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104 Meadow Brook Court Lot 35DAVIE 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 #: 990005752 Tax PIN!EH #'. E816OA0035 Billed To: David White Subdivi:ioh info: Meadows Edge Lot # 35 Reference Name: REPAIR PERMIT LocationiAddress ' 104 Meadow Brook Ct.-27006 Proposed Facility: Residential Repair Per Prop qV1%' pNe' C(Repaii ❑Expansion igTe, ; RC?AiP_ 5823 A'tCWffibtffhi582torization 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 chance. Residential Specifications: # Bedrooms # Bathrooms # People Basement❑ Basement plumbing❑ Non -Residential Specifications: Facility TypeJ' # People # Seats Square Footage (o Di a nsions of Facility) Lot Size Type of Water Supply: ❑Cou�n�ty/City ❑Well ❑Community Well System Specifications: Design Wastewater Flow (GPD) Ai z - Tank Size GAL. Pump Tank GAL. Trench Width Max. Trench Depth t"� Rock Depth_ZLinear Ft. Site Modifications/Conditions/Other: 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 c DCHD 11/06 (Revised) b At 2&11 ,3q5---721 Davie County Health Department 1;) 1836 f Environmental Health Section P.O. Box 848 J41]210 Hospital Street 0'1 Courier # : 09-40-06 3 2011 Mocksville, NC 27028 Phone: (336) - 753 - 6 Fax: (336) - 7531680 ON-SITE WASTEWATER CERTIFICATION (Check One) Replacement Remodeling Reconnection Name: b /iv % 1a w N TE Phone Number ti 1 3 5 3 g 1 (Home) Mailing Address: 1 0 4 W, %Z AD o %,j 0(2-0-01— c--_-. (Work) t--'�>VAtJG6 , rJC- 2700 C Detailed Directions To Site: 15Sr f A -ST RT O t-) BA L -r -i wt &i - LIZ -1 . \ Le FT D► -r 1?�hy �4r.w. P r R -'T" o r� r��c �pc��„l cfZ��n Property Address: 104 Y►\ C A IS 0 W 'M R o 0 1 L -T E91&QAQ0� Please Fill In The Following Information About The EXISTING Facility: Name System Installed Under: C. A _ q Al2Z S Co NSTr-,J cjn o d Type Of Facility: 17Z 1= Lo W '11C Date System Installed (Month/Date/Year): I - 2 8 - 0 8 Number Of Bedrooms:-3—Number Of People: 3 Is The Facility Currently Vacant? Yes No If Yes, For How Long?. Any Known Problems? Yes No If Yes, Explain: Please Fill In The Following Information About The NEW Facility: Type Of Facility: Number Of Bedrooms: Number of People Pool Size: Gara;e Sizc: 'Lo )1- 2 o Other: Requested By: ✓ �,.11%I.�.Y� Date Requested: (Signature) For Environmental Health Office Use Only Approved Disapproved Comments: Environmental Health Specialist Date: *The signing of this form by the Environmental Health Staff is in no way intended, nor should be taken as a guarantee (extended or limited) that the on-site wastewater system will function properly for any given period of time. Payment: Cash CheIt, Money Order # / / /) F\ Amount:$ / OD, Date: R - 13 - 11 Paid By: V% 4Received By:— Account #: v576 Z Invoice #: I V4 DAVIE COUNTY ENVIRONMENTAL HEALTH P.O. Box 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 Fax # (336)751-8786 Account #: 990004019 OPERATION PE"J1 PIN/EH #: 5871-42-9294.35 Billed To: E.J. Hanes Construction Subdivision Info: Meadows Edge Lot # 35 Reference Name: Location/Address: 104 Meadow Brook Ct.-27006 Proposed Facility: Residence Property Size: see map ATC Number: 4860 �ervrLr�{�P Az 3 �12, **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 bet en as a guarantee that the system will function satisfactorily for any given period of time. `Z- & c. --J System Type:_ S.T. Manufacturer Tank Date �' �` Tank Size / Pump Tank Size Syl Install �40 �•��E.H. Specialist/,,"5Date:J �G -0 110 B1 -Atop a 1 Map Erame . Page 1 of 1 Davie County, NC - GIS/Mapping System W Click Here To Start Over �7 y✓ Quick Search: (County ID or Owner Ni ActiveLayer. ❑`/ Use Map TIps 0 4e 0 PARCELS (Map Tips Available) Ma `�' dd 0018 ift A re - --- ----- ji000000f204 �• ii 20!5:218AC OA f VALLEY GLV �5 / •" } �� ~1 1 7,,12 $1 ' 1, 1 3' 15 7-1 1 i4� t I '_ ' � _BEAUCH^rap RD a ---_ _j Tpi - 7e l haCADUt'!_CRCC�L7.I1[ADOV.S CDUC D http://maps.co.davie.nc.us/GoMaps/map/mapframe.cfm?CFID=4129&CFTOKEN=616408... 9/14/2011 DAVIE COUNTY ENVIRONMENTAL HEALTH P.O. Box 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 Fax # (336)751-8786 Account #: 990004019 OPERATION PER1VJj PIN/EH M 5871-42-9294.35 Billed To: E.J. Hanes Construction Subdivision Info: Meadows Edge Lot # 35 Reference Name: Location/Address: 104 Meadow Brook Ct.-27006 Proposed Facility: Residence Property Size: see map ATC Number: 4860 **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 bet en as a guarantee that the system will function satisfactorilyfor any given period of time. �J System Type:_ S.T. Manufacturer Tank Date /� ),?Tank Size Pump Tank Size LtA r—,0QSys Install y: 40 Cit E.H. Specialist:gi,&'/,",Date: d 1 c u G O C -t— VO nrun 11m6 (uPvi.qPd) : 2v I L .T DAVIE COUNTY ENVIRONMENTAL HEALTH P.O. Box 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 Fax # (336)751-8786 Account #: 990004019 OPERATION PER1VJj PIN/EH M 5871-42-9294.35 Billed To: E.J. Hanes Construction Subdivision Info: Meadows Edge Lot # 35 Reference Name: Location/Address: 104 Meadow Brook Ct.-27006 Proposed Facility: Residence Property Size: see map ATC Number: 4860 **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 bet en as a guarantee that the system will function satisfactorilyfor any given period of time. �J System Type:_ S.T. Manufacturer Tank Date /� ),?Tank Size Pump Tank Size LtA r—,0QSys Install y: 40 Cit E.H. Specialist:gi,&'/,",Date: d 1 c u G O C -t— VO nrun 11m6 (uPvi.qPd) : 2v I L • DAVIE COUNTY ENVIRONMENTAL HEALTH ,z P.O. Box 848/210 Hospital Street `. Mocksville, NC 27028 (336)751-8760 Fax # (336)751-8786 AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION Account #: 990004019 Billed To: E.J. Hanes Construction Reference Name: Proposed Facility: Residence ATC Number: 4860 Tax PIN/EH #: 5871-42-9294.35 Subdivision Info: Meadows Edge Lot # 35 Location/Address: 104 Meadow Brook Ct.-27006 Property Size: see map Site Type: Clew ❑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❑ Non -Residential Specifications: Facility Type # People # Seats Square Footage(or Dimensions of Facility) Lot Size 0 _ -7CC C f c Type of Water Supply: 2 ounty/City ❑ Well ❑ CommunityWell System Specifications: Design Wastewater Flow (GPD) 3 (e o Tank Size 1. 00 r)GAL. Pump Tank ff/k GAL. r Trench Width 3 b i Max. Trench Depth Rock Depth Linear Ft. Site Modifications/Conditions/Other: 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. FCS ` c)c � C �.J-e- 5 i 51'il �.- c.> 7 0 .^� . 1�+Vn (rev-C,1.0p1 k-c3Igk, LCc.yGiw� f -e v s u •5 j e k6, o,-1 6t T P U d r Gr G,4 K 5 r A A -I o c c1 -,J �—e sem /, y ,/,zy-. T - 75 Environmental Health Specialist //��L��4 Date:--ff—Q DCHD 11/06 (Revised) OLD POWER LINE TRENCH Meadow Creek Court DECK t000g tank SURFACE SWALE NEEDED TO DIVERT WATER SYSTEM AREA 145.51 GRAPHIC SCALE 40 0 1 " — 40' 40 80 x` ¢rnrtr: -LCT •Me CT.. 5 E) HANES CCNSTRUCTIC�N 3 6EDR00;1i SEPTICu„ MG NDOW K EDGE , 3 SYSTEM LAYOUT iv u"' LLEC Soil &Environmental Consultants, PA g -, 10' utility ease— ase REQ 5� EP—-7 pRN 73, w J 86 REPAIR AREA � 1 Q > w J I.C: NEW POWER Q . LINE TRENCH LO 0 io N N DECK t000g tank SURFACE SWALE NEEDED TO DIVERT WATER SYSTEM AREA 145.51 GRAPHIC SCALE 40 0 1 " — 40' 40 80 x` ¢rnrtr: -LCT •Me CT.. 5 E) HANES CCNSTRUCTIC�N 3 6EDR00;1i SEPTICu„ MG NDOW K EDGE , 3 SYSTEM LAYOUT iv u"' LLEC Soil &Environmental Consultants, PA g -, ' Davie County Environmental Health • P.O. Box 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760/ Fax (336)751-8786 IMPROVEMENT PERMIT Account #: 990004019 Billed To: E.J. Hanes Construction Reference Name: Proposed Facility: Residence ATC Number: 4860 Tax PIN/EH #: 5871-42-9294.35 Subdivision Info: Meadows Edge Lot # 35 Location/Address: 104 Meadow Brook Ct.-27006 Property Size: see map **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: ❑New ❑Repair ❑Expansion Permit Valid for: 05 Years ❑No Expiration Residential Specifications: # Bedrooms # Bathrooms # People Basement❑ Basement plumbing❑ Non -Residential Specifications: Facility Type # People # Seats Square Footage(or Dimensions of Facility) Design Flow(GPD): Type of Water Supply: ❑County/City ❑Well ❑Community Well Site Modifications/Permit Conditions: System Type LTAR Initial Repair v 0 ►5 ► v, ED NoT� al 0 I tj�5- I Two + 133~s IRS g5. 0 r'�" . - • � O 231•pQ. -r 11-1 LI T'( 9LE'• UTILITY rn 'L TP40A TP408 \ . 1 N` O p POE rn39A 40 39 ft. 130,162 S/0. f_t. 30,105 sq. �s 1 0.69 acres, o 0.69 acrE 1 1 o 127.9:24.6 143:0 )145.0 T 3.3 IN \ to ,� -� '4` til • � ' ` 34 _ ,. 35 1 ?_sq-. t. 302525 sq. ft. r � �� .7�res � 36 ac ..., � - 30,082 Sq. ft. i B TP36A OA9 acres, j TP 3 .�^ tq / ;,jell � FROM , ��, V. ^ -.. �36B Possl -ED PAINT �'� :�''� �`', OVER A �� LINE F CSM DB/1 12t P1 r; •, ► FENCE LIN --- UNE SHOWN.. AS P/L AND l l(zr-r I L15.51 Elf Z 'd Z890'ON WdZE:Z COOZ 'bZ 'daS L� AP I 1 3 2001 SEP �EWNVIR0%,% EI JTAL HEAL DAVIECOUNIY E LUATION/IMPROVEMENT PERMIT V untyHeafth Department Ty, mental Health Section P. B x 848/210 Hospital Street .1 M cksville, NC 27028 336)75 -8760/ Fax (336)751-8786 Application For: 0 Site Evaluation/Improvement Permit & ATC C Authorization To Construct(ATC) ❑ Both ***IMPORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL OF THE REQUIRED INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions. APPLICANT INFORMATION Name to be-Billede �lU�C O Contact Person e Billing Address Home Phone City/State/ZIP Business Phone UA -3 to 7 WO O Name on Permit/ATC if Different than Above Mailing Address City/State/Zip PROPERTY INFORMATION NOTE: A survey'plat or site plan must accompany this application. (Permit is valid for 60 months with site plan, no expiration with complete plat.) Street Address 0 d rD L C City U Tax PIN# 5 7 / �{ ��Z9 V. Subdivision Name Sectio o Lot Size Directions To Site: - %, it Date House/Facility Corners Flagged �Jl n l 6LOUJ If the answer to any of the following questions is "yes", supporting documentation must be attached. Are there any existing wastewater systems on the site? ❑ Yes 'Qlo Does the site contain jurisdictional wetlands? ❑ Yes �94o Are there any easements or right-of-ways on the site? (Yes ❑No Is the site subject to approval by another public agency? 0Yes *o Will wastewater othet than domestic sewage be generated? ❑Yes Xlo IF RESIDENCE FILL OUT THE BOX BELOW l# People # Bedrooms -,K— # Bathrooms Basement:TAyes ❑No Basement Plumbing: %A es IF NON-RESIDENCETILL OUT THE BOX BELOW Garden Tub/Whirlpool AYes ❑No Type of Facility/Business Total Square Footage of Building # People # Sinks # Commodes # Showers # Urinals Estimated Water Usage (gallons per day) (Attach documentation of similar facility water consumption) FOODSERVICE ONLY: # Seats Type system requested: Conventional ❑Accepted ❑Innovative ❑Alternative ❑Other Water Supply Type:XCounty/City Water ❑ New Well ❑Existing Well ❑ Community Well Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes J(f"No If yes, what type? This is to certify that the information provided on this application is true and correct to the best of my knowledge. I understand that any permits) 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 falsified or changed I understand that I am responsible for all charges incurred from this application. I hereby grant right of entry to the Authorized Representative of the Davie County Health Department to conduct necessary inspections t dete ne compliance with applicable laws and rules on the above described property located in Davie County and owned by J Aa auy, Corysi V -1I A i gia (3), 04 f, � n A X o " Site Revisit Charge P e owner or owner' egal representative signature Date(s): Client Notification Date: Date EHS: cox [� / Sign given ❑Yes ❑No ~ ( Account # / 01 9 Revised 2/06 �� - Invoice # Elf I LA5'.5( t °1.V6 1J 11I'LICATION 1:011 SITE EVALUATION/lAIIIIINUILN'l• I'L1I1MIT Ji ATC t,�A� 2QQ4 Davie County Health Department E17Yironi1lenta/He,7&11 Section P.O. Dox 040/210 11ospital Street- EtNIRONMENTpLH�L�N Mocksville, NC 27020 pAV1ECOUNTY (33G)751-0760 ***IHPORT.,INT*** THIS APPLICATION CANNOT DL PROCESSED WILLSS ALL TILL REQUIRLD - I INFORMATION IS PROVIDED. Refer to the INFORMA'T'ION DULLETIN for instructions. 1. llamc to be Dillcd 2 Jade Associates II, LLC COn L'ae L• Peruon Alap Jones Mailing Addres5 Post Office Box 4062 Ilonlc Phone City/,tate/'LIP nuuinuus ll,u,rc Ilinston—Salem, NC 27115-4062 (336) 759-9688 ltamo on Permit/ATC if Different than Above Hailing Address City/SLaLe/Zip _.__._ •.,, ,_.,_._._ 3. Application For: Site Evaluation ❑ ImprovemenL• PerwiL/ATC ❑ 110th 9. Syccem to Service: ® house ❑ Idob.ile Home ❑ DusincSs ❑ InduSL•ry ❑ OL•llct — _ -- ti S. Type system requested: 91 Conventional ❑ conventional modified ❑ innovaLive G. If Residence: II People 4 ti Dedrooms 4 II IlaLllroulu:. 2.5 bDinllwasher !"!Garbage Disposal ElWashing Machina Ma::emenL/1llwal,ing ❑Uas:c,ucnL/llo 1'lwubing 7. If BuDinclaz/Industry /Other: verify type It People It :;ill)-:; _ - — I Commodes It Showers 11 Urinalu It I'IaL•cr Cooleru IF FOODSERVICE: It Seats Estimated water U age (gallons par day) 8. Type of water supply. IXI County/City ❑ well ❑ Couuuunity 9. Do you anticipate additions or CXpiUlSiolls of Elie facility this s)'stelll is ill(clik(l to set ve? ❑ Yes n No lf)'cs, 11'llat type? lhfl'O1tTIIIYT*** CL1EN'rSil1USTCO/il1'LLTL'rllE: REQUIRED 1'lcol'lslc7'1' 1Nh01{n'IA'I'ION 1t1�U1:5'I'I:U __I BELOW. EifficrnPLATorSITE PLAN d1USTEESUIllUMIWDbythe client frith '1'1115 r1 t'PI,ICr1'I'ION. Property Diulcnsiulls: See attached map Tax Office PIN: 11 5871615955 Property Address: Road Na111C Beauchamp Road Ci ty/Zip Advance, 27006 If 111 a Subd1YW011 I)r0Y1dC IlllU1'1112t1011, aS 1701IMS: Name: Proposed Jade Associates Scctiou: Bloch: Lot; ' 35 WRITE UIRLCTIONS (rruu, Alucl;sville) lu I'ltOI'I:II'I'I': East on highway 153, turn right onto Gun Club Road and proceed to the end of the road, turn left -onto Beauchamp Road and the site is located approximately two tai 1 es down Beaucharip 'P,oad on the right and left side of the road. 3/8/04 Date honle corucrs !lagged: This is to certify that Elle iuformatiou provided is correct to the best ol'uly knowledge. I uuderS[and Ella( any ))erulil(s) issued hereafter arc subject to suspension or revocaliou, if the site plallS or intended use change, or if the infurrlla(iun submitted in this applicaliall is f:dsilied ur changed. 1, also, understand that I urn respunsible fur rill charges hicrlrrol•%ruln this application. I, hereby, give consent to the Au(horizcd Represerllalive of Elle I)al'ic Cuunl' Ilcaltll 1)c``,:u (u cn to enter upon above described pruperty located in Davie County and oil -lied by Jade Ass)ociates to conduct all testing procedures as necessary to deteruline the silo suits ilii)'. DA'1'L 3/15/04 SIGNAruIu; THIS AREA MAY BE USED FOR DRAWING YOUR SITE PLAN (Include all ul' Elle fullowing: Existing and prulwsetl Property lines and dinlellsiolls, structures, setbacks, and septic IOCali011S). Sign givcu SAC Rcvisit Charge Client Notifica(iali Date: ,1rr•niti,, No APPLICANT INFORMATION DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/Site Evaluation PROPERTY INFORMATION Account #: 990003105 Tax PIN/EH #: 5871-61-5955.35 Billed To: Jade Associates II, LLC Subdivision Info: Prop. Jade Assoc. Lot # 35 Reference Name: Location/Address: Beauchamp Rd -27006 Proposed Facility: Residence Property Size: see map Date Evaluated: - L4011 Supply: Evaluation By: On -Site Well Auger Boring_ Community Pit Public Cut SITE CLASSIFICATION: QS�jat��v� EVALUATIONBY: iiHyl"`i LONG-TERM ACCEPTANCE RATE: p'� ~ �� 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 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 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 DCHD 05/99 (Revised) HORIZON I DEPTH ropw—M ff"j— M1 WORM Consistence �'Q7AMMA&MW&M MUM M AFMMOWsMineralogyem HORIZON ... Texture r��rra■�t�� - • ��«��rY�;rr;�� E t�r HORIZON III DEPTH Consistence Mineralogy HORIZON IV DEPTH Texture group Consistence SOIL WETNESS • • • • SAPROLITE %��AOe CLASSIFICATION SITE CLASSIFICATION: QS�jat��v� EVALUATIONBY: iiHyl"`i LONG-TERM ACCEPTANCE RATE: p'� ~ �� 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 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 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 DCHD 05/99 (Revised) Soil & Environmental Consultants, PA 248 L.ePhiMp Court • Concord, North Carolina 28025 • Phone: (704) 720-9405 • Fax: (704) 720-9406 www.SandEC.com May 12, 2008 Davie County Health Department Attn: Robert Nations PO Box 848 Mocksville, NC 27028 Re: Meadows Edge Subdivision Lot 35 Mr. Nations, As you are aware S&EC has performed a septic system layout for a 3 -bedroom home at lot 35 of Meadows Edge subdivision. Based on our recent site visit S&EC has performed a layout for an initial system in the backyard of the lot. In all, S&EC demonstrated placement of 300 linear feet of drainline for an innovative system (Chamber or EZ Flo). We believe effluent from the proposed septic tank location can enter the proposed drainlines via gravity distribution. A surface swale (slight ground modification) could be done at the time of installation to further insure sheet flow of precipitation can be directed away from the proposed initial system. As for the repair area S&EC has demonstrated placement of proposed drainlines in the front yard of the lot. We recommend the new buried power line avoid the repair area as shown on the attached site plan. Additionally, there is sufficient drainline placed in the front yard such that the gas line can stay in its current location. Likewise it appears the proposed driveway location can remain in the same location. A pump tank will be i needed if the repair field is ever installed. In addition, construction of concrete dams will be needed for 4 of the repair lines. We have reduced some of our initial layout lines in the front yard to 1) avoid the gas line and 2) not cross the power line trench. Therefore install repair lines at the lengths shown on the site plan and not what is currently shown in the field. Details for construction of the concrete dams are attached with this letter. In addition layout specifications are enclosed with this letter. Please call if you need more information or clarification of our proposal. Sincerely, ende erby NC Lice ed Soil Scientist _Greensboro Office: 3817-E L.awndale Drive Greensboro, NC 27455 Phone: (336) 540-8234 Fax: (336) 540-8235 So!` SO 0e4t 'L�► 0 N 7 � , co ,► 'c, " Raleigh Office: 9f401 121 Q. 11010 Raven Ridge Road Y,ft n�"�' Raleigh, NC 27614 Phone: (919) 846-5900 Fax: (919) 846-9467 63 97 105 109 110 71 49 27 9 May -08 Meadows Edge Lot 35 FLAGGED DESIGN ELEVATION LINE LENGTH LENGTH Project No. 5-2109s1 75 layout for a 3 bedroom home 96.2 75 12 FLAG 96.1 75 LINE # COLOR BS HI FS TBM 5.0 * System INSTR. 1 CO APPROVED 105.0 Repair 459 0.25 INNOV 25% CO APPROVED REPAIR IR Notes: Red 3.00 102.0 2 Orange 4.10 100.9 3 Yellow 5.10 99.9 4 Blue 5.70 99.3 5 Pink 6.10 98.9 6 Red 6.50 98.5 7 Orange 7.00 98.0 8 Yellow 2.8 7.40 97.6 Total SYSTEM 63 97 105 109 110 71 49 27 9 May -08 96.7 FLAGGED DESIGN ELEVATION LINE LENGTH LENGTH 100.0 75 63 97 105 109 110 71 49 27 9 Blue 3.50 96.7 75 10 Pink 3.80 96.4 75 11 Red 4.00 96.2 75 12 Orange 4.10 96.1 75 LINE LTAR SYSTEM INNOVATIVE LENGTH GPD/FT' TYPE TYPE DISTRIBUTION * System 300 0.300 INNOV 25% CO APPROVED Repair 459 0.25 INNOV 25% CO APPROVED Notes: ** TBM located top of bottom house step **TBM is assumed to be 100' **All measures in feet **Nitrification lines are demonstrated on contour via colored pin flags **BS and FS indicate rod readings 50 73 86 88 91 71 0 0 459 75 75 75 75 300 NOTE: NITRIFICATION TRENCH DETAIL FOR EZ -FLOW (or CHAMBER) 1. PERFORATED CORRUGATED PLASTIC PIPE SHALL EARTH BACKFILL JoeNO. 59S1 PROJECT MG SCAB , NTS 3611 SOIL PROJECT NAME: SHEET TITLE MEET REQUIREMNTS OF ASTM D 2729. 2. PIPE SHALL BE LEVEL. OVERFILL TO ALLOW FOR SETTLEMENT 3. END CAP SHALL BE PROVIDED AT END OF ALL CORRUGATED PLASTIC PIPE LINES. !'\ NATURAL GROUND SURFACE 4. TRENCH BOTTOM SHALL BE LEVEL. At 5. SEE INFORMATION FOR INSTALLER. :. 1211 BUILDING PAPER 24' 2" 3' 6" OF SOIL 6" OF CONCRETE OR BENTONITE SOIL MEADOWS EDGE LOT 35 TRENCH DETAIL (REPAIR LINES AS INDICATED) SOIL NOT TO SCALE OF Soil & Environmental Consultants, PA I 11010 Raven Ridge Road • Raleigh, North Carolim 27614 • Phone: (919) 846-5900 • Fu: (919) &169467 wwwSandEC.com DA171E COUNITY I1EALTH DEPART1:l-,"EENT Environmental Health Section R0. Box 848/210 Hospital Street Courier 409-410-06 Mocksville, NC 27028 Phone#:(336)751-8760 Fax#: (336) 751-8786 May 15, 2008 E.J. Hanes Construction 2437 W. Clemmonsvi Ile Road Winston=Salem, NC 27127 RE: Notice of Intent to Revoke/Suspend Improvement Permit/Construction Authorization Dear Mrs. Hanes: Attached is a letter notifying you that your permit for Authorization to Construct was revoked. The permit was revoked due to site modification that altered the available space needed to install an initial and repair septic systems. Luckily, there was sufficient space in the rear of the home to add septic, which previously deemed unsuitable due to topography. A soil scientist was needed to design a remediation for the repair area in the front of the home. All violations of permit #4755 have been rectified. A new permit # 4860 has been issued and is attached The design layout for the current septic system and repair is attached. If you have comments, concerns, questions, and/or suggestions, please don't hesitate to contact me. Sincerely, n% ! 75�571 Robert M. Nations, RS Environmental Health Specialist See attached: New Permit, Design Layouts, Repair Design Layout DLAFI , CUNTY�.E1;f H DEPARTMIENT'F Environmental Health Section P.O.01 Box 848/210 Hospital Strcet Courier 409-40-06 Nlocksvillc. NC 27028 Phone#: (336) 751-8760 Fax#: (336) 751-8786 Notice of Intent to SUSPEND/RE'VOKE Improvement Permit or Construction Authorization May 15, 2008 E.J. Hanes Construction 2437 W. Clemmonsville Road Winston-Salem, NC 27127 RE: Notice of Intent to Revolve/Suspend Improvement Permit/Construction Authorization Dear Mrs. Hanes: The Davie County Environmental Health Department inspected the site for the onsite wastewater system located at Meadow Brook Court / Meadows Edge Subdivision Lot 35 for compliance with the Laws (Article 11 of Chapter 130A of the North Carolina General Statutes), Rules (15ANCAC ISA .1900 et seq.), and Improvement Permit/Construction Authorization 4700 conditions. As a result of this inspection, the Department has determined the following violations: 1. 15A NCAC 18A. 1937i This is to notify you that based on these violations, the Department intends to revoke your Construction Authorization #4755, 30 days from the date of this notice. If the health department determines that all of the violations have been corrected before thirty (30) days expire, the revocation will not go into effect. If the permit is revoked, you must apply for a new Construction Authorization and meet the current laws and rules necessary to obtain a new permit. You have a right to an informal_ review of this decision. You may request an informal review by the environmental health supervisor at the local health department. You may also request an informal review by the N. C. Department of Environment and Natural Resources regional specialist. A request for informal review must be made in writing to the local health department. You have the right to a formal appeal of this decision by filing a petition for a contested case hearing with the Office of Administrative Hearings, 6714 Mail Service Center, Raleigh, NC, 27699-6714. To obtain a petition form (H-06), you may write the Office of Administrative Hearings, call that office at 919.733.0926, or from their web site at www.oah.state.nc.us/hearings. The petition for a contested case hearing must be filed in accordance with the provisions of North Carolina General Statutes 130A-24, 15013-23, and all other applicable provisions of Chapter 150B. N. C. General Statute 130A-335 (g) provides that your hearing would be held in the county where your property is located. If you wish to pursue a formal appeal, you must file the petition form with the Office of Administrative Hearings WITHIN 30 DAB'S OF THE DATE OF THIS NOTICE. Meeting the 30 day deadline is critical to your right to a formal appeal. Beginning a formal appeal within 30 days will not interfere with any informal review that you may request. If you file a petition for a contested case with the Office of Administrative Hearings, you are required by law (NCGS 15013-23) to send a copy of your petition to the North Carolina Department of Environment and Natural Resources. Send the copy to: Office of General Counsel, NC Department of Environment and Natural Resources, 1601 Mail Service Center, Raleigh, NC 27699-1601. Sending a petition or a copy of the petition to the local health department will NOT satisfy the filing requirements of the NC General Statutes. You may call or write the local health department if you need additional information or assistance. Sincerely, �y G'41 Robert M. Nations, RS Environmental Health Specialist Cc: Joe Mando, Environmental Health Supervisor (Revised Jan. 31, 2003) Soil & Environmental Consultants, PA 248 LePhillip Court • Concord, North Carolina 28025 • Phone: (704) 720-9405 • Fax: (704) 720-9406 www.SandEC.com May 12, 2008 Davie County Health Department Attn: Robert Nations PO Box 848 Mocksville, NC 27028 Re: Meadows Edge Subdivision Lot 35 Mr. Nations, As you are aware S&EC has performed a septic system layout for a 3 -bedroom home at lot 35 of Meadows Edge subdivision. Based on our recent site visit S&EC has performed a layout for an initial system in the backyard of the lot. In all, S&EC demonstrated placement of 300 linear feet of drainline for an innovative system (Chamber or EZ Flo). We believe effluent from the proposed septic tank location can enter the proposed drainlines via gravity distribution. A surface swale (slight ground modification) could be done at the time of installation to further insure sheet flow of precipitation can be directed away from the proposed initial system. As for the repair area S&EC has demonstrated placement of proposed drainlines in the front yard of the lot. We recommend the new buried power line avoid the repair area as shown on the attached site plan. Additionally, there is sufficient drainline placed in the front yard such that the gas line can stay in its current location. Likewise it appears the proposed driveway location can remain in the same location. A pump tank will be needed if the repair field is ever installed. In addition, construction of concrete dams will be needed for 4 of the repair lines. We have reduced some of our initial layout lines in the front yard to 1) avoid the gas line and 2) not cross the power line trench. Therefore install repair lines at the lengths shown on the site plan and not what is currently shown in the field. Details for construction of the concrete dams are attached with this letter. In addition layout specifications are enclosed with this letter. Please call if you need more information or clarification of our proposal. Sincerely, eendeqerby Soil Scientist Solt S V gjeND44 Greensboro Office: 1 Raleigh Office: 3817-E Lawndale Drive J.'R CfAV4 �VO 10 '^•. 11010 Raven Ridge Road Greensboro, NC 27455 1218 ,'` �f Phone: (336) 540-8234 CA Raleigh, NC 27614 Fax: (336) 540-8235 ^ GQ�+, Phone: (919) 846-5900 �� ,c' Fax: (919) 846-9467 10-4- MP/L\DOW- Ll