Pudding Ridge Foodservice r, .
DAVIE COUNTY HEALTH DEPARTMENT
- IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
NOTE:Issued in Compliance With Article I I of G.S.Chapter 130a
Sanitary Sewa a Systems 7
�sl<r. Permit Number
�;
Name s' 1� u� ffr' = Date N2 7 7 2 9
Location ..: f "�e/Ila
Subdivision Name �JJ� fit. !�o�� ��IT ('Ou+�Lot No. Sec. or Block No.
Lot Size '`/ House Mobile Hpme _ Business —�^'"'� Industry
No. Bedrooms—4&k? .No. Baths — No. in Fam�ly �: Public Assembly Other
Garbage Disposal YES ❑ NO [}r f Specifications for System:
Auto Dish Washer YES a NO ❑ /vOG�'uf'� �.�r Tr%< 0 �'�
Auto Wash Ma^hine YES ❑ NO <0c /
Type Water Supply _-- ��� / G
'This permit Void if sewage system described below is not installed within 5 years from date of issue.
This permit is subject to revocation if site plans or the intended use change.
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Improvements permit by
*Contact a representative of the Davie County Health Department for final inspection of this system between 8:30-9:30 A.M.,
1:00-1:30 P.M.or 4:30-5:00 P.M.on day of completion.Telephone Number:704-634-5985.
Final Installation Diagram: System Installed,Oi
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a Rte �
SX n
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t S All d
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Certificate of Completion Date
'The signing of this certificate shall indicate that the system described above has been installed in compliance with
the standards set forth in the above regulation, but shall in NO way be taken as a guarantee that the system will function
satisfactorily for any given period of time.
APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PE
` ED
�� Davie County Health Department `
Environmental Health Section ON 1 91994
P. O. Box 665
,Ia�y V Mocksville, NC 27028
' ---------------
1. Application/Permit Requested By
Mailing Address iR Z 3 o K / Home Phone 9 Y z'�O 3
yVl 6zr-K—X </r,� � N • C• Business Phone 9 9 7 7 9/
2. Name on Permit if Different than Above FA
3. Application for: d General Evaluation A.Septic Tank Installation Permit
4. System to Serve: ❑ House ❑ Mobile Home ❑ Place of Public Assembly
❑ Business ❑ Industry eOther C l L)b k o cv f--t—❑ Unknown
5. If house, mobile home: Subdivision Section Lot #
❑ Basement/Plumbing
No. of People 3 ❑ Basement/No Plumbing
No. of Bedrooms ❑ Washing Machine
No. of Bathrooms ❑ Dishwasher
Dwelling Dimensions ❑ Garbage Disposal
6. If business, industry, place of public assembly, other: Specify type .F C-0
3-5Wo,,,K t>'to 3D iry immty'-I '`/ �
No. of People Served r-00 � , ;, �T, , '// No. of Sinks (� '
No. of Commodes -S '7'0 A/ No. of Urinals 3 Yo 244
No. of Lavatories No. of Water Coolers
No. of Showers Water Usage Figures
7. Type of water supply: l4'Public ❑ Private ❑ Community
8. Property Dimensions P 0 r a c 7/3 c-r c f Sewage Disposal Contractor
9. Do you anticipate additions/expansion of the facility this sytem is intended to serve? ❑ Yes 2 No
If yes, what type?
'NOTE: Improvements Permits shall be valid for a period of 5 years from date issued. Improvements Permits are subject to
revocation, if site plans or the intended use change. Effective October 1, 1989.
Directions to Property: o iJ12 I Y2' � L w�-J 60 t?�,J LJ 11 /IA-z
1s = ��$o
This is to certify that the information provided is correct to the best of my knowledge, and I understand I am responsible for all charges
incurred from this a plication.
/00 9 0
DATE 7 SIGNATURE
CONSENT FOR SITE EVALUATION TO BED NE_ON ABOVE DESCRIBED PROPERTY
MUST CHECK ONE: I� 1. 1 OWN the property. ❑ 2. 1 DO NOT OWN the property.
If you checked Box #2, the rest of this form MUST be completed by the owner or a person authorized by the owner:
I hereby give consent to the authorized representative of the Davie County Health Department to enter upon above described
property located in Davie County and owned by
to conduct all testing procedures as necessary to determine said site's suitability for a ground absorption sewage treatment
and disposal system.
DATE SIGNATURE
DCHD(1/93)
' DAVIE COUNTY HEALTH DEPARTMENT
x Environmental Health Section
Soil/Site Evaluation
NAME D f ! �� DATE EVALUATED
ADDRESS PROPERTY SIZE
PROPOSED FACIILTY y 6l/S LOCATION OF SITE >Z
Water Supply: On-Site Well Community Public
Evaluation By: Auger Boring Pit b,/ Cut
FACTORS 1 2 3 4
Landscape position
Tr—
Slope %. a-
HORIZON I DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON II DEPTH •, 72 .15el
Texture groupef
Consistence
Structure /� T
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: EVALUATED BY:
LONG-TERM ACCEPTANCE RATE: OTHER(S) PRESENT:
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 +:lay 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
3C-Single grain M-Massive CR-Crumb GR-Granular ABK-Angular blocky
SBK-Subangular blocky PL-Platy PR-Prismatic
Mineralouy
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(01-901
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Dan? County Yfealll `Department
and Nome Neall§r qa- ency
210 HOSPITAL STREET I P.O. BOX 665
MOCKSVILLE.N.C. 27028
PHONE:(704)634.5985
May 3, 1994
Earl Groce
Pudding Ridge Golf Course & Clubhouse
Rt. 2, Box 128
Mocksville, NC 27028
Re: Site Evaluation
Pudding Ridge Golf Course & Clubhouse
Pudding Ridge Road/b+ Acres
Dear Mr. Groce:
This letter is to confirm our conversations of April 27 and May 2, 1994,
regarding the sewage systems to serve the clubhouse at Pudding Ridge Golf
Course.
The building will be served by two sewage disposal systems. One will
serve the meeting room, which will have two bathrooms. The other will serve
the restaurant, which will have 12 seats and 5 employees. The system that will
serve the meeting area will consist of one 1000 gallon tank, D—box and 400
linear feet of nitrification line. The system that serves the restaurant will
consist of one 1000 gallon grease trap with riser,, one 1500 gallon septic tank
with riser, one 1500 gallon pump tank with riser (should topography dictate the
need), splash box, and 4-6 D—boxes and 800 linear feet of nitrification line.
Any part of the nitrification field that is crossed by a cart path or other
pavement shall use solid schedule 40 pipe- for the width of the path. It would
be better to redirect any cart paths and/or any payment away from the drain
field area.
When the clubhouse floor level is determined this office can reassess the
need for any effluent pump for the restaurant sewage system.
It should be noted that all commodes. shall be ultra—low flush and
lavatories be spring loaded.
Contact this office before construction begins. If you have any questions
feel free to call this office.
Sincerely,
A�l
Robert B. Hall, Jr. , R.S.
Environmental Health Section
RH/wd
Enclosure