC 28682 PIN#:46160472919104
Operators Responsible for Care (O.R.C.'s): System Classification
Jack Moore - Certified Operator #985357 Phone (704) 904-7538 Type IV-A
Phone
David Lynch - Certified Operator #996383 Alternate Mailing Address
J.C. Moore Phone (704)873-2171 Subdivision
1227 Troutman Drive Fax (704)873-9928 Kiser Sunset Keys 1
Statesville, NC 28625 Mobile(704)902-1122 County Phone
Catawba Phone
SEPTIC TANK AND PUMP TANK LOW PRESSURE PIPE SYSTEM
Risers accessible? [5] Satisfactory Turnups,cleanouts,valves
Signs of infiltration? [5] Satisfactory located and protected? [S] Satisfactory
Structurally sound? [5] Satisfactory Laterals free of excess solids? [S] Satisfactory
Landscape position? [S] Satisfactory Laterals flushed? YES
Septic tank filter cleaned? YES
Pump tank filter cleaned? [N/A] Not Applicable
PRESSURE HEADS
SOLIDS ACCUMULATION DESIGN HEAD ADJUSTED HEAD
Line 1 2 2
Approximate Quantity of Solid Waste in Septic Tank Line 2 2 2
Line 3 2 2
INLET Scum: — 1 in. Sludge: ^' 10 in. Line4 2 2
OUTLET Scum: ^' 0 in. Sludge: — 12 in.
Approximate Percentage of Solids to Liquid Waste in Tank
~ 25
DRAIN FIELD
No effluent surfacing? [S] Satisfactory
Surface water diverted? [5] Satisfactory
Line cover maintained properly? [S] Satisfactory
Protected from traffic? [S] Satisfactory COMMENTS
Distribution devices operating properly? [S] Satisfactory
Repair area reserved? [5] Satisfactory
PUMP
Pump present and operating?
Design GPM 27
Actual GPM 27
Efficiency 100%
High water alarm operating properly? [S] Satisfactory RECEIVE.
Pipework in good condition? [S] Satisfactory
Control panel in good condition? [5] Satisfactory
Control floats operating properly? [S] Satisfactory
Straps/float tree in good condition? [S] Satisfactory MAR 2 8 2025
Effluent free and clear of solids? [S] Satisfactory
Environrerital Health