The URL can be used to link to this page

270 Lee Jackson Dr` OPERATION PERMIT Davie County Health Department 210 Hospital Street P.O Box 848 Mocksville NC 27028 Phone: 336-753-6780 Fax: 336-753-1680 Applicant; Wallace Farm Inc. / Eric Wallace . Address: 14410 Eastfield Road City: Huntersville SWOOP: NC 28078 Phone #: Ptnpertygwner. Eric Wallace- Address: 9401 Hams Road City: Concord State/Zip: NC �P�hone (980) 428-3185 Pro a Location $ Site information Address/Road #: Subdivision: Phase: Lot: 270 Lee Jackson Drive Advance NC 27006 Directions Hwy 158 east, left on Rainbow Rd. left on Lee Structure: BUSINESS Jackson Dr # of Bedrooms: # of People: 'Water Supply: EXISTING WELL *System Classification/Description: ' IP Issu6d by. 2144 - Nations. Robed TYPE it A. cow SYSTEM (SINGLE-FAMILY OR 4eo GPC1 o)R LESS) *CA issued by: 2140 -Nations. Robert SaproliteSystem? OYes *No Design Flow: a 0 0 *Distribution Type: GRAVITY -SERIAL Pump Required? OYes *No Soil Application Rate: 0 - 1 7 5 *Pre Treatment: Drain field Nitrification Field 1 1 4 a Sq. It. *System Type: INFILTRATOR QUICK STANDARD No. Drain Lines a Installer Jamie Games Total Trench Length: a 8 8 It. Certification #: Trench Spacing: _ 9 2inches O.C. Feet O.C. "EH S: 2140 - Nations. Robert Trench Width: — 3 Inches • Feet 0 8/ 0 7/ 2 0 1 5 Date: W V� Aggregate Depth: inches Minimum Trench Depth: 3 6 Inches = ye Minimum Soil Cover. 4 Inches Approv�af Status Maximum Trench Depth: 6 Inchesppro+et'"Dtspproyd k Maximum Soil Cover. 4 Inches CDP Fite Number 194655 -1 County ID Number: 5851443634 Manufacturer: Shoaf STB: 760 Gallons: 1000 - Date: 0 4 / 0 a/ a 0 1 5 "Filter Brand: POLYLOK PL -122 With Pipe Adapter ST Marker. ❑ Yes O No nforced Tank: ❑ Yes O No 1 Piece Tank: ❑ Yes ® No 2tic Tank Let. 13. Long: Installer. Jamie Bames Certification #: *EH S: 2140 - Nations. Robert Date: 0 .8 ,/ 0 7 l a 0 1 5 Pump Tank Manufacturer. Installer. PT: Gallons: Dosing Volume: - Date: Gal Certification #: Draw Down: RiserSealed ❑ Yes ❑ No RiserHebht: ❑ Yes ❑ No (Min.6 in.) nforced Tank: ❑ Yes ❑ No 1 Piece Tank: ❑ Yes ❑ No 91 Pipe Size: inch diameter Pipe Length: feet *Schedule: Pressure Rated 11 Yes ❑ No ►pproved fittings ❑ Yes ❑ No Certification #: *EH S: Date: pply Line Installer, Certification #: *EH S: Date: / / Pump Type: Installer. Dosing Volume: - Gal Certification #: Draw Down: Inches *EH S: *Chan: Date: _ Valves Accessible ❑ Yes ❑ No Flow Adjustment Valve ❑ Yes ❑ No Check -valve ❑ Yes ❑ NO AjptiaralstatusWy :w PVC Unions ❑ Yes ❑ No r❑ Apprcma�ed ❑ Dtsa�rove�lAL Vent Hole [I Yes ❑ No .. rdh V-111 �:_{xr,.,. Pr,..h ..., fi� Anti -siphon Hole ❑ Yes ❑ NO CDP File Number 194655 " I NEMA 4X Box or Equivalent ❑ Yes Box 12 inches Above Grade ❑ Yes Box Adj. To Pump Tank ❑ Yes Conduit Sealed ❑ Yes Pump Manually Operable ❑ Yes 'Activation Method: Alarm Audible ❑ Yes Alarm Visible ❑ Yes `Operation Permit completed by. Authorized State Agent: Electric E ent ................... .. ...... .......... .. .......... . County ID Number: 5861443634 ❑ No Installer. ❑ No Certification #: ❑ No ❑ No 'EH S: ❑ No Date: _ El No ApprevalStatus Approved ❑ Disapproved ❑ No Date of Issue: Owner/Applicant Signature: This system has been installed in compliance with applicable NC General Statutes: Article 11, Chapter 130A, Rules for Sewage Treatment and Disposal, l5A NCAC.18A.1900 et. Seq., and all conditions of the Improvement, Permit and: Construction Authorization. This property is served by a TYPE It A Sewage sept1C system TYPE IIA, Rule A 961 requires that a T septic system meet the following criteria: Minimum System Review ByThe Local Health Department: NIA Management Entity: OWNER Minimum System InspectiontMaintenance Frequency By Certified Operator, NIA Reporting Frequency By Certified Operator NIA Rule .1961 requires that a Type IV and V septic systems desgned iota home/business owner must maintain a valid contract with;a public management entitywith a,certified operatorora private certified operatorfortfie life of the septic system. Rule .1961 requires that Type VI septic systems designed for a 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 entiity prior to the issuance of en Operatlon Pertn`it for a system: required to be maintained by a public, or private management entry, unless the system ownerand certified operator are the same. The contract shall require specific requirements for matenance and operation, `responsibilities of the ownerand 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. R shalt eiso be a condition af' the Operation Permit thatsubsequentowners'"of the systemsexecute such a contract.. 0 Hand Drawing OlmportDrawing „ **Site Pian/Drawing attached.**'` OPERATION PERMIT Davie County Health Department 210 Hospital Street P.O. Box 848 Mocksville NC 27028 COP File Number: 194655, 1 County File Number: 5851443634 Date: / Q inch Scale:. QBlock = ft. Applicant: Address: City: State/Zip: Phone #: CONSTRUCTION AUTHORIZATION Davie County Health Department 210 Hospital Street P.O. Box 848 Mocksville NC 27028 Phone: 336-753-6780 Fax: 336-753-1680 Wallace Farm Inc. / Eric Wallace 14410 Eastfield Road Huntersville M 28078 For Office Use Only *CDP File Number 194655-1 County ID Number: 5851443634 Evaluated For: NEW Township: NtRMI I VALID LIN I IL: 0 7/ 1 7/ x 0-a 0 Property Owner: Eric Wallace Address: 9401 Harris Road City: Concord State/Zip: NC Phone #: (980) 428-3185 Property Location & Site Information "Address/Road #: Subdivision: 270 Lee Jackson Drive Advance NC 27006 Structure: BUSINESS # of Bedrooms: # of People: *Water Supply: EXISTING WELL Phase: Lot: Directions Hwy 158 east, left on Rainbow Rd. left on Lee Jackson Dr Classification: Provisionally suitable Minimum Trench Depth: a a Inches \Site Minimum Soil Cover: a Saprolite System? OYes (gNo —1 Inches Design Flow: x 0 0 Maximum Trench Depth: 3 6 Inches Soil Application Rate: 0 1 7 5 Maximum Soil Cover: a 4 Inches *System Classification/Description: *Distribution Type: TYPE II A. CONV SYSTEM (SINGLE-FAMILY OR 480 GPD OR LESS) Septic Tank: 1 0 0 0 Gallons *Proposed System: 25016 REDUCTION 1 -Piece: OYes ®No Pump Required: OYes ®No O May Be Required Nitrification Field 1 1 4 a Sq. ft. Pump Tank: Gallons No. Drain Lines a 1 -Piece: OYes ONo Total Trench Length: a 8 5 GPM --vs— ft. TDH ft Trench Spacing: _ 9 R Inches O.C. Feet O.C. Dosing Volume: Gallons Trench Width: 3 2 Inches Feet _ Grease Trap: Gallons Aggregate Depth: inches Septic Tank Pre -Treatment: O NSF OTS Installer Grade Level Required: 01.011 O -1 O TS -II / III 01V Page 1 of 3 CDP File Number 194655 - 1 County ID Number: 5851443634 .,% ❑ Open Pump System Sheet uired:®Yes O No O No, but has Available Space *Site Classification: Provisionally Suitable Design Flow: a 0 0 Soil Application Rate: 0 1 7 5 *System Classification/Description: TYPE II A. CONY SYSTEM (SINGLE-FAMILY OR 480 GPD OR LESS) *Proposed System: 25% REDUCTION Nitrification Field 1 1 4 a No. Drain Lines a Total Trench Length: a 8 5 ft Sq. ft. Trench Spacing: _ 9O Inches O. ® Feet O.C. Trench Width: _ 3O 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: a 4 Inches *Distribution Type: GRAVITY - PARALLEL (eq. d -box) Pump Required: OYes (g No O May Be Required Pre -Treatment: O NSF OTS -1 OTS -ll *Site Modifications No grading or construction activity is allowed in areas designated for system and repair without approval of Health Department. RBma�n9 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. RBTBcteg 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 ONO Applicant/Legal Reps. Signature- Date: *Issued By: 2140 - Nations, Robert Date of Issue: 0 7 1 7 / a 0 1 5 Authorized State Agent: L Malfunction Log Oyes (gHand Drawing OlmportDrawing **Site Plan/Drawing attached.** Page 2 of 3 CONSTRUCTION AUTHORIZATION 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: 5851443634 Date: 07 /1y/.1015 O Inch Scale: O Block O N/A Page 3 of 3 P1 P2 CONSTRUCTION AUTHORIZATION Davie County Health Department 210 Hospital Street P.O. Box 848 Mocksville NC 2 Click below to import an image from an external location: �S �w� -� J l� CDP File Number: 7028 County File Number: 5851443634 Date: A7./ .1.7 / ..10 1.5 . Drawing Type: Construction Authorization skad-r- L 100._..1 yr LA G 4, 10 1rjLd Page 3 of 3 P1 • IMPRCpVEMENT PERMIT ,.. Davie County Health Department 210 Hospital Street. P.O. Box 848 Mocksville NC 27028 Phone: 336-753-67$O Fax: 336-763-16$0 PERMIT VALID UNTIL: 7/17/2020 *NOTE TO INSPECTIONS DIVISION: Building Permits cannot be issued with this Improvement Permit. Applicant: Wallace Farm Inc. / Eric Wallace Address: 14410 Eastfield Road City. Huntersville State/Zip:; NC 28078 Phone # Address/Road #: Subdivision: 270 Lee Jackson Drive Advance NO 27006 Structure: BUSINESS # of Bedrooms: # of People: "Water Supply: EXISTING WELL Suitable Saproiite System? OYes @No Design flow: a 0 0 Soil Application Rate: 0 1 7 5 "System Classification/Description: TYPE Il A. COW SYSTEM (SINGLE-FAMILY OR 480 GPD OR LESS) *Proposed System: 25% REDUCTION Property owner. Eric Wallace Address: 9401 Harris Road Cay: Concord State/Zip: NC Phone # (980) 428-3185 Phase: Lot: Directions Hwy 158 east, left on Rainbow Rd. left on Lee Jackson Dr Minimum Trench Depth: a a Inches Maximum Trench Depth: 3 6 Inches Septic Tank: 1 0 0 0 Gallons 1 -Piece: OYes ONo Pump'Requined: OYes (j)No OMay Be Required Pump Tank: Gallons 1 -Piece: OYes ONo Repair System Required:* Yes ONo ONo, but has Available Space Repair System 'Site Classification: Provisionally Suitable Soil' Application Rate: 0 -1 7 5 "System Classification/Description TYPE 11 A. CONY SYSTEM (SINGLE-FAMILY OR 480 GPD OR LESS) *Proposed System: 25% REDUCTION Minimum Trench Depth:. a 4 inches Maximum Trench Depth 3 6; Inches Pump Required: OYes @No 0MaybeRequired Page 1 of 3 CDP File Number 194655 1 County ID Number. 5851443634., *Site Modifications ❑ Open Fill Sheet No grading or construction activity is allowed in areas designated for system and repair without approval of Health bepaltment. *Permit Conditions The issuance of this permit bythe 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. Site Plan The Improvement Permit shall be valid far s years from dateof issue with a site pian (means a drawing not necessarily drawn to. scale shows the existing and proposed property brass with dimensions, the location of thefacility and appurtenances, the site forthe proposed Wastewater system, and the location of water supplies and surface waters). Plat The Improvement Permit shall be valid without expiration with plat (means a property surveyed prepared by a registered land surveyor, drawn to a scale of oneInch equals no morethan 60 feet 'that Includes: the specific location of the proposed facility 0 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 pian that is drawn to state). The Department and Local Health Department may impose conditions on the Issuance and may revoke the permits for failure of the system to satisty the conditions, the rules, or this article: This permit is subject to revocation If the she plan, plat, or Intended use changes (NCGS 13OA-335(1)). 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 (A 938(b)j. Applicant/Legal Reps. Signature Required? QYes ONO Applicant/Legal Reps. Signature; *Issued By: 2140 -Nations, Robert Authorized State Agent* Date: / / Date of Issue: 0 7 l 1 7/ a 0 1 5 --- QValid without Expiration? O Create CA? Hand Drawing {Import Drawing **Site Plan/Drawing attached.** Page 2 of 3 • IMPROVEMENT PERMIT 194655-1 Davie County Health Department CDP File Number: 210 Hospital Street P.O. Box 848 County File Number: 5851A43634 Mocksville NC 27028 Date: Q Inch Drawing Drawing Type: Improvement Permit Scale:. QBlock ()N/A = ft ., I!waad juawamidwi :adA 16ulmeja wol;000l leuiepce ue woij o6owl ue liodwl o; moleq)IollO S10c EZ /EO .9i6Q :aagwnN ali_q fl4unoo t�sstiti�sas - 559:P6� :aagLunN al!d dao OZOLZ ON apinsIOow M xo8 'O'd jea4S lelldsOH MZ ;uawuedaa y)le8H fqunoo einep llWU3d1N3W3A0HdWl r90- T of Application: E` ew System ❑Repair to Existing System ❑Expansion/Modification of Existing System or Facility *** T*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL OF T -HI; REQUIRED ` �A A 9ROVIDED. Refer to the INFORMATION BULLETIN for instruct 6h INFORMATION Name to be Billed \•4Ll a c a c, Contact Person/fir, c T l�a l I Q c e- BillingAddress I y U, I O Co.s kF ; 4e I A R oa o Home Phone 9 g0- -4 8 - 3 t 85 City/State/ZIP Aic . 9802-$ Business one _70V- 97.5- a9TS 6-e0-17 {; �C;c� Wa11a.-c-C �atnntiptociuc�s,.rco,�Ll_�-�'�� Name on Permit/ATC if Different than Above Mailing Address PKUPEK'1'Y 1Nk'UKMA"11UN `Date House/Facility Corners NOTE: A survey plat or site plan must accompany this application. Included: I -Site Plan ❑Plat(to scale) (Permit is valid for 60 months with site plan, no expiration with complete plat.) Owner's Name, r- \4,-- lea c e- Phone Numbergo- 4a8 - 318 Owner's Address q 1 a1 K acc; c R o<�d ` _ City/State/Zip C o ra c o r -d. NG , Property Address 270 Lee cTa G kS 0 n i2(-,' J ecity A k n e e NC Lot Size 16a ck c re s Tax PIN# i x-363 y Subdivision Name(if applicable) Section/Lot# Directions To Site: 1-1 vJV , 158 N �P R Rcx;,,bn A) PA. Y6k no i e2 Scl-AioN Z If the answer to any of the following questions is "yes", supporting documentationust be attached. Are there any existing wastewater systems on the site? ❑Yes o pp Does the site contain jurisdictional wetlands? ❑ Yes 2<0RECEIVE D Are there any easements or right-of-ways on the site? Dyes � �O Is the site subject to approval by another public agency? ❑Yes Pr 0 JUN Q 8 2015 Will wastewater other than domestic sewage be generated? ❑Yes 1 o DC HEAL 11, IF RESIDENCE FILL OUT THE BOX BELOW # People # Bedrooms # Bathrooms Garden Tub/Whirlpool F1 Yes ❑No Basement: ❑Yes ❑No Basement Plumbing: ❑Yes ❑No IF NON -RESIDENCE FILL OUT THE BOX BELOW fihbilc Orl"ice Type of Facility/Business Total Square Footage of Building_G L.$ # People 9 # Sinks 1 # Commodes I # Showers O # Urinals O Estimated Water Usage (gallons per day) 6 (Attach documentation of similar facility water consumption) FOODSERVICE ONLY: # Seats Type system requested: 2<onventional []Accepted ❑Innovative ❑Alternative ❑Other Water Supply Type: ❑ County/City Water ❑ New Well r xisting Well ❑ Community Well i Do you anticipate additions or expansions of the facility this system is intended to serve? 2-Ves El No If yes, what type?Qu 1 rrncinP�,�- oFF:cP. �� n�x-I' 3--� v(`s, 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 and flagging or stakfing� a house1acility location, proposed well location and the location of any other amenities. �� n � T ) , in -tet o Site Revisit Charge Property owner's or owner's legal repr'esentative signature F-, • * - !%SCP -�-- s lJ KDQ lo 4.1 MAC r t 1� ;r - w 4 4wma ieasta� �. —sawR�l►JiD � f' it # v •sus / �� o�y� ..r ♦. �i t , r �Ht7�� M1� wf N /� t � /t• � amnio WAAC +- S U 1014 NO.j , 7 ♦�,1 - Y ..r .h� .. N f is N 1 • r �y ¢ �qti .• �. � .-•i .: M111®�iioat.. W4w.tC i[4i t'N00�. ;: ': ♦ 1 �, .. • �/ .��F x�*, h �ogluea�imiin�osi:0 too c RR.EnT� � WAUACE FARMS INC. TYPE 3 COMPOST FACIUTY SITE PLAN =. PROPOSED SITE FEATURES — lr—� set, owta� . am DAVIE COUNTY NC �; DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil /Site -Evaluation APPLICANT INFORMATION Wallace Farm Inc Eric Wallace 704-875-2975 EXT17 Water SuPP1Y On -Site Well Community Evaluation By: Auger Boring Pit PROPERTY INFORMATION Lee Jackson Drive 162 Acres Office Building. ` 'ublic �ut FACTORS 1 2 3 4 5. 6 7- .. Landscape position Slope % HORIZON I DEPTH . Texture groupC Consistence k Structure Mineralogy HORIZON H DEPTH Texture group q Consistence Structure Mineralogy HORIZON III DEPTH I Texture group Consistence Structure Mineralogy HORIZON IV DEPTH I Texture group Consistence Structure Mineralogy SOIL WETNESS I RESTRICTIVE_ HORIZON SAPROLITE I CLASSIFICATION LONG-TERM ACCEPTANCE RATE + (7 0. SITE CLASSIFICATION: P-15 �- EVALUATION BY: �H iC / � LONG-TERM ACCEPTANCE RATE: L1, (7 5 OTHER(j1-_e__ PRESE : — _ (lel-e u" S REMARKS: Ozz C C-,- LEGEND, sLEGEND 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 lope 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 - Mois VFR - Very friable FR - Friable FI - Firm VFI - Very firm EFI - Extremely f 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 bloc ky SBK - Subangular blocky PL - Platy PR - Prismatic Mineralogy 1:1, 2:1, Mixed LYQt� 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 :F Classification S(suitable), PS(provisionally suitable), U(unsuitable) LTAR - Long-term acceptance rate - eal/dav/ft2 I . nmm ncinc