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1992 Hwy 801SDAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section P. O. Boz 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 IMPROVEMENT/OPERATION PERMIT Account M 990000822 Billed To: Johnson & Company Inc. Reference Name: Henry Johnson Proposed Facility: Business Tax PIN/EH #: 5880-20-5640 Subdivision Info: Location/Address: Hwy. 801 S.-27006 Property Size: See Map ATC Number: 2220 **NOTE** This Improvement/Operation Permit DOES NOT authorize the construction of a septic tank system or any wastewater system. An AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION must be obtained from this Department prior to the construction/installation of a system or the issuance of a building permit (in compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems). THIS PERMIT IS SUBJECT TO REVOCATION IF SITE PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE INSTALLING SYSTEM. Residential Specification: Building TypeCU Le -ea #People #Bedrooms #Baths Dishwasher: ❑ Garbage Disposal: ❑ Washing Machine: ❑ Basement w/Plumbing: ❑ Basement/No Plumbing: ❑ Commercial Specification: Facility Type #People -41:9— #People/Shift _/ #Seats Industrial Waste: ❑ Lot Size Type Water Supply C 6 Design Wastewater Flow (GPD) Site: New 2`* Repair ❑ System Specifications: Tank Size 1,M GAL. Pump Tank Other: Required Site Modifications/Conditions: GAL. Trench Width `,Rock Depth c? Linear Ft.;_ IMPROVEMENT/OPERATION PERMIT LAYOUT - APPROVED EFFLUENT FILTER RISER(S) IF 6 " BELOW FINISHED GRADE. a****NOTICE: Contact a representative of the Davie County Health Department for final inspection of this system between 8:30 a.m. to 9:30 a.m. or 1:00 p.m. to 1:30 p.m. on the day of installation. Telephone # is (336)751-8760.**** Environmental Health Specialist's Signature: Date: DCHD 05/99 (Revised) DAME COUNTY HEALTH DEPARTMENT Environmental Health Section P. O. Boa 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 Account #: 990000822 Billed To: Johnson & Company Inc. Reference Name: Henry Johnson Proposed Facility: Business ATC Number: 2220 Tax PIN/EH #: 5880-20-5640 Subdivision Info: Location/Address: Hwy. 801 S.-27006 Property Size: See Map AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION **NOTE** This Authorization for Wastewater System Construction MUST BE ISSUED by the Davie County Environmental Health Section prior to issuance of any building permit(s). This Form/Authorization Number should be presented to the Davie County Building Inspections Office when applying for building permit(s) (in compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems). THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION IS VALID FOR A PERIOD OF FIVE YEARS. Environmental Health Specialist's Signature: Date: CERTIFICATE OF COMPLETION **NOTE** The issuance of this Certificate of Completion shall indicate the system described on Improvement/Operation Permit 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. M Septic System Installed By: Environmental Health Specialist's Signature: DCHD 05/99 (Revised) 3' IF SwA►J Date: APPLICATION FOR SITE EVALUATION/IMPROVEMENT PERMR & ATCL� 0 U t5 Davie County Health Department ('6 r �� EnKmnmenfal HMO Seaton OGT (4 1999 P.O. Box 848/210 Hospital Street Mocksville, NC 27028 �iCCUU (336)751-8760 - QALTFI DVIE COUi,,TY ***DV0RTJUfV** THIS APPLICATION CANNOT BE PROCdSMW UNLESS ALL THE REQUIRED INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions. 1. Was,* to be Billed l�'�z'�Is a f»iAni/� /,i L. Contact Person hklZ, O , Mailing Address ��_� ( some phone O City/stat./L2P 1�.n� 1�C �1 C �? C) Business Phan*— 2. Haas on Perait/ATC if Different than Above Mailing Address City/state/sip 3. Application For: Site Evaluation 0 Improvement Permit/ATC `Both 4. Systan to servioet 0 House 11 Mobile Home V-19 inesa 0 Industry 0 Other 5. If Residence: i People t Bedrooms # Bathrooms O Dishwasher O Garbage Disposal O Washing Machine 0 Basement/Plusbing 0 BaswntMo Plumbing 6. sf Business/industrVother: specify type f Commodes s showers i people 6 # sink* _— f Urinals * Rater Coolers IF FOODSERVICE: # Seats Estimated Water Usage (gallons per day) 7. Type of nater supply: a-County/City 0 Well 0 Community e. Do you anticipate additions or expansions of the facility this system Is Intended to serve? 0 Yea 19'No If yea, what type? ***IMPORTANT*** CLIENTS MAST COMPLETE THE REQUIRED PROPERTY INFORMATION REQUESTED BELOW. Either a PLAT or SITE PLAN MUST BE SUB11BIM by the client with THIS APPLICATION. Property Dimensions: 5;-uG //i,Qp IF "-Z omen puq. Property Address: Road Name . f�w//1 AV City/Zip If in a Subdivision provide information, as follows: Name: Section: Block: Lot: WRITE DIRECTIONS (from Mocknille) to PROPERTY: r-:?Qoo (5). g'1 ;5-. Date Property Flagged: ��0 —/y`�� This Is to certify that the information provided Is correct to the best of my knowledge. I understand that any permit(s) Issued hereafter are subject to suspension or revocation, If the site plans or Intended nae change, or if the Information submitted In this application Is falsified or changed I, also, understand that I am rtspoxslble jor all charges lncan ed from this applicadom I, hereby, give consent to the Authorized Representative of the Davie Counik kealth Department to enter upon above described property located in Davie County and owned to conduct all testing procedures as necessary to determine the site sui• ty.� DATE /P —/Y`2 9 SIGMA THIS AREA MAY BE USED FOR DRAWING YOUR SITE PLAN property lines and dimensions, structures, setbacks, and septic lot Revised DCHD (07/99) following: Ya&ting and proposed Site Revisit Charge Da"): : Ciieiat irotMcsiion Late: I ERS: Account No. Invoice No. �'2� 10. P . 30' PROPOSED �< h 30'x42' ' v OFFICE PROPOSED 60'x98' PROPOSED BULIDING WAREHOUSE JOHNSON & COMPANY IRRIGATION SALES ADVANCE, N. C. t ( 10 G P/l�- DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/Site Evaluation APPLICANT INFORMATION Account #: 990000822 Billed To: Johnson & Company Inc. Reference Name: Henry Johnson Proposed Facility: Business Water Supply: On -Site Well PROPERTY INFORMATION Tax PIN/EH #: 5880-20-5640 Subdivision Info: Location/Address: Hwy. 801 S.-27006 Property Size: See Map Date Evaluated: Community Public l� Evaluation By: Auger Boring k____ — Pit Cut FACTORS 1 2 3 4 5 6 7 Landscape position L Sloe % HORIZON I DEPTH Texture group Consistence Structure Mineralogy HORIZON II DEPTH Texture group Consistence C2 Structure Mineralogy 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: Z-� LONG-TERM ACCEPTANCE RATE: /�-, (!/ REMARKS: 5Z_2 l I0e" � LEGEND EVALUATION BY: A41 GZ 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 Wet 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 Mineralogv 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 DCHD 05/99 (Revised) ON No onu ON ii ■■ on No ■ MEMO■■■EEE■E■E■■ ■■■■■■■■■■■■■■■■ ■EEE■■■■■■■■■■■■ i MMES■ ■■■■■ ■E■■■ ■■■■■ ■■■M■ ■■■■■ OMENS ■ME■■ ■■■M■ BEEN■ ■■■E■ ■■■M■ MESON ■■■■■ ■■NEON ■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■MNSOMM■■■ ■■■EMM■■■■■■■■■■ eE■■■■■■EEE■■■■■■■■■■■,■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■ ■ME■■■E■■ME■ ■OMMEMME■■■■ ■■MMEMEMOM■■ M■ME■EM■■EM■ ■■M■■E■■■EM■ ■■■■■■■■■■■■ ■■■MEMM■■■■■ ■■■■■■■■■■■■ ■■■■E■■■E■E■ ■EMESES■■■E■ ■■■■■■■■■■■■ ■■■■■■■■■■■■ ■■M■■■■■■■■■ ■■■■E■■■■■■■ EE■ME■E■■■■■ NEEM■■■■■MM■ ■■■MOM■■■M■■ ■■■■■M■■M■■■ ■■M■■■■■■M■■ ■■■■MM■M■■M■ ■■■■■■■■M■■■ ■■M■■M■■M■■■ ■■■■■■■M■■E■ ■E■■■■ ■■MEMO■■■ ■■■■SME■■E■ ■■■■■■■■■■■ ■■EEE■EEE■■ ■■■■■■■■■■■