2331-2347 Hwy 801N (2)DAVIE COUNTY ENVIRONMENTAL HEALTH
P.O. Box 848/210 Hospital Street
Mocksville, NC 27028
(336)751-8760 Fax # (336)751-8786
OPERATION PERMIT
Account #: 990004221 Tax PIN/EH #: 5842-68-1051
Billed To: Arthur and Beth McCashin, Subdivision Info:
Reference Name: Location/Address: NC Highwary 801 N.-27028
Proposed Facility: Retail/Restaurant Property Size: 4.81 Acres
ATC Number: 4971
**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. t y
System Typ;lzel
S.T. Manufacturer Y`��� Tank Date 3— Tank Size �o
Pump Tankov C e6 -e w
Ll -1 �O�• �
System Installed By: 8 (1yQ U M. i%Le t� �1 E.H. Specialist: lC 06kctl, '61)ate:
r
k
I 15
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DCHD 11/06 (Revised)
/1I
l
DAVIE COUNTY ENVIRONMENTAL HEALTH
P.O. Box 848/210 Hospital Street
Mocksville, NC 27028
(336)751-8760 Fax # (336)751-8786
AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION
Account #: 990004221 Tax PIN/EH #: 5842-68-1051
Billed To: Arthur and Beth McCashin, Subdivision Info:
Reference Name: Location/Address: NC Highwary 801 K-27028
Proposed Facility: Retail/Restaurant Property Size: 4.81 Acres
ATC Number: 4971 Site Type: Rgew ❑Repair ❑Expansion
**NOTE** This Authorization to Construct (ATC) MUST BE ISSUED by the Davie County Environmental
Health Section prior to 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❑
R-es+aL%.r«Nr n
Non -Residential Specifications: Facility Type -t- &6o51P QTfol l# People # Seats DZ
Square Footage(or Dimensions of Facility) 0056 r fZe�ot
Lot Size Type of Water Supply: BI ounty/City ❑Well ❑Community Well
e� 00 aa 000
System Specifications: Design Wastewater Flow (GPD) 7 02;L Tank Size J GAL. Pump Tank 1 GAL.
Trench Width "Sta Max. Trench Depth 3(el' Rock Depth ) a l " Linear Ft.
e1:�C�
Site Modifications/Conditions/Other: � r, crre n Ste- ��C-2 0 7,6 r-eG p J u •2 �
-11f
the Davie County Environmental Health Section for
8:30 — 9:30a.m. on the day of installation. Teli
this system between
33-
116 K
rte_ P
T
Qf>!yy °�0� c 5r5
Environmental Health Spec 1istlg Z
DCHD 11/06 (Revised)
p�nSP-ecfCyJ (mac � � �a�
la r VL'1 r
Date: ` 7 U
Davie County Environmental. Health
• P.O. Box 848/210 Hospital Street
Mocksville, NC 27028
(336)751-8760/ Fax (336)751-8786
IMPROVEMENT PERMIT
Account M 990004221
Billed To: Arthur and Beth McCashin,
Address: 158 McCashin Lane
City: Mocksville
Tax PIN/EH M 5842-68-1051
Subdivision Info:
Location/Address: NC Highwary 801 N.-27028
Property Size: 4.81 Acres
Reference Name:
Proposed Facility: Retail/Restaurant
**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: ONew ❑Repair ❑Expansion Permit Valid for: tl-5 Years ❑No Expiration
Residential Specifications: # Bedrors # Bathrooms # People Basement❑ Basement plumbing❑
K -e -iayra,4 4 (apo SFP-Am'`r—
Non -Residential Specifications: Facility ype —# People 9— # Seats
Square Footage(or Dimensions of Facility)
Design Flow(GPD):� Type of Water Supply: RIn'ounty/City ❑Well ❑Community Well
Site Modifications/Permit Conditions:
System Type LTAR
Initial
Repair 6 11
' Environmental Health Specialist
i.p.11-06
Davie County Environmental Health
• P.O. Box 848/210 Hospital Street
Mocksville, NC 27028
(336)751-8760/ Fax (336)751-8786
IMPROVEMENT PERMIT
Account #: 990004221
Billed To: Arthur and Beth McCashin,
Address: 158 McCashin Lane
City: Mocksville
Reference Name:
Proposed Facility: Retail/Restaurant
Tax PIN/EH #: 5842-68-1051
Subdivision Info:
Location/Address: NC Highwary 801 N.-27028
Property Size: 4.81 Acres
**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: 3<ew ❑Repair ❑Expansion IPermit Valid for: e5 Years ❑No Expiration
Residential Specifications: # Bedrooms # Bathrooms # People Basement❑ Basement plumbing❑
Non -Residential Specifications: Facility Type ..P Uwir6 # People # Seats i �t
Square Footage(or Dimensions of Facility)
Design Flow(GPD): A )�w
Site
Site Plan
15
Type of Water Supply: aunty/City ❑Well ❑Community Well A j
4FlM�m
P
�1tAc
5 Li
Environmental Health Specialist
i.p. 11-06
G
LTAR
Date" .� ��
Mar, 17 Uta U4 234P � eountiy envneaatin *00 ran 4,1120 r•�
DIU
CATION FOR ALUATION/IMF'ROVEMENTPFRMIT & ATC
ty Enviroamentd Hsamt
r.4, s�Ie a�opmu :��treet
NC 2702:;
mP'ovemcnt Pamir O Atnlairat on To Catsttnd(ATQ
ofAppl' C Repair to Exbft System ODcpandonNodification of Existing Systdm or Facility
Ir
Rum—Tw APpum ION GINNOrBEPROa+mm UNLESS ALL OF'I wRmUIBED
INFORMATION IS PROVIDED. Relrr to the INFORMATION MXLMUf far ksUnWoma
�►rri.lt,;nlvr IlvrumviArlyri
M= to be BRIed I ILS ra5�`L/ Cal wt %=
Billing Address' Srh_ tA_ n_ 1t -, _ _ _ H -me Phone 33& -
City/StaWMC-r 5A&+ n,@_ fi M 6 BushessPhom I-S'A7- -333-&-jr 75
Name on Pernnit/ATC if Dfferoxf du n Above
PROPERTY INFORMATION Vate House/Facility Comers Fiagged
NOTE: A survey ptat or site plan must accompany this apples tm:htded: O Site Plan OPtat(to scale)
(PamitiivalidfN60momhswAsitephn.»o maroracompxte1lat-)
Owner's Nam ?cbKn f Z.' WMnC4i-%h,-A PhoneNumber3
Lot S
Lize a PGtC,� b Tax PIldM Z Address Cit '
Subdivision Name(tf cable) _ Sectiod7
Directions To Site: X04D- SHePrtN6rr'm14t1:T AT
If the Answer to am of the following que wns is W. ampportiug d m meutat,= mmn be attached -
Am there any existing wutm-ster systems on the sde? OYes
Does me site contain jurisdictional wetlands? Oyes it IP
Are time any easements or Aft ofwsys on the site? Oyes ONO -a
Is the site s*ed to approval by ano&ap&& agency! Dyes pito
Will wastcewatet Other than domestic be DYes ONO
IF RESIDENCE FILL OUT THE BOX BELOW
# People O — # Bedruon s -0 — # Bathrooms - C - Garden Tob/V I&II3ool Dyes QNS r
Basemeat: OYea m
o BanentPlumftm OYes 8� �� I
IF NON -RESIDENCE FILL OUT THE Box BELOW .� u
Type of Facility/Hu"inessTotal SquarelFbotagv of # People -
# Sinus �_ # Commodes, # Shown O # Urinals Z
Estimated Wates Usage (gallons per tiny)(Attach docvar:ntatioa of similar fncifity water oti
csumpdoa)
FOODMVICE ONLY: # Seats M -_
Type systemrequesteds OConvrationsl JAcceptad Olanovative OAhemative Md6nr
Water So y Type: Qtouoty/Ciw water eu misting well . O Cauattmity well
Do you anticipate additions o: expamions of tie f mlity this syatw is iakoded-a scrw? V Yes Own
Ifyes.whattype? Cr Qm [ A1% GGa•r DA w tar „, Ar M Cu mw AA DV
D
This is to certify that the fidavation provided on this application is las and owned to &c best ofmy Imowledge. I understand gist -any permit(s) or ATgs) issm d hacatter wa subject to smpwiou or revocation if the site is ahw4 theintended use dmV:s, orif -
theinfo toed in this appiicabaa is falsified changed I hereby gcmt aigU ofenhy to the Authorized Representative .
of ie Departent to ooaduct necessary' to determine compliance with applicable laws and rules..
I tststtd - mwWomsi' 1 yfor of props ty lines and garters and locating and flagging
r tlor 11 load I* location of any other amenities:
Revisa Q�Arge.
Date
f
AUAMSS
Sign given Oyes ON* ' Account 6
Revised 11106 Invoice #
Q2 4 rS
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r.o.Dox eaxmaC 270lscycet Mnekav111,PC 37tYS:t
G1�d)751-57601YaQ�7,Cf.K7Rd /
/jpplu.twu C•or: f1.Sne' f>ComuinNl.pv.w"Yvmw U-Authurvluen T0CnnwuaN7Q
type oCApplic,tiox Sytsca - LKepautdl:aiadagSystm nrotvmieWNo &.*ion of EeistingSyslan nr►acility
e1•iNPpRTAKlei THIS AMI KION GINN0rb6PROC=EL) tIML•SS ALL OF 711Y, KEQUIRED
RdFORMAT1oN 1S PKUVMW. Relate dw WPORMAMN 6ULLMN far imuoctio..
APPLICANT INFORMATION
.n,c to be Baled Conmcl raison
linK Address •— . -H-1wrhone_,_.,. -..— .
Nootc wt ramit)A('(if nr,Q'eee.1 tM n Above
M,amRAtidrrs, _ ty'y/5lntdZi�
J'.90PERTY INFORMATIONv'•` •, — aD.teHourciPaci�tfir l' -t it
lyEYIL' hstwey'IK evade ptan imct sr:aepanytttnepp "I.e1m�J: Ll Sme t'bm OPlat(toank) ..
"....lie vsUd la A thi xithate +lion wi0. cvrm.sk VIOL) .L 1.!�•'"`
V _
�r's Name Win. � A 3y1?!1 Phone Number -
Owner a$meCil�w_ ++�—t 1.r(!, e.y/Ctnlet7�p, nlptYJ✓_/ ., '� �o,
Suremy Addre+u _ city y
Latt Siee. C.Z e. _ T.rt PMR _
'SllbdivisimNatrc(ifapDltcable)__ „_,_„^,_ ,_tieUioMntff _ .,
DireclionsToSito:�t[w[l�d�Q_ SMePri�TGrrv�tr ,aT -rNE iwf7�tSft� p
Ifdrea war to any oflhe�bl°w kALAQ Ltfttd f mantMaosdalQ rfltt;A1C .
aE 9 YR”. sM7'^m M.
Are dtere any eruoingwasteever splens ondwsae7.... DYe.Y1fo •
Don rhe six eotnai. tutistlicitonal wcuodaT. :--ryes %(a
a
Ate9 N any nscancaor FUR of"r at Etc site? _UYp g110 �t;{i y,E6ttr1{{,' �1t.Ma S ' J
Is ate aitr. subjeel toIpptoval by anotia public agency? - Dyes bM%n//l) { a—
Wal wesa�..+uvaehra-WndotR the eewitl,�ae�nnatrdt 'flyer tlNn_ ..�.._- __.
RE.tiIDF,NCE IFILLOUT TIM tiOX BROW
ymple -O^ NDrdnwuls. .R.R thasc.ae ^P" ._Wrdrw 7..b/WJ.:.lpoolVYrs. o.
D+!.cetxnt i]Ycs U --71:ue.nent7'Iun09tnX OYet PIC
IF NONAIrS1DENCE FILL 0117 THF BOX BELOW _
Typo afFacili"usmtas ifir?�Ait'a TolalSgalfeFoangcu(BwminP oreuple
•NSinks_8_ YConunWu Jr_.:.t rShowcn O - Nlltinala—.7,—
Estimated W.to Usebc (Sell—. per dry)„ _ (Atwh.dwumauatinn ofsiroilar faciluy.wrus aansutlyniew)
FfX)triP.RVICf ONLY NSeals
ayaov.t requested; nennveaie.ul )Are<pree//Iwtwali.< awtmmat:.<Q%61
W.I. Supply Type: P C..wuyrChy water ve Ovist' well O Cnm.melny welt tf
Dn you antu:p+tr.d.lit or cspenaiens.f" li ility 0—ygctn is u".'" :o a 1 M Yue ON. j
try*, wlnllypey St-gtE.l'r-w7�ehcrf—
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7fi6 ab ramify dui dr w.fvrmditm pmetded on ass epplicuinn
is me and carat h dw best of awknowledge. I vedersand d.at
any pemd(s) orATO(s) icswd Arvada a e yubjectio suspermine w tevocadoe if the tae is altered, the intended u+e dueRes, of if
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ahh Mpatt—a to :�aal.crlrecea�tq l �ryunstblforfProperty tine adumtere end location a...t fLly:..N
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�GoMAPS • Davie County NC Public Access
Davie County, NC - GIS/Mapping System
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• DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
Soil/ Site Evaluation
PP i1'E"fft jNF WQN Tax PIN/EH #: 584MOKY
INFORMATION
Billed To:' Arthur and Beth McCashin, Subdivision Info:
Reference Name: Location/Address: NC Highwary 801 N.-27028
Proposed Facility:.Retail/Restaurant Property Size: 4.81 Acres Date Evaluated:
Water Supply: On -Site Well ! Community Public
Y
,Evaluation By: Auger Boring Pit Cut
FACTORS 1 2 3 4 5
6 7
Landscape position
Slope % 1
HORIZON I DEPTH
Texture group L__ G C t^
C t—
Consistence -fl" J 1l- 641 5P
N 1 f
t�
Structure A B KV5$k Ab kY5 k
V_a1 r Y
Mineralogy A il'r P ,ice t fc-9
A X,r
HORIZON 11 DEPTH / — 1 - T5 3(e
-,L
Texture group I— 15 GL I,jc
e
-
Consistence Ar5E.1420M5P TrIf ('
t/
Structure
Mineralogy i ® µ, irLi i- &4
9
HORIZON III DEPTH
Texture groupL
(�
Consistence
vd-5 v —5
1 i
Structure
Mineralogy�+
HORIZON IV DEPTH
Texture group
Consistence
Structure
Mineralogy
SOIL WETNESS
RESTRICTIVE HORIZON Zr If / G
a`{
-3. (�
SAPROLITE
CLASSIFICATIONS 5 5
LONG-TERM ACCEPTANCE RATE . 17 z a - �
0,17!�_
SITE CLASSIFICATION: EVALUATION BY:
a p
f
-TERM ACCEPTANCE RATE: PRESENT:
OTHERS)
Jt`CTt
_
V
REMARKS:
LEGEND
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
NS - Non sticky. SS.- Slightly sticky S - Sticky VS - Very Sticky
NP - Non plastic SP - Slightly plastic P - Plastic VP - Very plastic
,
Structure
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
Notes
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
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IT
�-�-- NOV 2 5 2008
NCDENR
North Carolina Department of Environment and Ntural Resources
Michael i=. Easley
. Governar
DAVIE COUNTY HEA[?N DEPARTMENT
i Division of Waste Management '.-�...._
William G. Ross Jr., Secretary Underground Storage Tanlc Section
November 20, 2008
CERTIFIED MAIL 7007 0710 0000 7368 1214
RETURN RECEIPT REQUESTED
Mr. Walter Hill, Sr., Registered Agent
Hill Oil Company, Inc.
P.O. Box 367
Lexington, NC 27292
Dear Mr. Hill:
Dexter R. Matthews, Director �.�.
Co -
Re:
Re: Notice of Violation of 15A NCAC 2L..0400
Risk-based Assessment and Corrective Action for
Petroleum Underground Storage Tanks
Furches Shopping Mart -B
2339 NC Hwy 801 North, Mocksville
Davie County
hicident Number: 30768
Risk Classification: High
Ranking: 145
Information received by this office confirms a release or discharge from a petroleum underground
storage tank (UST) system at the above -referenced location. Records indicate that you are the owner or
operator of this UST system. This letter explains the violation(s) and associated corrective action(s) you
must take as a result of the release or discharge in accordance with North Carolina statutes and rules. The
Division of Waste Management, UST Section administers the state's rules for USTs and the required
response for petroleum releases. Those rules are located in Title 15A, Subchapter 2L and Title 15A,
Subchapter 2N of the North Carolina Administrative Code (NCAC).
VIOLATION 1:
Failure to submit a response to the Notice of Regulatory Requirements letter, dated September 10, 2008,
in accordance with Title 15A NCAC 2L .0407(b) to the UST Section by October 15, 2008.
REQUIRED CORRECTIVE ACTION:
Submit a response to the Notice of Regulatory Requirements letter, dated September 10, 2008, in
accordance with Title 15A NCAC 2L .0407(b) to the UST Section by January 5, 2009..
:. i .* ; iAn cquai rpuiI ri;iv: A 0" G?piVy r 1.10 4J.: ^yc'f:d{..P4J1Consumer wCi
,
Please take the corrective action(s) for the above violation(s) as necessary to bring the site into
compliance. , Corrective' actions must be taken and reported to the Winston-Salem Regional Office, within
30 days from the date of this notice, unless otherwise noted in the above corrective actions, to avoid
recommendation of civil penalties for continuing violations.
Penalties may be assessed for the violation(s) described within this Notice of Violation. Your
prompt attention to the items described herein is required. Failure to comply with the State's rules, in the
manner and time specified, may result in the assessment of additional civil penalties and/or the use of ;
other enforcement mechanisms available to the State. Each day that a violation continues may be
considered a separate violation.
Please note that performing'assessment and cleanup work that is not required under. 15ANCAC
2L .0400 is not'reimbursable from the Commercial or Noncommercial Leaking Petroleum Underground
Storage Tank Cleanup Funds.
If you have any questions regarding the actions that must be taken or the rules mentioned in this
letter, please contact me at the address or telephone number listed below._, If you have any questions`
regarding trust fund eligibility or reimbursement, please contact the UST Section Trust Fund Branch at
(919) 733-8486.
Sincerely,
9z
Linda Estkowski
Hydrogeologist
Winston-Salem Regional Office
cc: Davie County Health Department
WSRO
Ryan Kerins
TerraQuest Environmental Consultants, P.C.
100 E. Ruffin Street
Mebane, NC 27302
UST Regional Offices
Asheville (ARO) — 2090 US Highway 70, Swannanoa, NC 28778 (828) 296-4500
Fayetteville (FAY) — 225 Green Street, Suite 714, Systel Building, Fayetteville, NC 28301 (910) 433-3300
Mooresville (MOR) — 610 East Center Avenue, Suite 301, Mooresville, NC 28115 (704) 663-1699
Raleigh (RRO) — 1628 Mail Service Center, Raleigh, NC 27699 (919) 791-4200
Washington (WAS) - 943 Washington Square Mall, Washington, NC 27889 (252) 946-6481
Wilmington (NIL) —127 Cardinal Drive Extension, Wilmington, NC 28405 (910) 796-7215
Winston-Salem (WS)'—'585 Waughtown Street, Winston-Salem, NC 27107 (336) 771-5000
Guilford County Environmental.Health, 1203 Maple Street, Greensboro, NC 27405, (336) 641-3771
FTP: REPORT failure NOV0307.dot
Davie County, NC Tax Parcel Report Thursday, September 22, 2016
- --- - - -
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1951
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WARNING: THIS IS NOT A SURVEY
Parcel Information
Parcel Number: 0500000032 Township: Farmington
NCPIN Number: 5842681051 Municipality:
Account Number: 82530007 Census Tract: 37059-802
Listed Owner 1: J AND B OF FARMINGTON LLC Voting Precinct: FARMINGTON
Mailing Address 1: 158 MCCASHIN LANE Planning Jurisdiction: Davie County
City: MOCKSVILLE Zoning Class: DAVIE COUNTY R-A,H-B
State: NC Zoning Overlay: DAVIE COUNTY QD
Zip Code: 27028-0000 Voluntary Ag. District: No
Legal Description: 5.685 AC HWY 801 Fire Response District: FARMINGTON
Assessed Acreage: 5.06 Elementary School Zone: PINEBROOK
Deed Date: 8/2008 Middle School Zone: NORTH DAVIE
Deed Book / Page: 007680233 Soil Types: MrB2,EnB
Plat Book: Flood Zone: X
Plat Page: Watershed Overlay:
Building Value: 49120.00
Outbuilding & Extra 5580-00
Freatures Value:
Land Value: 218390.00
Total Market Value: 273090.00
Total Assessed Value: 273090.00
All data is provided as is without warranty or guarantee of any kind either expressed or implied including but not limited to the
implied warranties of merchantability or fitness for a particular use. All users of Davie County's GIS website shall hold
Davie County, NC harmless the County of Davie, North Carolina, its agents, consultants, contractors or employees from any and all claims or
°u HS I causes of action due to or arising out of the use or inability to use the GIS data provided by this website.