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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