219 Redwood Drive Y-Lot 13Davie County, NC
Tax Parcel Report Wednesday. January 4, 2017
_.
WARNING: THIS IS NOT A SURVEY
Parcel Information
Parcel Number:
K5070A0013
Township:
Mocksville
NCPIN Number:-
5747332642
Municipality:
Account Number:
8306914
Census Tract:
37059-805
Listed Owner 1:
LONG"TABITHA ''
Voting Precinct:
SOUTH MOCKSVILLE
Mailing Address 1: :'
219 REDWOOD DRIVE
Planning Jurisdiction:
Davie County
City: MOCKSVILLE
Zoning Class:
DAVIE COUNTY R -A
State:
NC
Zoning Overlay:
Zip Code:. _ ,
27028
Voluntary Ag. District:
No
Legal Description: _.
LOT 13 SOUTHWOOD ACRES
Fire Response District:
JERUSALEM
Assessed Acreage:
0.47
Elementary School Zone: CORNATZER
Deed Date: -
12/2013
Middle School Zone:
WILLIAM ELLIS
Deed Book / Page:
2014EO359
Soil Types:
GnB2,PcC2
Plat Book:
0005
Flood Zone:
Plat Page:
065
Watershed Overlay:
DAVIE COUNTY
Outbuilding & Extra
Building Value
Freatures Value:
Land Value:
Total Market Value:
Total Assessed Value:
I.V I All data Is provided as Is without warranty or guarantee of any kind either expressed or implied Including but not limited to the
9 ie3e ti` Davie County, Implied warranties of merchantability or fitness for a particular use. All users of Davie County's GIS website shall hold harmless the
County of Davie, North Carolina, Its agents, consultants, contractors or employees from any and all claims or causes of action due to
�pUN� NC or arising out of the use or Inability to use the GIS data provided by this website.
'OPERATION PERMIT
Davie County Health Department
J ~� 210 Hospital Street
P.O. Box 848
` Mocksville NC 27028
Phone: 336-753-6780 Fax: 336-753-1680
Applicant. Tabitha Long/Deena Abee
Address: 3480 US Hwy 601 S
City: Mocksville
State/Zip: NC 27006
Phone #: (336) 492-2089
t -or uttice use univ
*CDP File Number 202024-1
5747332642
County ID Number.
Evaluated For: NEW
Township:
�roperty Owner: Evelyn Smith
Address: PO Box 325
CRY: Mt. Aetna
State/Zip: PA
Phone #:
19544
Property
Location & Site Information -7
Address/Road #:
Subdivision: Southwood Acres Phase: Lot: 13
219 Redwood Drive
Mocksville NC
27028
Directions
Hwy 601 S, left on Deadmon Rd. left on Rewood.
Structure: SINGLE FAMILY
property on left
# of Bedrooms: 3
# of People: 4
*Water Supply: PUBLIC
'System Classification/Description:
*IP Issued by. 2140 -Nations,
Robert
TYPE 11 A. CONV SYSTEM (SINGLE-FAMILY OR 480 GPD OR LESS)
*CA issued by: 2140 -Nations,
Robert
Sapralite System? (Yes QNo
Design Flow:GRAVITY-SERIAL
3
6 0
Pump Required?
*Distribution Type: OYes QNo
Soil Application Rate: 0 -
a 7
5 *Pre -Treatment:
Drain field
rNdrification Field
1
3 0 9 Sq. h• *System Type: BIODIFFUSERARC36
Drain Lines
3
Installer:TimAl�e
l Trench Length:
3 3
0 fl. Certification #: Int t
Trench Spacing:
_
9 eFeet s O.C.
Feet O.C. *EH S: 2140 •Nations. Robert
Trench Width:
_
3 Inches
Feet 0 6/ 0 8/ 2 0 1 6
Date:
Aggregate Depth:
inches
Minimum Trench Depth: 3
6
Inches
Minimum Soil Cover. a
4
Inches Approval Status
Maximum Trench Depth: 3
6Inches
EY,ApprbvedD Disapproved
Maximum Sail Cover: a
4
Inches
CDP File Number 202024 - 1
Septic
Manufacturer. Shoat
STB: 760
Gallons, 1000
Date:
03/
2 5/.2
0 1 6
*Filter Brand:
POLYLOK PL -122 With Pipe Adapter
ST Marker:
❑
Yes
Q
No
nforced Tank:
❑
Yes
[9
No
1 Piece Tank:
❑
Yes
Q
No
Vent Hole ❑ Yes
❑
No
Anti -siphon Hole 0 Yes
County ID Number: 5747332642
Lat. I
Long:
Installer: Tim Abee
Certification #: 1011
*EHS: 2140 - Nations, Robert
Date: 0 6/ 0 8/ 2 0 1 6
Approval Status
® Approved ❑ Disapproved
Pump Tank
Manufacturer: Installer.
PT:
Gallons:
Date:
/
/
RiserSealed ❑
Yes
❑
No
RiserHeight: ❑
Yes
❑
No (Min.6 in.)
einforced Tank: ❑
Yes
❑
No
,,1 Piece Tank: ❑
Yes
❑
NO
Pipe Size: inch diameter
Pipe Length: feet
*Schedule:
Pressure Rated ❑ Yes
Approved fittings ❑ Yes
Pump Type:
S
Certification #:
*EH S:
Date:
Approval Status
❑ Approved ❑ Disapproved
ppiy Line
Installer:
Certification #:
*EHS:
❑ No Date:
❑ No Approval Status
❑ Approved ❑ Disapproved
Installer.
Dosing Volume: — Gal Certification #:
Draw Down: Inches *EHS:
*Chatn:
Date:
Valves Accessible ❑ Yes
❑
No
Flow Adjustment Valve ❑ Yes
❑
No
Check -valve ❑ Yes
❑
No
Approval Status'
PVC unions ❑ Yes
❑
No
❑ Approved ❑ Disapproved
Vent Hole ❑ Yes
❑
No
Anti -siphon Hole 0 Yes
❑
NO
CDP File Number ,202024 - 1
County ID Number: 5747332642
I
tlectnc equipment
N EMA 4X Box or Equivalent
❑
Yes
❑
No
Installer:
Box 12 inches Above Grade
❑
Yes
❑
No
Certification #:
Box Adj. To Pump Tank
❑
Yes
❑
N o
Conduit Sealed
❑
Yes
❑
No
*EHS:
Pump Manually Operable
❑
Yes
❑
No
*Activation Method:
Date: /
Alarm Audible
El
Yes
❑
No
Approval Status
❑ Approved ❑ Disapproved
Alarm Visible
❑
Yes
❑
No
2140 • Nations, Robert
*Operation Permit completed by;
Authorized State
Owner/Applicant Signature:
Date of Issue: 0 6/ 0 8/ 2 0 1 6
This system has been installed in compliance with applicable NC General Statutes: Article 11, Chapter 130A, Rules for
Sewage Treatment and Disposal, 15A NCAC 18A .1900 et. Seq., and all conditions of the Improvement Permit and
Construction Authorization. This property is served by a TYPE Ilk sewage septic system.
Rule .1961 requires that a Type TYPE 11 A. septic system meet the following criteria:
Minimum System Review ByThe local Health Department: NIA
Management Entity: OWNER
Minimum System Inspection/Maintenance Frequency ByCertified Operator:
NIA
Reporting Frequency By Certified Operator: NIA
Rule .1961 requires that a Type IV and V septic systems designed for a home/business owner must maintain a valid contract
with a public management entity with a certified operator or a private certified operator for the life of the septic system.
Rule .1961 requires that Type VI septic systems designed fora home/business owner must maintain a valid contract with a
public management entity with a certified operator for the life of the septic system.
Rule. 1961 (2) (e) requires a contract shall be executed between the system owner and a management entity prior to the
issuance of an Operation Perm it for a system required to be maintained by a public or private management entity, unless the
system owner and certified operator are the some. The contract shall require specific requirements for maintenance and
operation, responsibilities of the owner and systems operator, provisions that the contract shall be in effect for as long as the
system is in use, and other requirements for the continued proper performance of the system. It shall also be a condition of
the Operation Permit that subsequent owners of the systems execute such a contract.
G Hand Drawing Olmport Drawing
**Site Plan/Drawing attached.**
OPERATION PERMIT
Davie County Health Department
210 Hospital Street
P.O. Box 848
Mocksville NC 27028
Drawing Drawing Type: Operation Permit
36
c
(G
(b
CDP File Number: 202024 -1
County File Number: 5747332642
Date:
O Inch
Scale: OBlock
ON/A
2
ON
' I i
}
l� i j
CAN8TRUCTION
AOTHORIZATION
6,111 Davie County Health Department
210 Hospital Street
P.O. Box 848
Mocksville NC 27028
Phone: 336-753-6780 Fax: 336-753-1680
Applicant: Tabitha Long/Deena Abee
Address: 3480 US Hwy 601 S
City: Mocksville
State/Zip: NC 27006
Phone #: (336) 492-2089
1 For Office Use Only
*CDP File Number 202024 - 1
County ID Number: 5747332642
Evaluated For: NEW
Township:
0 4/ 1 5/ a 0 a 1
Property Owner: Evelyn Smith
Address: PO Box 325
City: Mt. Aetna
State/Zip: PA
Phone #:
19544
Address/Road #: Subdivision: Southwood Acres Phase: Lot: 13
219 Redwood Drive
Mocksville NC 27028 Directions
Structure: SINGLE FAMILY Hwy 601 S, left on Deadmon Rd. left on Rewood.
property on left
# of Bedrooms: 3
# of People: 4
*Water Supply: PUBLIC
Site Classification:
Provisionally suitable
Minimum Trench Depth:
a 4 Inches
Saprolite System?
No
OYes (9 No
Soil Cover:
1 a Inches
Design Flow:
3 6 0
Maximum Trench Depth:
3 6 Inches
Soil Application Rate:
0 a 7
5
Maximum Soil Cover:
a 4 Inches
*System Classification/Description:
*Distribution Type:
GRAVITY - SERIAL
TYPE 11 A. CONV SYSTEM (SINGLE-FAMILY
OR 480
GPD OR LESS) Septic Tank:
1 - *0 0 0
Gallons
*Proposed System: 25%
REDUCTION
1 -Piece:
O Yes ® No
Pump Required: O Yes
®No O May Be Required
Nitrification Field
1 3
0
9
Sq. ft. Pump Tank:
Gallons
No. Drain Lines
3
1 -Piece:
OYes 0 N
Total Trench Length:
3 a 7
GPM --vs-- ft. TDH
ft
Trench Spacing:
—
g
Inches O.C.
Feet O.C. Dosing Volume:
_ Gallons
Trench Width:
3
R
Inches
Feet
—
Grease Trap:
Gallons
Aggregate Depth:
inches
Pre -Treatment: O NSF OTS -1 OTS -11
Septic Tank
Installer Grade Level Required: 01011
O 111 01V /
Page 1 of 3
CDP File Number 202024 - 1 County ID Number: 574733242
❑ ,Open Pump System Sheet
r
*Site Classification: Provisionally Suitable
Design Flow: 1 A 01
ired: VY T eS V Ivo vivo, oUL rias mvallaole J
Soil Application Rate: 0 , 2 7 5
*System Classification/Description:
TYPE II A. CONV SYSTEM (SINGLE-FAMILY OR 480 GPD OR
LESS)
*Proposed System: 25%, REDUCTION
Nitrification Field 1 3 0 9
No. Drain Lines 3
Total Trench Length: 3 D 7 ft.
Sq. ft.
Trench Spacing: 9 O Inches O.
® Feet O.C.
Trench Width:— 3 R Inches
Feet
Aggregate Depth:
inches
Minimum Trench Depth: a 4
Inches
Minimum Soil Cover:
1
a Inches
Maximum Trench Depth:
3
6 Inches
Maximum Soil Cover:
.2
4 Inches
*Dlstdbution Type:
GRAVITY - SERIAL
Pump Required: Oyes ®No O May Be Required
Pre -Treatment: O NSF OTS -I OTS -II
- *Site Modifications
No grading or construction activity is allowed in areas designated for system and repair without approval of Health Department. Rem s
750
*Permit Conditions
The issuance of this permit by the Health Department in no way guarantees the issuance of other permits. The permit holder
is responsible for checking with appropriate governing bodies in meeting their requirements. Rhwadw9
2000
This Authorization for Wastewater System Construction shall be valid for a person equal to the period of validity of the Improvement Permit, not
to exceed five years, and may be issued at the same time the Improvement Permit issued (NCGS 130A -336(b)). If the installation has not been
completed during the period of validity of the Construction Permit, the information submitted in the application for a permit or Construction
Authorization is found to have been incorrect, falsified or changed, or the site is altered, the permit or Construction Authorization shall become
invalid, and may be suspended or revoked (.1937(g)). The person owning or controlling the system shall be responsible for assuring compliance
with the laws, rules, and permit conditions regarding system location, Installation, operation, maintenance, monitoring, reporting and repair
(1938(b)).
Applicant/Legal Reps. Signature Required? O Yes O No
Applicant/LegakReps. Signature: Date: /
*Issued By: 2140 - Nations, Robert Date of Issue: 0 4 / 1 5 / a 0 1 6
Authorized State Agent: 000Malfunction Log O Yes
® Hand Drawing O Import Drawing
**Site Plan/Drawing attached.**
Page 2 of 3
• CONSTRUCTION AUTHORIZATION
• i Davie County Health Department
210 Hospital Street
P.O. Box 848
Mocksville NC 27028
Drawing Drawing Type: Construction Authorization
CDP File Number:
County File Number: 5747332642
Date: 04/ 15 /.2016
O Inch
Scale: O Block
O N/A
Page 3 of 3 Pi P2
CONSTRUCTION AUTHORIZATION
Davie County Health Department
210 Hospital Street
P.O. Box 848
Mocksville `" NC 27028
CDP File Number:
County File Number: 5747332642
" � � / &Date: 1-4 / .1.5 . / ..2 0 1.6.
Click below to import an image from an external location: Drawing Type: Construction Authorization
\13
Page 3 of 3
1�v
P1
P2
IMPROVEMENT PERMIT
�.� Davie County Health Department
210 Hospital Street
-.. P.O. Box 848
Mocksville NC 27028
For Office Use Only
"CDP File Number 202024-1
County ID Number: 5747332642
Evaluated For. NEW
Township:
Phone: 336-753-6780 Fax: 336-753-1680 PERI.IIT VALID UNTIL: 4/15/2021
"NOTE TO INSPECTIONS DIVISION: Building Permits cannot be issued with this Improvement Permit.
Applicant: Tabitha Long/Deena Abee
Address: 3480 US Hwy 601 S
Cay: Mocksville
State/Zip: NC 27006
Phone #: (336) 492-2089
Address/Road #:
219 Redwood
Drive
Mocksville
NC 27028
Structure:
SINGLE FAMILY
# of Bedrooms:
3
# of People:
4
"Water Supply:
PUBLIC
/10—roperty Owner: Evelyn Smith
Address: PO Box 325
Cay: Mt. Aetna
State/Zip: PA 19544
Phone #:
,erty Location & Site Information
Subdivision: Southwood Acres Phase: Lot: 13
Directions
Hwy 601 S, left on Deadmon Rd. left on Rewood.
property on left
"Site Classification: Provisionally Suitable
Minimum Trench Depth: a 4 Inches
Saprolite System? QYes ONO Maximum Trench Depth: 3 6
Inches
Design Flow: 3 6 0 Septic Tank:
1 0 0 0 Gallons
Soil Application Rate: 0 a 7 5
'System Class ifrat io n/Description:
TYPE II A. CONY SYSTEM (SINGLE-FAMILY OR 480 GPD OR
,LESS)
'Proposed System: 25% REDUCTION
1 -Piece:
Pump Required:
Pump Tank:
1 -Piece:
Repair System Required:@Yes ONo ONo, but has Available Space
Repair System
.Site Classification: Provisionally suitable
Soil Application Rate: 0 2 7 5
'System Classification/Description:
TYPE 11 A. CONV SYSTEM (SINGLE-FAMILY OR 480 GPD OR
LESS)
'Proposed System: 25% REDUCTION
O Yes O N o
QYes Q No O May Be Required
Gallons
O Yes O N o
Minimum Trench Depth: 2 4 Inches
Maximum Trench Depth: 3 6 Inches
Pump Required: QYes ONO O Maybe Required
Pagel of 3
CDP File Number 202024-1 County ID Number: 5747332642
*Site Modifications I , ❑ Open Fill Sheet
No grading or construction activity is allowed in areas designated for system and repair without approval of Health Department.
*Permit Conditions
The issuance of this permit by the Health Department in noway guarantees the issuance of other permits. The permit holder
is responsible for checking with appropriate governing bodies in meeting their requirements.
Site Plan The Improvement Permit shall be valid for 5 years from date of Issue with a site pian (means a drawing not necessarily drawn to
O scale that stows the existing and proposed property lines with dimensions, the location of the facility and appurtenances, the
site for the proposed Wastewater system, and the location of water supplies and surface waters).
Plat The Improvement Permit Shap be valid without expiration with plat (means a property surveyed prepared by a registered land
O surveyor, drawn to a scale of oneinch equals no morethan 60 feet, that Includes: the specific location of the proposed facility
and appurtenances, the site for the proposed Wastewater system, and the location of water supplies and surface waters. Plat
also means, for subdivision lots approved by the local planning authority and recorded with the county register of deeds, a copy
of the recorded subdivisions plat that Is accompanied by a site plan that Is drawn to scale).
The Department and Local Health Department may impose conditions on the issuance and may revoke the permits for failure of
the system to satisfy the conditions, the rules, or this article: This permit is subject to revocation If the site plan, plat, or intended
use changes (NCGS 130A335(fl). The person owning orcontrolling the system shall be responsible for assuring compliance
with the laws, rules, and permit conditions regarding system location, Installation, operation, maintenance, monitoring,
reporting, and repair (.1938(b)}
Applicant/Legal Reps. Signature Required? Oyes ONo
Applicant/Legal Reps. Signature: Date: / /
'Issued By: 2140 -Nations, Robert
Authorized State Agent:
Date of Issue: 0 4/ 1 5/ 2 0 1
OValid without Expiration?
0Create CA?
@Hand Drawing Olmport Drawing
**Site Plan/Drawing attached.**
Page 2 of 3
0
•IMPROVEMENT PERMIT
Davie County Health Department
210 Hospital Street
P.O. Box 848
Mocksville NC 27028
Drawing Drawing Type: Improvement Permit
CDP File Number: 202024 -1
County File Number: 5747332642
Date: / /
Q Inch
Scale: OBIock
QN/A
IMPROVEMENT PERMIT
Davie County Health Department
210 Hospital street
P.O. Box 848
Mocksville NC 27028
CDP File Number: 202024 -1
County File Number: 5747332642
Date: 04/ 15 / 2 0 1 6
Click below to import an image from an external location: Drawing Type: Improvement Permit
Davie County.NC _ _ Tax Parcel ReDort Friday. March 18. 2(
`. 103 `� 171 145 106 24 8
i
C1
14
10
132 a 2642 3651
\ 8505 as 0601 �l°' b. _� , 27
209
5666
5566 �-
�, I
\� 100 104
100
\ Boa
r net�v�opQ o,i
be
100 5400
233
5475i6
00 tij
P 22� -0-
R 1395 239, 4304 o \_ ,► j
0342 __.. _L _1_ _-_ ...._.__...___ _ _ 'x.._._._53.33 _-.--_-"_----
Parcel Number:
K507OA0013
NCPIN Number:
5747332642
Account Number:
8304802
Listed Owner 1:
SMITH EVELYN M
Mailing Address 1:
PO BOX 325
City:
MOUNT AETNA
State:
PA
Zip Code:
19544
Legal Description:
LOT 13 SOUTHWOOD ACRES
Assessed Acreage:
0.47
Deed Date:
12/2013
Deed Book IPage:
2014EO359
Plat Book:
0005
Plat Page:
065
Building Value:
0.00
Outbuilding & Extra
0.00
Freatures Value:
Land Value:
24000.00
Total Market Value:
24000.00
Total Assessed Value:
24000.00
WARNING: THIS IS NOT A SURVEY
Davie County, NC
Parcel Information
O p�
Township:
Mocksville
Municipality:
Census Tract:
37059-805
Voting Precinct:
SOUTH MOCKSVILLE
Planning Jurisdiction:
Davie County
Zoning Class:
DAVIE COUNTY R -A
Zoning Overlay:
Voluntary Ag. District:
No
Fire Response District:
JERUSALEM
Elementary School Zone:
CORNATZER
Middle School Zone:
WILLIAM ELLIS
Soil Types:
GnB2,PcC2
Flood Zone:
X
Watershed Overlay:
-
v�
° "• a
Davie County, NC
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
harmless the County of Davie, North Carolina, its agents, consultants, contractors or employees from any and all claims or
O p�
causes of action due to or arising out of the use or inability to use the GIS data provided by this website.
T * l
PAWx PPLICATION FOR SITE EVALUATIONAMPROVEMENT PERMIT & ATC
a� Davie County Environmental Health
flgltt �' P.O. Box 8481210 hospital Street
' Mocksville, NC 27028
(336)753-6780/ Fax (336) 753-1680
Application For: i Site Evaluationnmproveinent Pennit E Authorization To Construct(ATC) G Both
Type of Application: CiNew System []Repair to Existing System i Expansion/Modification of Existing System or Facility
***IMPORTANT*** THIS APPLICATION C,4NNOT BE PROCESSED UNLESS ALL OF THE REQUIRED
INFORMA'110N IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions.
APPLICANT INFORMATION
Name to be Billed kit6 1"Jgdr) ' _Contact Person-hjUr-%a
Billing Address,!�Ml IA -S W111 (e J Home Phone '4Qa -aD1R q
City/State/ZIPncL �,Jt_-Ilei PIG —)7GL�8 Business Phone 104-DM-3Lvi3
Name on Permit/ATC if Different' than
Mailina Address ARll 1 i S 4A%A)
VKUFLK 1 Y IN f UKMA t IUN 'uate mouse/ractltty corners v taggea
N01E: A survey plat or site plan must accompany this application. Included: G Site Plan GPlat(to scale)
(Permit is valid for 60 months with site plan, no expiration with complete plat.)
Owner's NamePhone Number
Owmer's Addres City/State/Zip JIJ . A,24r�a_., PA IQ51
Property Address City _pC�CkISui I k e.,
Lot Size Tax PIN#
Subdivision Name(ifapplicable) - — e- Section/Lot# �J
Directions To Site: I o() 15 - - (L) 1 LI 44
If th saver toany of the following questions is "yes", supporting documentation must be attached.
Are there any existing wastewater systems on the site?
GYesc'K/vo
Does the site contain jurisdictional wetlands?
Dyes i�4Vo
Are there any easements or right-of-ways on the site?
GYes Kqo
Is the site subject to approval by another public agency?
Kies GNo
Will wastewater other than domestic sewage be generated?
❑Yes 1(lNo
IF RESIDENCE FILL OUT THE BOX BELOW
# People� # Bedrooms �_ # Bathrooms _ Garden Tub/Whirlpool []Yes No
Basement: GYes ��O Basement Plumbing: [:]Yes C-Xo
IF NON-RESIDF,NCF. FILL OIJT THE BOX BELOW
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: GConventional XAccepted Glnnovative ClAltenrative GOther
Water Supply Type:ACounty/City Water G New Well GExisting Well G Community Well
Do you anticipate additions or expansions of the facility this system is intended to serve? C; Yes KNo
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 permit(s) 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 hereby grant right of entry to the Authorized
Representative of the Davie County Health Department to conduct necessary inspections to determine compliance with applicable
la d rules. I understand that I am responsible for the proper identification and labeling of property lines and comers and
locati a a ging or nG the ho' se/facility location, proposed well location and the location of any other amenities.
/b Site Revisit Charge
Property owner's or ow er's legal representative signature
Date(s):
136 d Client Notification Date:
Date EIIS:
Sign given GYes GNo
Revised 11/06
b
Account # iz
Invoice #
I
MEN
L0�
Ivnry+.
Wood
ocksvi IIS.
DAVIT; COUNTY HEALTH DEPARTMUT
PERCOLATION TEST RESULTS
DATE_
LOCATIOIN eyy 1?a11t'- //,? _
FINDINGS: HOLE NO.
a
2 7 3:o/ _�.� �!<
3 8" 3;az
s
6
LOT DIAGMM
q 8"9,e-.— .7.4
¢o
-/ 1/ 1ioc.�a
m
'e3
1pl-�
4
'*2,
COMMEOTS
By: 9./f%rIZ—
�3j,Cpds crf L°a��/`srn� �A�eAi�
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
Soil/ Site Evaluation
APPLICANT INFORMATION Ubm 0
)n /
(oil's I ��l V
0 AM -3693
Water Supply:
Evaluation By:
On -Site Well Community
Auger Boring Pit
PROPERTY INFORMATION
�.ec�woQc� IJ2.
'q1 Ate.
PQdwoad WAeodotaJ
Public
Cut
FACTORS
1 2 3 4 5 6 7
Landscape position
(�
Slope %
HORIZON I DEPTH
( 6 -
Texture group
4 e C
Consistence
t5
Structure
$
Mineralogy
HORIZON II DEPTH
Texture group
Consistence
Structure
S
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
7
SITE CLASSIFICATION:
LONG-TERM ACCEPTANCE RATE: 0• 1 % J
REMARKS:
LEGEND
EVALUATION BY: lit ! ,
OTHER(S) PRESENT -
Lan scape
RESENT:
Lanndscane 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
LYQte�
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 - aal/dav/ft2 nruun ncinc M-4—AN