The URL can be used to link to this page

232 Essic RdDAVIE COUNTY ENVIRONMENTAL HEALTH P.O. Box 848/210 Hospital Street Mocksville, NC 27028 (336)753-6780 /Fax # (336)753-1680 Account #: 990005952 Billed To: Tony Montieth Reference Name: Proposed Facility: Residential - Kennel ATC Number: 5986 OPERATION PERMIT Tax PINIEH #: B400000002 Subdivision Into: Location/Address: 232' Essic Road -27028 Property Size: , 18:63 Acres **NOTE** The issuance of this Operation Permit shall indicate the system described on the ATC has been installed in compliance with Article 11 of G.S. Chapter 130A, Section .1900 "Sewage Treatment and Disposal Systems," but shall in NO WAY be taken as a guarantee that the system will function satisfactorily for any given period of time. �� 1 J 2_ System Type:_ S.T. Manufacturer Tank Da Size �_ Pump Tank Size Bedroomss System Installed By: Installer# Date: (7 aQ GPS Coordinate: Environmental Health DCHD 11/06 (Revised) r hfllFvs iA 0qr1V oock ,6V �1 pw P d lja;r Is I , DAVIE COUNTY ENVIRONMENTAL HEALTH P.O. Box 848/210 Hospital Street. Mocksville, NC 27028 (336)753-6780 / Fax # (336)753-1680 AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION Account ##: 990005952 Billed To: Tony Montieth Reference Nanie: Proposed Facility: Residential - Kennel ATC Number: 5986 Tax PIN/EH ##: B400000002 Subdivision Info- Location/Address: 232' Essic Road -27028 hroperi.y Size:: 18:63 Acres Site Type: New ❑Repair ❑Expansion **NOTE** This Authorization to Construct (ATC) MUST BE ISSUED by the Davie County Environmental Health Section prior tp issuance of any building permit(s), (in compliance with Article 11 of G.S. Chapter 130A Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems). THIS AUTHORIZATION TO CONSTRUCT IS VALID FOR A PERIOD OF FIVE YEARS. This ATC is subject to revocation if site plans, plat or the intended use change. Residential Specifications: # Bedrooms # Bathrooms # People Basement❑ Basement plumbing❑ Non -Residential Specifications: Facility Type_A0LLKe4 ntf # People # Seats Square Footage(oZpimensions of Facility) Lot Size Type of Water Supply: ❑County/City UWell ❑Community Well ra System Specifications: Design Wastewater Flow (GPD) B0_Tank size ICOO GAL. Pump Tank GAL. Trench Width Max. Trench Depth Rock Depth I Z it Linear Ft. � (O`(ao&�O( Site Modifications/Conditions/Other:Arl 04-C &A Contact the Davie County Environmental Health Section for final inspection of this system between 8:30 = 9:30a.m. on the day of installation. Telephone # (336)751-8760. Environmental Health Specialist DCHD 11/06 (Revised) D /Z Y INDUSTRIAL PROCESS SUBSURFACE WASTEWATER SYSTEM DESIGN CRITERIA FOR DOG KENNELS AND/OR VET CLINICS WITHOUT X-RAY FACILITIES* 1. Flow shall be determined as follows: Dog Kennel Only: 10 gpd per dog or per run, whichever is greater, plus 25 gpd per employee. Vet Clinic Only: 150 gpd/1000 sq. fi. of clinic area plus 25 gpd per employee. Vet Clinic and Dog Kennel: 150 gpd/1000 sq. ft. of clinic area plus 25 gpd per employee plus 10 gpd per dog boarded. 2. Screens to catch hair and other solids shall be provided at the floor drains or, ifa trench system is used, at the inlet to the collection pipe 3. Rain water must be prevented from entering the wastewater subsurface system. 4. Two state -approved septic tanks, with access openings extended to finished grade shall be installed in series. The capacity of each tank shall be sufficient to handle the total flow and shall be determined in accordance with 15A NCAC 18A. 1952(b). The first septic tank shall receive only process wastewater generated at the dog kennels (no toilet wastewater). The second septic tank shall receive effluent from the first tank, in addition to sewage, if any. 6. The effluent end of the first septic tank shall be fitted with a filter capable of filtering animal hair. The second septic tank shall have an effluent filter or a standard effluent sanitary, tee. 7. Graveless nitrification trench systems [. 1956(3)(a)] shall not be used. 8. Approved chamber trench systems and polystyrene trench systems [15A NCAC 18A .1969 (3)], may be used. The design (equivalent) trench width and equivalency factor shall not exceed the excavated trench width (no reduction in area from comparable conventional trench system shall be permitted). 9. For low pressure pipe systems [. 1957(a)] the long-term acceptance rate shall not exceed the mean rate for the applicable soil group. 10. Operation and Maintenance procedures shall be agreed upon by the owners and made conditions of the operation permit, including: a. The provisions of 15A NCAC 18A. 1961 shall be met. b. Soaps, shampoos, and other cleaning agents shall be biodegradable. Synthetic pesticides and insecticides (e.g. those used in the treatment for ticks) shall not be discharged in the system. DESIGN CRITERIA FOR DOG KENNELS AND/OR VET CLINICS WITHOUT X-RAY FACILITIES* (CONTINUED) C. A Material Safety Data Sheet of each chemical used at the facility shall be provided to the health department. d. Disinfectants shall not be used during washdown. Cages and runs may be disinfected manually without rinsing. e. Hoses shall be fitted with pressure spray devices to control flow and minimize water loss. f. Solids deposited in the runs shall be raked or otherwise prevented from entering the subsurface system. g. The hair filter in the first septic tank shall be cleaned weekly. *NOTE FOR DOG KENNELS AND/OR VET CLINICS WITII X-RAY FACILITIES: I. Wastewater System Plans and specifications shall be prepared by a professional engineer and approved by the On -Site Wastewater Section. II. All criteria for Dog Kennels and/or Vet Clinics without X -Ray facilities shall also be met. III. Spent fixer and developer solutions shall be handled off-site by a specialized hazardous waste hauler. No virgin or spent fixer and developer solutions shall be discharged into the subsurface system. IV. Rinse bath wastewater only may be discharged after treatment by a silver recovery unit. Silver recovery unit plans and specifications including treatment capacities, and predicted discharge silver concentration must be provided. Maintenance procedures shall include the replacement or replenishment of the silver recovery unit at 50 percent utilization, and the requirement to maintain a contract for unit service. Operational controls required may include periodic sampling of the effluent and of the groundwater for Total Silver concentration. Davie County Environmental Health P.O. Box 848/210 Hospital Street Mocksville, NC 27028 (336)753-6780 / Fax (336)753-1680 IMPROVEMENT PERMIT Account #: 990005952 Tax PIN/EH #: B400000002 Billed To: Tony Montieth Subdivision Info: Address: 232 Essic Road Location/Address: 232' Essic Road -27028 City: Mocksville Property Size: 18.63 Acres Reference Name: Proposed Facility: Residential - Kennel **NOTE* *This Improvement Permit DOES NOT authorize the construction of a wastewater system. An Authorization To Construct a wastewater system must be obtained from this office prior to the construction/installation of a wastewater system or the issuance of a building permit(in compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems). This Improvement Permit is subject to revocation if site plans, plat or the intended use change. Permit Type: f(New ❑Repair ❑Expansion Permit Valid for: 05 Years ❑No Expiration Residential Specifications: # Bedrooms # Bathrooms # People Basement❑ Basement plumbing❑ Non -Residential Specifications: Facility Type # PeopleQ�J� Square Footage(o i ensions of Facility) // Design Flow(GPD): b Type of Water Supply: ❑County/City (2i7Well []Community Well Site Modifications/Permit Conditions: I.p.1 i-vo 09/20/2012 09:35 2076673617 bt THE UPS STORE TION FOR SITE EVALVATION/IN(I'ROVEMENT PERMIT Davie County Environmental Health P.O. Boa 848/210 Hospital Street Mocksville, NC 27028 (336)753-6780/ Fax (336)753-1680. PAGE 03 & SFp top By. �52012 � ration For: ❑ Site�;valuationAmptovement ??ermit ❑ Authorization To Construct (.ATC) Both Tvpe of Apolication.: ew Svstem ORepair to Existing System ❑Exoansioa/Modifrcation of Rxistini%vstem or Facility .*'Idfl10RTAN7'=' TMS APPLICATION CANNOT BE PROC'FSSED UNLESS ALL OF THE REQUIRED INFORMATION TS PROVTDED. Refer to the INFORMATION. BULLETIN for instructions. APPLICANT TNFORMAT ON Name Tes r4 M o" -f t arH Contact Person Address �),'3'�. f S tS C Room Home Phone 3CQ- 399- y/4 6 City/State/ZIP /ha tint s � ts" L & ni L -T XC32.% Business PhcdK - 311ct - y 19 C) Email r- n +ru i r+ e cg2eJryr,net roM1./ Name on P it/ATC if Dererrt than Above - Mailing Address City e/7-ip PROPERTY INFORMATION *Date NOTE; A survey, plat or site plan must accompany this application. Included: 0 Site Plan OPlat(to scale) (Permit is valid for 60 months with site plan, no expiration with complete plat.) Oxmer's Name' ' To r•t 4 H a e:x t er'i H Phone Number Ownet'sAddress 232 esSiC 2oft�, City/State/Zip r"cc.r-svikcp Nc za g Property Address 7 -VL grss/c MCAV City___ &ac - Lot Size Tax PIN# Subdivision Name(if applicable) Section/Lot# 9 40 00 0o o o�7 +� Directions To Site: If the answer to any of the following questions .is"Yes",supporting documentation must be attached: ^ n Are there any existing wastewater systems on the site? _Yes No o N (S Does the site Contain jurisdictional wetlands? Yes ✓No Are there any easements or right-of-ways on the site? _Yeso Is the site subject to approval by another public agency? ,_Yes o Will wastewater other than domestic sewaue be r=eratcd? Yes V Vo TF RRSID NCR, FTT 7, OT JT TRF.13OX BELOW # People 2_ #.Bedrooms 0 _ # Batilooms Garden Tub/Whirlpool ❑Yes ❑No Basement:OYes Ko Basement Plumbing: ❑Yes EiNo IF NON-RF,SID NCV FIT.1, OUTi' THF. T3OX AF.L0W Type of Facility/Business 4ef. e/ rb,- oc.w V A•,fyTotal Square Footage of Building 674 # People V # Sinks ! # Commodes 0 # Showers / # Urinals D Estimated Water Usage (gallons per day) (Attach. documentation of similar facility water consumption) FOODSERVICE ONLY: # Scats Type system requested: 9Conventional ❑Accepted UInnovative ❑Alternative ❑Other Water Supply Type: O County/City Water ❑ New Well ilYExisting Well O Community We}l Do you anticipate additions or expansions of the facility this system is intended to serve? O Yes Vrq. Tf yes, what type? This is to certify that the information provided on this application is true and correct to the best of my knowledge. l understand that any permit(s) or ATC(s) issued hereafter are subject to suspension or revocation if the site is altered, the intended use changes, or if the information submitted in this application is talsifled or changed I hereby grant right of entry to the Authorized Representative of the Davie County Health Department to conduct necessary inspections to determine compliance with applicable laws and rules. �Iu,D der �r�esponsiblq for the proper identification and labeling of property lines and comers and locating and flagging *Aed well location and the location of any other amenities. ( Site Revisit Charge pe wner's legal representative signature Date(s): Client Notification Date: Oat EHS: �k Si 14i Ia t f0- c�Q,z-53s-'l�l�s �j_q �f Sign given Cites a Account # `� j5Z, Revised 11106 Invoice # g el o DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/ Site Evaluation APPLICANT INFORMATION PROPERTY INFORMATION Account #: 990005952 Tax PIN/EH #: B400000002 Billed To: Tony Montieth Subdivision Info: Reference Name: Location/Address: 232' Essic Road -27028 Proposed Facility: Residential - Kennel Property Size: 18.63 Acres Date Evaluated: WVIZ Water Supply: On -Site Well Community Public Evaluation By: Auger Boring Pit Cut FACTORS 1 2 3 4 5 6 7 Landscape position l_ Slope % c p HORIZON I DEPTH 0-_ - Texture rou Texture Consistence Structure Mineralogy HORIZON II DEPTH Texture group Consistence F Structure Mineralogy; 1 HORIZON III DEPTH Texture group Consistence Structure Mineralogy HORIZON IV DEPTH Texture group Consistence Structure Mineralogy SOIL WETNESS RESTRICTIVE HORIZON SAPROLITE CLASSIFICATION LONG-TERM ACCEPTANCE RATE SITE CLASSIFICATION: D LONG-TERMACCEPTANCE L tCE RATE: • f REMARKS: 2 AankI I1QQta& C(1 �' 1V1 Cif LEGEND EVALUATION BY: /T A&L) ctawa ff OTHER(S) PRESENT: Landscape Position R - Ridge S - Shoulder L - Linear slope FS - Foot slope N - Nose slope CC - Concave slope CV - Convex slope T - Terrace FP - Flood plain H - Head slope Texture S - Sand LS - Loamy sand SL - Sandy loam L - Loam SI - Silt SICL - Silty clay loam SIL - Silty loam CL - Clay loam SCL - Sandy clay loam SC - Sandy clay SIC - Silty clay C - Clay CONSISTENCE Moist VFR - Very friable FR - Friable FI - Firm VFI - Very firm EFI - Extremely firm HSI NS - Non sticky SS - Slightly sticky S - Sticky VS - Very Sticky NP - Non plastic SP - Slightly plastic P - Plastic VP - Very plastic SC - Single grain M - Massive CR - Crumb GR - Granular ABK - Angular blocky SBK - Subangular blocky PL - Platy PR - Prismatic Mineralogy 1:1, 2:1, Mixed otes Horizon depth - In inches Depth of fill - In inches Restrictive horizon - Thickness and inches from land surface Saprolite - S(suitable), U(unsuitable) Soil wetness - Inches from land surface to free water or inches from land surface to soil colors with chroma 2 or less Classification - S(suitable), PS(provisionally suitable), U(unsuitable) LTAR - Long-term acceptance rate - gal/day/ft2 DCHD 05105 (Revised) ro 1 JAMES E. D.B. 201 EXIS I'll Roy EXISTIN IRON V ko E. ESSIC NOW OR F0RA(EIfLY OWNED BY HWY 801 NO SCALE VI C'INI T Y MAP . , . EXISTING IRON •••�� w ��e w w DFF�� r +ew w r wow w r w+.�ar w r ��w w r w��r r r 7,� _ 680. 1 ��www �rww�wwww��wrw�ssewwa��ww�www��ww N 1 1 0 I 1 .L 1 I U/�vo I 06 I I � 1 w CID 1 � I TONY R. MONTIETH (W l D.B. 4349 PC. 137 I§ PIN# 5823872523 00 1 1 0 1 I i I I f I I W� I 1 r#oK I z z� f 8If I w www w w anav w r �wa� r I w rs�ww w w�..r w .rwe' w. r w .rw,.w w w r„� r w w�„r, w w r•w� r r s w w �,�� w DEED LINE I 1d j�iii. N 86.22 17 w�_ w ww°w•�w wwrwwrr��rw®�rwr„�ww0�ww www.www rww.�rr �rrw,ww�rw�_www..... _ I — cb t' BOB L. SArITfir NOW OFa1 FORMERLY 0 WNED BY TU'I'i'EROIf SURVEYING COMPANY 107 NORTH SALISBURY ST. MOCKSVILLE, N.C. 27028 (336) 751-5616 I, GRADY L. TUTTEROW, CERTIFY THAT UNDER MY DIRECTION AND SUPERVISION, THIS MAP WAS DRAWN FROM AN ACTUAL. FIELD SURVEY MADE BY TUTTEROW SURVEYING COMPANY. SITE PLAN MAP FOR: jwr4 TONY R. MONTIETH PROFESSIONAL "illoSURVEYOR L-2527 REVISIONS S 1 : 50' ARm ". OR"m BY: mE Iim MON-TON �- SEPT -24-2012 G.LTUTTEROW I I 000m NIwE MON—TONY BEING THE TONY R. MONTIETH PROPERTY 50 25 0 50 100 150 (D.B. 434, PG. 137) LYING IN THE CLARKSVILLE TOWNSHIP DAVIE COUNTY, NORTH CAROLINA SCALE IN FEET DR"""0 mumaft 11412-3