Loading...
951 Dulin RdDAVIE COUNTY ENVIRONMENTAL HEALTH P.O. Box 848/210 Hospital Street ` (" Mocksville, NC 27028 (336)753-6780 / Fax # (336)753-1680 OPERATION PERMIT Adenuot #: 990005568 Tax PINIEH #: G600000080 Billed To: , Jerry Foster Subdivision, Info: Reference Dame: Jack and Jessica Thomas LocationiAddress: Dulin Road-27028 Proposed Facility: Residental Property Size: .810 Acre ATC Number: 5904 **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 be taken as a guarantee that the system will function satisfactorily for any given period of time. ��Q��t' System Type: &ayV\ Manufacturer Tank Date 511-7 Tank Size 16CO Pump Tank Sizer Bedrooms: 3 System Installed By: stalle# tev-V-64)n GPS Coordinate: �2Vl� it 3'X(afi' Z H Z1t Environmental Health Specialist 0j Date: DCHD 11/06 (Revised) DAVIE 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 #: 990005568 Tax PIN/EH #: G600000080 Billed To: Jerry Foster Subdivision Info: Reference Name: Jack and Jessica Thomas Location/Address: .Du7ih Road -27028 Proposed Facility: Residental Property Size: .810 Acre ATC Number: 5904 Site Type: ❑New ❑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 3 Basement❑ Basement plumbing❑ Non -Residential Specifications: Facility Type # People # Seats Square Footage(or Dimensions of Facility) ?I MqAfek Lot Size O Q Type of Water Supply: ❑County/City Wel❑Comm ity ellI� System Specifications: Design Wastewater Flow (GPD)_Tank Size /(GAL. Pump Tank GAL.. Trench Width S Max. Trench Depth �Rock Depth Linear Ft. _yw�ds 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 Specialist, DCHD 11/06 (Revised) Davie County Environmental Health P.O. Box 848/210 Hospital Street Mocksville, NC 27028 (336)753-6780/Fax(336)753-1680 IMPROVEMENT PERMIT Account #: 990005568 Tax PIN/EH #: G600000080 Billed To: Jerry Foster Subdivision Info: Address: 951 Dulin Road Location/Address: Dulin Road -27028 City: Mocksville Property Size: .810 Acre Reference Name: Propoagq&Eillit bf3q"&t4nent 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: VNew ❑Repair ❑Expansion Permit Valid for: 95 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 t�iWell Community Well Site Modifications/Permit Conditions: System Type LTAR Initial D e«. - rt . APPLICATION FOR SITE EVALUATIONAMPROVEMENT PERMIT Davie Cmuty Enwhver ientalitnithC E', /C® P.O. -Boa 848/210 hospital Street �/ t� Mocksville, NC 27028 O C j 7 (336)753-6180/Fax( 336) 7 -1 8Q t," I Zo l l Application For: Cl"Site valuation/Improvement Permit VAuthorizat n o Coostruct(AT.0 .,, 0 Both Type of Application: Mew System ❑Repair to Existing System ❑Expansion/Modification of�ftr ystem or Facility •" 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 Billed P G 1 V Contact Person r er Billing Address l Home Ph, City/State/ZIP usiness Phone - Name on Permit/ATC if Different than Mailing Address PC) 1, PROPERTY INFORMATION "Date House/Facility Comers Flagged NOTE: A survey plat or site plan must accompany this application. Included: Mite Plan ❑Plat(to scale) (Permit is valid for 60 months with site Ian, no expiration with complete plat.) Q Owner's Name Phone Number 01 Ct 8 ^ V Owner's Address City/State/Zip Property Address l City \ \9— Lot Size Tax 111N# Subdivision Name(if applicable) Section/Lot# Directions To Site: 7M N s Mckin —t-0 V-%1 t t:\ ft I "t^e� i 16221 rN % t - If the answer to airy of the following questions is "yes", supporting documenta�tio�n must be attached. Are there any existing wastewater systems on the site? ❑Yes'60 (,,� �r Does the site contain jurisdictional wetlands? ❑Yes o �v�Q Z) Q Are there any easements or right-of-ways on the site? ❑Yes 9'fl0 Is the site subject to approval by another public agency? 0 Yes 9i 0 Will wastewater other than domestic sewage be generated? ❑Yes g o IF RESIDENCE FILL OUT THE BOX BELOW # People # Bedrooms 13 #Booms Garden Tub/Whirlpool V es ONo Basement: ❑Yes o Basement Plumbing: ❑Yes o IF NON -RESIDENCE FILL OUT 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: sZonventional ❑Accepted ❑Innovative ❑Alternative ❑Other Water Supply Type: &/County/City Water ❑ New Well ❑Existing Well ❑ Community Well Do you anticipate additions or expansions of the facility this system is intended to serve? 0 Yes i5Ao 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 laws and rules. I understand that I am rjgj§ati e per identification and labeling of property lines and comers and locating and fl or stal g th Y on proposed well location and the location of any other amenities. Property o is or owner' egal re esentative sigma a Site Revisit Charge l C/ ` Client Notification Date: Date EHS: Q7 O c-�B EG��� TT7J Sign given ❑Yes Account# y Revised 11/06 Invoice # OCT z� `•" L-1- ET - C90\1 i �itest- AiYNR.. b ,bq A- W I T' ' •1 i hF y -,. I _ � - O`" ;� T 1 . � USF, l �b i - f tet... �-� ` ��„ f, .. \ / �I ` ' .1 � �, i ,� I � � � .. _ yrs. ,z,. �� .... Jr �' / J 1 J J �- 1. - - .,-� I -f,� t �� 1 .t ..�aM ��. '.�`�. �� ,./ ! , -� !�. _ �� 4,.,: p;_ _ -� -dpi., .. �l,��� � r = _ ` - i _ /" - � re - . .. � a; � -..9 a .c �„ �-fi�vi'�i'114,����"^� �, .. {. J ~ y,p '�;� 'Y 'y�� at L :tom 1 � r S � ,y+ss'� e!„�.'1' 1 � � h.iyt,,lra��y.� f � . ',X � `s'�`ti .,� . timet . �;. �. � �1 � ���, h� � � t „ f y,� �4 i -�a � ; •w .. � t, .. �..� rah` � � � _ _ _ 1 '� . !, t .,.� r � i (� _ _ " -. �;�� ria' i' i •t `' " ,a e , t 1� , .. s. bl . � � .�.t v. inti , 1�' �' , _ !� A DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/ Site Evaluation APPLICANTINFORMATIONt�,RbbD,ERTY Tax PIN/EH #: G600a INFORMATION Foster z'Subdivision Info: and Jessica Thomas Location/Address: 951 Dulin Road -2702 Property Size:. 0.69 Ac Date Evaluated: On -Site Well Community. Public Auger Boring Pit "' Cut Account #: 990 )05771 Billed To:* Jer Reference Name: Jac c 'roposed Facility: Res dence Water Supply: Evaluation By: FACTOIR S 1 2 3 4 5 6" 7 Landscape position L L Slope % HORIZON I DEPTH -,, z U Texture grow c— Consistence Structure" a=; Mineralogy 12 :1 HORIZON H DEPTH Z,7, Texture group (•,,n Consistence ' g, Structure {.- Mineralogy t ; 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 CLASSIFICATIO EVALUATION BY: •F'f (n� ,��( \ (�ii (, KUO . I �1_40 L LONG-TERM ACCEP10 NCE RATE: -oW OTHER(S) PRESENT: REMARKS: LEGEND LandscapePositi n R - Ridge S - Should r L - Linear slope FS -Foot slope N - Nose slope CC - Concave slope ZV - Convex slope T - Terrace FP - Flood plain H - Head slope Texture S - Sand LS - Loam sand SL - Sandy loam L - Loam SI - Silt SICL - Silty clay loam SIL - Silty loam j CL - Clay loam SCL - Sandy clay loam ' SC - Sandy clay SIC - Silty clay C;. clay CONSISTF.N _ . Moist VFR -.Very friable - Friable FI - Firm VFI - Very firm EFl-Extremely firm MeA NS - Non sticky SSSlightly 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 lYot€S Horizon depth In inches Depth of fill - In inches Restrictive horizon - Thic ness and inches from land surface Saprolite - S(suitable), U( nsuitable) . Soil wetness - Inches fro 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) iTAR - i.nno-term arrrnt nra rate oat/riav/ft) rinrTTN ncInc in__.:__�� ■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■ ■sUMSUSMUMMUURMMMMNMMU■Me■ ■■NEEM■e■n■■n■o■■e■n■■■■N■ ■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■Rat■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■E■■■ME■■11",9.mam ■O■■■■MMMMUMMM■ ■■E■EEME■E■■■■■ ■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■ ■ ■ ■ ■ ENSURE RESUME ■■■E■■ ■■■■■■ Samoan ■■MONS OMEN■■ ■■■■M■ MUMMER ■■■E■ in■■m■ Mammon mammon ■■S■■■ ■■■■a■ ■ff■Un■u■■■■ ■MMMmM SOU■■ ■mommon■em■ zzzz..;-w:mM■■ ■MEMO ■■■■ ■■Mn■ �■UNN ■■■■►,■■■■■■ ■■■■S■■■■■■ ■■■N■■SE■E■ ■E■■■■■M■E■ ■■■EMEMMEM■ ■■■■■■■■■M■ ■O■■■a■N■■■ MONSOON SOMEONE MONSOON ■E■■■M■ MESS■■■ ■M■■■■■■■■ ■■Maeoee■■ ■E■■N■■■■■ ■UM■■o■■M■ ■■EEM■■■■■ MONSOON i ■ ■■MM■■■■U■N■RE■■■■ ■■H■■■M■■■M■■■n■■ ■■ ■■ERRMME■a■M■■ ■■M■■■■■O■■■■■■■■■ ■RMMOO■MOM■M■R■RR■ ■■■EM■■MM■■■■■■■■■ ■■ME■a■■o■NE■■■MR■ ■■■■■■■■■■■■■ ■E■■■■■O■NE■■ I■■■■■■■■m■■■ ■■■■■E■■■EME ■■E■ NOME MEMO ■E■■ anon ■EM■ soon SEEN Noun ■ ■ iii ■■ ■ i MOOR■ ■■R■■ ■N■■■ NOOSE MOOSE ■■N■■ ■■■■■ ■o■ ONE mom ■U■ iii ■■MONS Samoa ■■■R■ OCT 24,2011 11:13A X9984604 G Nad 1 I r page 1 f L` a�,i Ca -717s giv-3"16 s�/ 41, Cn • ••• . as a DAVIE COUNTY PLANNING DIRECTOR I hereby certify that 1 am the owner of the property shown and described hereon, which located in the County of Davie that I hereby adopt this pian of subdivision with my free consent. established minimum building setback lines and dedicate all streets, alleys. walks, parks and other sites and easement to public or private use as noted. Furthermore, I hereby dedicate all sanitary sewer and water lines to the County of Davie : DATE JERRY K. FOSTER I REVIEW 0Frk0CS C'cirTc IFICATE I, . Review officer of Davie County, certify that the map or plat to which this certification Is afted meets all statutory requirements for recording. REVIEW OFFICER DATE Filed for registration at o'clock M. . 2012 and mcorded in Plat Book , Page - Filing fes ; pald. K MOU WAF — DANE Co. Rsgtster of Deeds DULIN UNITED METHODIST CHURCH, 07 t at D.B. 155, PG. CONTROL — -- CORNER ----- -------"-- REBAR ---...—_---_----- ' "/ 1�9 NEW IRON r�� J r NFW 30' EASEMENT AS OF MAR -28-2012 \ NEW 10' WATER LINE EASEMENT AS OF MAR -28-2012 /C/L DESCRiDED NEW IRON JERRY K. FOSTER D.F. 445, PG. 15 Sun== Cartiftratlon for _ Subdhrisian — Qm4a Couniy_ North Carolina I, Grady L Tutterow, Registered land Surveyor, Number L-2527 certify to one or more of the following as indicated by an X: X a. That this Is a plat of a survey that creates a subdivision of land within an area of a county or municipality that has an ordinance that regulates parcels of land; b. That this plat is of a survey that is located in such a portion of a county or municipality that to unregulated as to an ordinance that regulates parcels of land; c. That this plat is of a survey of an existing parcel or parcels of land; d. That this plot is of a survey of another category, such as the recombination of existingg ppaarcels, a court—ordered survey, or other exception to the definitlon of a subdivision; e. That the information available to this surveyor is such that I am unable to make a determination to the best of my professional ability as to provisions contained in a. through d. above. signature Surveyor Registration Number AREA= 0.810 AC. I, Grady L Tutterow, certify that this plat was drown under mysupeMsion from an actual survey made under my supervision (deed desc' tion recorded in Book ; Page , etc.) other);that the boundaries not surveyed are clea indicated as drown from information found in PL Book , Page ; that the ratio of precision is calculated as 1; +2000 ; that this plat was prepared in accordance with G.S. 47-30 as amended. Witness my original signature, registration number and seal this day of A.D., 2012 Surveyor (Seal or Stamp) Registration Number Firm Licence Number F-0372 NEW IRON NOTES: 13• .Irllrll DULIN UNITED METHODIST CHURCH, et D.D. 809, PG. 915 1. TOTAL TRACTS- 1 2. TOTAL AC.- 0.810 AC. 3. X— UNMARKED POINT OF PROPERTY do EASEMENT 4. NO NCGS GRID MONUMENT LOCATED WITHIN 2000 FT. VICINITY MAP I at I I I I I I I CONTROL I ! CORNER ! EXISTING I I I I I I I I I i JERRY K. FOSTER OWNER ------------------ DEVELOPER JERRY K. FOSTER 951 DUBLIN RD. MOCKSVILLE, N.C. 27028 SHDAY GROVE TOWNSHIP DAVIE COUNTY, NORTH CAROLINA DATE: MARCH -28-2012 TAX MAP REF. G-6, P/0 02 SURVEYED BY: TUTTEROII SURVEYING COMPANY 107 NORTH SALISBURY STREET MOCKSVILLE, NC 27028 (336) 751-5616 50 25 0 50 100 150 SCALE IN FEET FILE NAME: COORD NAME: DRAWING NUMBER: JK-FOST LEONHEP-74 3912-3 Davie County Environmental Health P.O. Box 848/210 Hospital Street Mocksville, NC 27028 (336)753-6780 / Fax (336)753-1680 IMPROVEMENT PERMIT Account #: 990005568 Tax PIN/EH #: 5759-89-0615 Billed To: Jerry Foster Subdivision Info: Address: 951 Dulin Road Location/Address: Dulin Road -27028 City: Mocksville Property Size: 4 more or less Reference Name: Proposed. Facility: Residental **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'l l 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: 6Z5 -Years ❑No Expiration Residential Specifications: # Bedrooms 3 # Bathrooms # People Basement❑ Basement plumbingC Non -Residential Specifications: Facility Type # People —# Seats Square Footage(or Dimensions of Facility) Design Flow(GPD): 3 (�lJ Type of Water Supply: ❑ County/City (l P Vell ❑ Community Well Site Modifications/Permit Conditions: Site Plan System Type LTAR Initial Wdl h2Z� Repair �M IVz � i Environmental Health Specialist Date i.p.11.06 AUG 2 5 2010 ITE EVALUATION/IMPROVEMENT PERMIT & ATC Davie County Environmental Health P.O. Box 848/210 Hospital Street Mocksville, NC 27028 �1 I (336)753-6780/ Fax (336)753-1680 rdement Permit ❑ Authorization To Construct (ATC) ❑ Both ❑Repair to Existing System ❑Expansion/Modification of Existing System or Facility ** *IMPORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL OF THE REQUIRED INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions. A PPT TC A ATT TATPOP TA A TTnNT Name ( _PAW Contact Person ( e 0 10C I e Address Owner's Name J e rl . Home Phone - City/State/ZIP A o tk0 '1 2 Business Phone Property Address oil Name on Permit/ATC if Different than} Above Mailing Address e --x ) F PROPERTY INFORMATION *Date House/Facility Corners Flagged NOTE: A survey plat or site plan must accompany this application. Included: ❑ Site Plan ❑Plat(to scale) (Permit is valU for 60 mo the with site lan, no expiration with complete plat.) � l Owner's Name J e rl . Phone N tuber Owner's Address ( ✓� -) 04 City/Sta a/Zi %�( 0 Property Address oil City aoc huc ke Lot Size--tbtZMalt - — 061,5 Subdivision Name(if applicalile) Di�ctions Site: 7 �n ection/Lot# � t o -f- V,/c '7a q �i� �,-. `/ k moo, o r, e P C 'c If the arlswer to any of the following ques ions is "Yes ',supporting documentatigqn rpust be attached: Are there any existing wastewater systems on the site? No Does the site contain jurisdictional wetlands? _Yes _Yes �E`No Are there any easements or right-of-ways on the site? Yes �No Is the site subject to approval by another public agency? Will wastewater other than domestic sewage be generated? _YesNo Yes No IF RESIDENCE FILL OUT THE BOX BELOW # People # Bedrooms # Bathrooms 2-- Garden Tub/Whirlpool ❑Yes ❑No Basement: ❑Yes Cho Basement Plumbing: ❑Yes EK -6 IF NON -RESIDENCE FILL OUT 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: Conventional ❑Accepted ❑Innovative ❑Alternative ❑Other Water Supply Type: ❑ County/City Water © /New Well .existing Well ❑ Community Well Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes 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 laws and rules. I understand that I am responsible for the proper identification and labeling of property lines and corners and locating an aggiagst ing the house/facility location, proposed.well location and the location of any other amenities. or „(((( Site Revisit Charge P orP or perty owner's or owner's legal representative signature ,-7 2 0 0 Date(s): Client Notification Date: Date ( EHS: Sign given ❑Yes ❑No Account #�Lf� a Revised 11/06 Invoice # -� rr� .41Ma� Frame Davie County, NC - GIS/Mapping System • Click Here To Start Over Q N� Active Layer. Ruse.+fap fps tj �u- - (PARCELS (Map Tips Available) j 'age 1 of 1 Quick Search: (County ID or Dili ner Ni M, Addre http://maps.co.davie.nc.us/GoMaps/map/mapframe.cfm?CFID=4129&CFTOKEN=616408... 8/25/2010 - 591 G600000087 6N (2.88A) 10 a 0820 MCDANIEL HOLDINGS LLC I E JOHN BRUCE (2.20A) 0643 G G600000086 HIATT KEITH B G600000085 A (12.39A) i 6220 ��„ (276N ails 60000008 H R FRANC EDULIN UNITED MET 6600000097 KORAS N G600000083 z, 3910 � DULINUNII . 2713 008202 INSHIP 6600000081 DUUNS CHURCH SHIP (2.87A) 2428 _ DULIN UNITED M H T CHURCH HENDRIX JERRY CLYD _ (2.09A) FOSTER SPURGEO H JR0197 G60000011305 G60000008001 1030 FOSTER SPURGE b JR 6000000820 FARMINGTON TOWNSHIP SHADY GROVE TOWNSHIP (16.29A) 8382 CHURCH METHODIST CHURCH FOSTER JERRY KENNETH G600000082 (70.43A) 0615. 29.24A 4095 MARKLAND DONALD J & LISA L G60000005801 MARKLAN4 DONALD J 81799A G60000006101 a;a t MARKLAND DONALD J G600000061 8799A 9920 FOSTER JERRY KENNETH G600000063 9678 ss7a MARKLAND RAYMOND JULI • FOSTER SP SON H SR(1-94A) 8802 G600000080 G600000082 FOSTER JERRY KENNETH A MCDANIELTROY E ' RG600000C , G6dbp0011304 11 746 ENDRIX THOMAS LESTER POTTS DANNY R ARNEY DE N HA OLD (3.10A) G6 000 067 \ 6600000078 (553A) 2111 x167 0600000079 SMI NAT AN 4153 RN, TOMMY NELSON ' WATTS KELLY G 30as a.00N 59 4 - (3 °A)G6 0000 6801 5594 RNEY TOMMY NELSON G600 G 0071 073 0000 065 w a31 MAU) rannnnnnAA APPLICANT INFORMA Account #: 990005568 Billed To: Jerry Foster Reference Name: Proposed Facility: Residental DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/ Site Evaluation PROPERTY INFORMATION Tax PIN/EH #: 5759-89-0615 Subdivision Info: Location/Address: Dulin Road -27028 Property Size: 4 more or less Date Evaluated: 14�D__ Water Supply: On -Site Well Community Evaluation By: Auger Boring Pit .y Public Cut FACTORS 1 2 3 4 5 6 7 Landscape position Slope % HORIZON I DEPTH Texture group Consistence Structure Mineralogy HORIZON II DEPTH — j Texture group Consistence Structure Mineralogy HORIZON III DEPTH -� ., Texture groupC Consistence Structure Mineralogy: , HORIZON IV DEPTH '7 77 Texture group Consistence Structure Mineralogyr s SOIL WETNESS RESTRICTIVE HORIZON SAPROLITE CLASSIFICATION (/` In LONG-TERM ACCEPTANCE RATE 2Z SITE CLASSIFICATION:_ LONG-TERM ACCEPTANCE RATE: REMARKS: EVALUATION BY. W�ffl If OTHER(S) PRESENT: A is 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 A 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 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) T TAR - T nna_tPrm up ---ton 09/16/2010 11:55 3366994545 KEN KETNER PAGE 01 U r C F SEP 1 6 2010 ENVIRON4?ENTAL HEALTH DAVIE COUNTY