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301 Leatherwood TrailDAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section P. O. Boz 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 Account #: 990001069 Tax PIN/EH #: 5769-4 2.A--_. Billed To: Jimmy & Chen Barringer Subdivision Info: Reference Name: Jimmy & Chen BarringerLocation/Adeie-7 Harrow Lane -27028 Proposed Facility: Residence Property25.83�es. --" ATC Number: 2475 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 S CTJON IS VALID FOR A PERIOD OF FIVE YEARS. Environmental Health Specialist's Signatur Date: Irl 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. Septic System Installed Environmental Health Specialist's DCHD 05/99 (Revised) DAME COUNTY HEALTH DEPARTMENT Environmental Health Section P. O. Boz 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 IMPROVEMENT/OPERATION PERMIT Account #: 990001069 Tax PIN/EH #: 5769-46-6372.A Billed To: Jimmy & Chen Barringer Subdivision Info: Reference Name: Jimmy & Cheri Barringer Location/Address: Harrow Lane -27028 Proposed Facility: Residence Property Size: 25.830 Acres **NOT & Ttii Fr6rovement/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 1 I 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 Type �� #People #Bedrooms 3 #Baths Dishwasher: E!r Garbage Disposal: 2r Washing Machine: Basement w/Plumbing: ❑ Basement/No Plumbing: ❑ Commercial Specification: Facility Type 13� #People #People/Shift #Seats Industrial Waste: Lot Size •� Ate, Type Water Supply 1 )ELL- Design Wastewater Flow (GPD) 7 Site: New 111"' Repair ❑ System Specifications: Tank Size 1()00GAL. Pump Tank GAL. Trench Width 31U" Rock Depth 1 Z' Linear Ft._&00t Other: A. U— L. Required Site Modifications/Conditions: , tJ `;YA'-` 0,3 C-0.�151 � ! �a% �� too I (--eo,- �''' vJ t1-(�-; IMPROVEMENT/OPERATION PERMIT LAYOUT - APPROVED EFFLUENT FILTER RISER(S) IF 6 " BELOW FINISHED GRADE. ****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.**** -10 '�V'ruv5 VW6'r -711e jam`' Environmental Health Specialist- tures DCHD 05/99 (Revised) Date: DAVIE COUNTY HEALTH DEPARTMENT F4 j°pi.ao Environmental Health Section { • • P. O. Boa 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 IMPROVEMENT/OPERATION PERMIT Account #: 990001069 Tax PIN/EH #: 5769-46-6372.A Billed To: Jimmy & Chen Barringer Subdivision Info: Reference Name: Jimmy & Cheri Barringer Location/Address: Harrow Lane -27028 Proposed Facility: Residence Property Size: 25.830 Acres **NOTE** Thi Kiprovement/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 Type 1-Tpl5u, #People_ #Bedrooms #Baths �. Dishwasher: Garbage Disposal: Washing Machine: Basement w/Plumbing: Basement/No Plumbing: ❑ Commercial Specification: Facility Type #People #People/Shift #Seats Industrial Waste: ❑ Lot Size A(.QC-SType Water Supply Lkval" Design Wastewater Flow (GPD) Q Site: New Repair ❑ System Specifications: Tank Size GAL. Pump Tank GAL. Trench Width W Rock Depth 12� "Linear Ft 619D ' Other:Ii 1�1$TRA &iT 1 O,� GCS 73)u�- 4AL-%jt . IAN-%-U S9 o•C• 4.a. Required Site Modifications/Conditions: CO C&JTOJ e_.�u-r 1 �f (3�� 1��, '� -Q �00� F2oe�, IMPROVEMENT/OPERATION PERMIT LAYOUT - APPROVED EFFLUENT FILTER. RISER(S) IF 6 " BELOW FINISHED GRADE. ****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.**** ti ?J J O? I-IoJs;✓ X t� 10 S 1 _ � 1 Environmental Health Specialist's Signature: DCHD 05/99 (Revised) C -4g 6alA- Date: .....�.� toms atuvuntNl MUM16 & AIG Davie County Health Department EnvinvnmenbiHealth Section P.O. Box 848/210 Hospital Street Books_ villa, XC 27028 (336)781-8760 MAR 2 82000 �+►•iitft7QtTAI+f!*** THIS "PlaCATIOIi Ci1ItIQm BE mwmsmw vitILE88 ALL THS RSQUISIM =2'OFMATIOH 18 BROMED. Refer -to the INTORRATIOH BULLSTIR for instructions. 1. Wase to be Billed ,IM=4 ~ (4art-in n •e.(- Contact person G r KAI nailing Addreas SO G CodD_r CA2.�IC Bo.e Phone 33V qg 7 -0-711 City/state/LIP Business "WM,33(0' 3`F'S-�O(p� Z. Wam,e on Pezmit/ATC it Different than Above Mailing Adds^sas ,./ City/state/Lip 3. 11pp1ioatioa Nor: V Site.Zvaluation 0 Improvement permit/ATC 0 Both 4. •ystei to servios: 15Uonse 0 mile Ho®m 0 Business 0 Industry 0 Other 0. It Residence: • people -IV / Bedroo:os „ YJ i / Bathrooms it Disbwasher P i•asbage Disposal tR' Bashing Machine "' aseeent/Plumbing O Basemant/Wo Plumbing 6. It Business/Industry/other: specify type i People / aims # commodes showers f Urinals i Vater Coolers Ir: rooD8EtmCB: Seats Sstis:ated Nater visage (gallons per day) 7. Tzps of iwabix 8MM13r 0 County/City hell 0 Community s. Do You anticipate` ldditions or eipanslow of.dw facility thti system Is intended to serve! 0 Yes 111No If 7� whai type! ***IMPq#TAN7*** CUIKN*S AIUSTCOMPLEWTIJINMUIRED PROPERTY INFORMATION REQUESTED BELOW. • Either s PLAT or Ski PLAN MUST SUBMITTED by the dient with THIS APPLICATION. Property Dimensions: WRITE DIRECTIONS (from Mocksrllle) to PROPERTY: Tazpf kic i : .._V3 7G T (6 3'7 a to � 1,%s� 1G SP L�t�yiyt4.�zPJ�" Property Address: Road Name 1VA H 1P6W .�N / T t�h rY[u�J Z7tra re 0 pity/Zip / . : ► n _��,n If in a Subdivision provide information, as follows: Name: Section: Blocks Lot. Date Property Flagged: This is to certify'that the information provided Is correct to the best of my knowledge. I understand that any permit(:) Issued hereafter are subject to suspension or revocation, If the site plans or Intended use change, or if the information submitted In this application Is falsitkd or changed 1, also, understand that I am naponAble for all charges Incurred f vm this gppU aatkm 1, hereby, give consent to the Authorized Representative of the Davie Cqunty He#lih Department to enter upon above described property located in Davie County and owned by PAVO 11 ')l o #e/ to conduct all testing procedures as necessary to determine the site blllty. DATE ' SAD 31GNATU %�-- THIS AREA Y BE USED FOR DRAWING YOUR SITE PLAN (include all or the following: Existing and proposed property lion and dimensions, stractanes, setbacks, and septic locations). JUN — 8 2000 ENVIRONMENTAL HEALTH DAVIE COUNTY pzwv �09_ PAW"41 Revised DCHD (07/98) b I i Z'co Q . Account Na D I Invoice Na ,` A/ 0� - _. r' �.O1 -- _ E- a t• ;'�� �AQ,L'- R� ..,;:; 'F '+d"K yFO.-' t OAC V 47��,4 '8«" ---k,. 3 i lr t?F �'- '4 • x .y ! r / .FjY r,' '�-3. y� i r 5 ' �` 'Y 3.0� µ""`Vi — �`�= � E�� t���� t is :0 SAS T s�� x' s/ t 13 Ac.) N J . � v r. r a e'° .4 2 ) - to 462 4uOD x ~; z F88,7- t 4 e' 4.01, z9 8�a 15.6 Ac .: v�, �— —�� .7Ac'e 13.5 '� , 4 • t } 24 Ac / (16 Ac. + q K1 y.w 9s (3.5 Ac.)I 3 U �' 5 C. r \ x (8.22Ac) =� (775.5) s P ' 79 - 8 `,: _ z (4.54!,c.), 1.7Ac sD s ;� <� 'S Se 37 ` �\ ar, �g 853.4 a Aoe .ri'� \ LO ]CJ .. ,_ 726.- sn'' cv 454.2 Q z. M (5.2 Ac. f73 �' i24 Ac.) CDAc CD o, 4 B tv 33 854.1 m 14-69-91, w t Wy. 5-04 AC. 6 $ G ro ' S. 9ZA 4 w ' N 2 �� 34Ln 2:; ACr: 4 Ac a ,� , { 5 5 A*.� �7p 42p 2.86�ACZ V ...,E � W, 7 12 t A APPLICANT INFORMATION DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/Site Evaluation Account #: 990001069 Billed To: Jimmy & Chen Barringer Reference Name: Jimmy & Chen Barringer Proposed Facility: Residence Property Size: PROPERTY INFORMATION Tax PIN/EH #: 5769-46-6372 Subdivision Info: Location/Address: Harrow Lane -2702$ 25.830 Acres Date Evaluated: Water Supply: On -Site Well '� Community Public Evaluation By: Auger Boring Pit Cut FACTORS 1 2 3 4 5 6 7 Landscape position (_. L L Slope % 77o -1,7o HORIZON I DEPTH IO - O - 6 Texture group ';C' S G G Gt- t - Consistence -41 Structure {l_ CA - GQ Mineralo Mineralogy VN M /Yl, HORIZON II DEPTH qI Z O 29 In % - 1(0 - 2Z Texture group C L' C + G Consistence ' S p Structure k S Mineralogy M, ,:i :1 HORIZON III DEPTH I I - Z -3 Z Texture group C C+-D c,- sKa Consistence Structure Mineralogy HORIZON IV DEPTH Texture group Consistence Structure VY) Mineralogy -Z - SOIL WETNESS Z RESTRICTIVE HORIZON SAPROLITE CLASSIFICATION (} l75 p$ LONG-TERM ACCEPTANCE RATE p SITE CLASSIFICATION: PS hot _i0 'kCk"3 4C'�' EVALUATION BY: LONG-TERM ACCEPTANCE RATE: 'D• Z OTHER(S) PRESENT: REMARKS: 214 -IS* ZS r SOIL -- C'D0 (.% 050 (�i' . �i A, (_ a t'tr Oso 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 I 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 Mineraloav 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) Davie County Health Department Environmental ,Health Section PO Box 848 / 210 Hospital Street Mocksville, NC 27028 Phone: (336)751-8760 April 28, 2000 J' and Ann rringer 369 Ce ree Road Mocksville, NC 27028 Re: Site Evaluation - 25.83 Acre Tract/Harrow Lane Tax PIN #: 5769-46-6372 Dear Mr. and Mrs. Barringer: As requested, a representative from this office visited the above site on April 27, 2000. Based on the information provided on the Application for Site Evaluation and after the evaluation was completed, the site was found to be provisionally suitable for the installation of an oversized, modified on-site sewage disposal system. Due to the proposed size and location of the residence and poor soil characteristics, a lift station may be required. Before a representative of this office will revisit the site to issue an Improvement Permit/Authorization to Construct, the appropriate application must be completed in full and submitted to this office. The location of the facility the system is to serve must be staked off. If you have any questions, feel free to contact this office. Sincerely C Jeff . eauchamp, R.S. Environmental Health Section Enc(s)