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A24 81. SUBSURFACE WASTEWATER SYSTEM INSPECTION REPORT ��I r� J� i 1 Z 10/25/17 Jeff Vau�han 24312 Date of Inspection Inspector's Name Certification Number 08-25-2005 A024 Permit Number Date of Operation Permit Tax Map Parcel PIN Lowe 455 Canvasback Drive, Semora. NC 27343 Lowe Owner Address of Properly Current Owner Instructions: Check yes or no for appropriate items and explain in space provided for remarks and comments. If an item is not applicable, indicate by "NA". If an item is not or cannot be evaluated, indicate by "N" and explain. Note that this inspection form is not totally inclusive for all systems. All maintenance and monitoring items specified in the permit are to be carried out. INSPECTIOPI RESULTS: COLLECTION/TANK SYSTEM: Evidence of leaks? Water level in tank: OK (fulll Tank risers accessible, free of infiltration and surface water diverted? Estimated distance from soil surface to Top of tank: 0-4 inches Tank has baffle wall? Outlet T is presendintact? Roots present in tank? Inlet pipe clear/unobstructed? Outlet pipe cleadunobstructed? Septic tank needs pumping? Inches of solids: 8 Date of last tank pumping known? If known, when: Estimated Distance From: House/Structure: 10+ ft WeIL• 100+ ft Water Line: unknown ft Property Line: 50+ ft Septic tank filter cleaned? PRETREATMENT SYSTEM: (Peat Biofilter) Filter surface maintained? Evidence of ponding? Filter effluent free of excess solids? Peat modules free of damage, accessible, properly ventilated & free of insects? Samples collected at this inspection? EFFLUENT DOSING SYSTEM: Required pumps present & functional? High water alarm(s) operating properly? Floats, valves, etc. in good condition? Control panel(s) & components in good condition? Evidence of leaks? Water level in tank(s): normal Tank riser(s) accessible, free of infiltration and surface water diverted? Roots present in tank(s)? Estimated distance from soil surface to Top of tank(s): 24 inches Date of last tank pumping known? If known, when: YES / NO ❑ � � ►� ■ ■ /1 �1 ■ ,►� ■ ■ // /1 ■ ►1 ■ ■ /� �� ■ ►1 ■ /�1 ■ ►1 ■ ►1 ■ ■ /1 REMARKS Risers buried under soil and mulch, difficult to access. Riser lids not screwed on, screw holes stripped and screws missing. Filter broken, but functioning. Will need to be replaced soon. Estimated Distance From: HuuseiStructure: lU+ n �. Weil: 100+ ft Water Line: unknown ft Property Line: 20+ ft Septic Tank: 5+ ft Ef�luent free of excess solids? � /❑ Inches of solids(pump/dose tank): <3 Elapsed time readings? 693.68hrs Counter readings? 000616 DISPOSAL FIELD: Evidence of effluent surfacing? Surface water effectively diverted? Diversions/swales properly maintained? Vegetative cover maintained? Protected from tr�c/unauthorized uses? Distribution devices in good condition? Field free of settled or low areas? Estimated Distance From: House/Structure: 15+ ft We1L• 50+ ft Water Line: unknown ft Property Line: 10+ ft Septic Tank: 30+ ft ADDITIONAL COMMENTS: �� ■ ■ ■ ■ ■ ■ INSPECTORS TEL. NO. 859-0669 office 349-5218 cell • Distribution box in good condition. ., � � State of North Carolina Department of Environment and Natural Resources Division of Environmental Health Michael F. Easley, Govemor William Ross, Secretary Terry L. Pierce, Director Bill Jeter, Chief March 25, 2004 Mr. Hazold Kelly Person County Health Department 20-B Court St Roxboro, NC 27573 (336) 597-1790, Fax: (336) 597-7808 1•• .�..�..� � D E NORTH CAROLINA DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES Subject: Approval of Engineering Plans and Specifications for the Jim Lowe Residential Sand Filter System, Person County, NC Project Number 2004-01 Deaz Mr. Kelly: We have reviewed revised engineering plans and specifications for the sand filter system proposed to serve the Jim Lowe residence, received March 1, 2004. There was a minor error in the submission that I have pen-changed per the request of William O'Daniel. It appears that all of our previous technical comments have been adequately addressed by the proposed revisions. Enclosed is one copy of the plans and specifications, stamped "Approved by the On-Site Wastewater Section, Division of Environmental Health, Department of Environment and Natural Resources. The Improvement ,� Pernut and Authorization to Construct to be issued for this new system must include the approved plans, specificarions, System Operation and Maintenance Plan, legal documents and any other conditions deemed appropriate by the health department The approved plans and specifications are for the following facilities and system components: Facilities: New two bedroom addition to an e�usting single family house Svstem: 1-1,200 gallon septic tank; 1-1,200 gallon pump tanlc; timer-based sand filter dosing system; 2,400 squaze foot sand filter. (Note approval extends from sepric tank to outlet of sand filter, and drainfield trench detail.} Desi Flow: 240 gallons per day SYstem classification: Va, requiring semi�nnual inspection by the ORC with semi-annual inspection reports submitted to the local health department and at least yearly inspection by your department. ON-SITE WASTEWATER SECTION 1642 Mail Service Center, Raleigh, North Carolina 27699-1642 Telephone: 919-715-3272 Fax: 919-715-3227 E-m�t: trish.an�oli_(a�ncmail.net Jim Lowe March 25, 2004 Page 2 of 3 It is critical that the Health Department require a preconstruction meeting be held prior to system installation. This meeting must be attended by representatives of the Health Department, owner, installer and the engineer certifying the installation. During this meeting, the sequencing of project conshuction, inspection, and testing activities must be discussed and clearly understood by all parties. Holding such a preconstruction meeting must be listed as a condition in the Authorization to Construct, with attendance required by all key parties prior to the onset of the system installation. As you are aware, there are a number of times during the installation of this system when direct supervision by the health department must be provided to insure that this system is installed properly. For this project, make certain that: Tanks to be provided (sepric tank and pump tank) are installed in strict accordance with the approved plans and specifications including properly constructed state-approved tanks, as indicated, paying strict attention to specified invert elevations, watertightness provisions including specified pipe penetrations, additional waterproofing, and dra.inage provisions to divert surface water from the tanks and their access openings. Ensure that access openings aze provided as shown and that openings aze modified or provided as shown and determined to be fully accessible and functional from the ground surface without requiring entrance into any basins. Ensure that all tanks aze determined to be fully watertight and infiltration-resistant per the watertightness test specified. Do not accept any tanks that have had holes cast into them below the working liquid level, whether patched or not. 2. Sand filter is properly constructed as indicated in the approved plans and specifications including the treated wooden wa11 supports, 30 mil PVC liner, pipe penetrations, leak test, vented underdrainage system, media sizes and specifications, including clean.sand filter sand (note that a good way to test for dust contect is to put some sand in a jar with water and shake it up and then let it rest; if an appreciable film forms on the water surface, the sand is not clean enough). 3. Sand filter distribution ssy tem is provided as indicated in the approved plans and specifications including material, size, and spacing of lines, orifice size and spacing, and properly constructed lateral turnups. 4. Pump tank must include a11 specified pumps and components, with all hardware of stainless steel or comparable corrosion resistance material. Ensure that all appurtenances, (e.g., floats and float support mechanisms, valves, etc.) are provided as shown and specified, including the use of conosion-resistant stainless steel and PVC/Sch 40 and/or ductile iron pipe where indicated. Level control floats must be readily accessible from above grade and installed at specified activarion elevarions. Control panel is to be installed directly adjacent to the tank in NEMA 4X enclosure with wires conveyed from pumps and controls directly to the panel through conduit installed in the riser. Wire conduits must be watertight and gastight, yet still enable floats or pumps to be changed without requiring entrance into the tanks. Pump delivery rates must a11 be measured (for each pump) and determined to be compazable to design specifications. Jim Lovve March 25, 2004 Page 3 of 3 5. Dosin� svstem appurtenances must be manually checked and controls must be tested for proper automatic operarion. The sand filter dosing system must be demonstrated to effecrively a11ow for specified design dose frequency and times to be delivered to the sand filter. Ensure that all lines are flushed and pressure head correctly set. Level control floats must also be set to acrivate at levels indicated on approved plans. The proposed high water alarm should also be tested and ensured to be properly functioning. 6. Operation and Maintenance (O&M): The operation permit must include, as conditions, the O&M procedures aitached to the approved Specificarions. It shall also include ti�e necessary information regarding the proposed management entity and certified operator as well as any additional concerns deemed appropriate by the health department for the O&M of this system. A certified subsurface system operator sha11 be contracted to operate the sand filter system. The operator shall inspect the system and report findings to the health department semi-annually. The health department shall review/inspect system operation annually. Note that a registered professional engineer must certify that the system has been installed in accordance with the approved plans and specifications. This certification is based upon periodic observations of construction and a final inspection for design compliance by the certifying engineer or his representative. Record drawings by the engineer shall accompany this certification. The installarion must be approved by the health department prior to the issuance of an operation permit. Feel free to contact us if you have any questions pertaining to this letter or if we may be of further assistance with this project. I can be contacted at (919) 715-3272 or by email at trishangoli@ncmail.net. Sincerely, ��i�i(�. 1 Tricia Angoli On-Site Wastewater Engineering cc: William O'Daniel, Duane K Stewart & Associates, Inc. 0 � �x s�� co�ip�.t �` �, n�t s�.�Bo� �4" X 4" Pxa��ara T��ted Po�t � �2,b, OFT�e Ganduit Gox�crai� Ri+ez S]opad To Shed Watax 1�" Sapantmn a�" ��.' i�aet�cal Con�it f ' � � � ' � ' 6° S�psration ; Th�aoded, (�ate Yalrn : .. . � IIbion . _ •;� � 6" Coaes � ' � . Acca� Corer• . , ' ' , ; ' •1_ � • . ; • ' PortLtid Concrete Crroui • . � ,' • • �' • r , � • � ��lt3C • . . • •r� ' . ��'�' t •� , � � • I• � � , • ► i �� ... , \ • / .,� ' � iillad With . � �ip Cord �� • ' , ' pp`niagllllad With • . . r .• �Pt�C 'AntiSipbcnHola 'Tias �pP�► � � . Po:tLadComentCxnut Ixdet Fmm Saplic Taia]e osiload Caxnastt Gxout ;;�� g� ,. . Liaa •�'` A" SCH 40 P�C Pipo "� 4atkt To D�utioa 9 SCH40PVC P' y Cl�sck .{.Np1on • . iPa Valve �Pe Flcat Wirts ' � � Higk Witar �11ozm Lav�l '' ' . . (6° Septraficn) .�; .. . �, . Hi�lt Lav+al-.s n:t�p CJu ,• ' .% ' '�VapoxLock F7oa�a : ' . ' � � Hols • .;. ••: � Drxwdown iIIP � �Ramcvable • .� �, � Float' �'ne � Law Lavel -P�np O$' � � ' . . .' �, � • — i : . .. �„ti . . �.: ' Pzaea�t Concrata T�k � 4" Cowc:ata :�. • , �;.; MatesiilS hr3500P 81ock � -:: , � . , . . r . . � � , . � � • 5 . y' � �� .; • .. ' ' �. t � f � • ' � � ti • , ' _ . OD� GALL�N'FIT1V/!F T.Al� - . • ' •..i:y')!: sr. . . _ , • . i.`.,r , • , . <.i �� Y:.. ' • . . . . ... . � . ' ' .' . • •. ; • �..�� f �� r1 14 1� �` ,('� 7jj� 1 ,"T�` 1J � �� 11 � IE�.�s��ffi.��,]l IH[��.]I.�]h� SITE SBETCH /Y� : e �/�� /�JCfd<�Q� C�r�� 6P�� • `v�.�ocv ��coG� , /.t/5T�'2�1-�'l�o�ii 9�1� oP�v1-n�N �P�c��ic,�- - �o�/s, Name ��i�l�,_�s �. j�nv� F Tax Map #�� P�cel # D�� Subdivision�' � yU � Section/Lot# 7 -t � /'�.3��YfT> z y o,�_ Authorized tat gent Date System components represent approximate contours only. The contractor must f Zag the system prior to be�;innin� the installation to insure that i�roi�er �rade is maintained. _ ___ _. _. _ _ ... � N.12'33'49"E � N 30• , . �- . 42,34� , n_ � Z v��2oD� �� ,y� G�� gda FTz 3oa G� F . �t��f Cv 6a, � iy'' T��c� �� 6 " o� G'Q✓�2. �s /�� 2. �� . cn cfl � v 9 o,�L,�r � � r �l- , 9 • 112-8� ., c� - - � �Z� �' � �L . \ �'� w � � m , : a �y o� 0 .- ,�,�� 4v�'°./s . . Con�T�� -��'•1-Lr� � �r �697 - /7 pd �"c.�rL� i''- � , � �� ,' � � �� 1!. � I��..a-� ��.11 IE-3L �,�.Il�III� Applicant: Location: 7��x �li�� I '�,rc ._ I:' I• I S�uhciiui:�i�� ri. P I�i��ti.c�:'`S e,c ti o ��i � L.a t#t � �provea�ent 1De�t Peramit �alid for � �+'ve'Y'ears. l�iq �girae�on �� Y Type of Facilitg: � New �ddition `b��ter �upply � # of Occupants # of Bedrooms Z� Projected Daily Flow -�� g.p.d. . Praposed Wastewater System: �i��-�r%� �,��r�-�� y'; s�,r�l��f�� Type: Proposed Repair: -�= � T 1'ype: � Permit Conditions: Owner or Legal Representative Authorized State Agent: � Date: ��'� � B � Date: � /a �.1 The issuance of this permit hy the Health Department in d�c.b nat guarantea the issu�nca of other peanits. It is the responsibiliiy of the applicant/property owner to in sure thQt all Person County Planning and� Zoning and Building Inspections requirements are met Td►ie �mprovement Permit is subject to revocation if the �ite plan, plat or the intended use changes. The Improvement Permit is not sffected by a'change in owner�hip of Yhe property. This permit was is�ued in complianc� with the provisions of the North Carolina `Laws a»d gules for SetYa�e Ti�eatment and Disposal Svstems' (15A NCAC. 18A .1900). Neither Person Cowuty nor #he Environmental �ealth 8pecialist warrants that tl�e sepHc tank system will continue to function satisf�ctority in the future ar that the water supply will remain potable. � � �Autlao,rization to Con�truc� �a�tewater Systea�i �Required %a� B�ilding I'erm.it) * See site plan and addittonal attachments (_�. Proposed Wastewater System: �.�it��,i✓,�16� ��f'Qfi9?' '�`ype Yt�. Wastewater Flow �.p.d. New X R.epair pansion � uoil I�TAlt: • 29 g.p.dJ ft 2 Type of Bacility: � � Basement ✓ Yes _ No �ast�water Sy�teffi Reqnirements Tank Size: Septic Ta�nk: fGbO �al ,. �°ump Tank:/6� D g�i' Grease Trap: -- gal Drainfield: Total Area: Q�a sq ft Total Length � G� ft 1Vla�mwn Treneii Depth /� in �rench'oY�dth 3_ fit 1l�Iinitpu� S�il Cover: �!v in Mi.nimum Trench Sepazation: � ft Distribution: i� Distn'bution Box Seri�l Distributian Author�aed 3tate rigent: '� Permit Expiration Date: Pressure Manifold Date: � � The type of system permitted is Conv o � 've Alternative. I accept the specificarions of the pennit. ' O�vnea-1�egal �epr�sentatave: / - �'� Date: Z. �' �� P 7/30 2002 T��x �rl��: :� P�rcel � � ,� � .,: ' I" � �- �� S�uhci�i��ipian . � � � dr . ( (�) � � � � _ `� - , , i � � ,- , i , i� h��:s�e�Sectiore Lat �= . •.. ..�., _/ Oper�tio��Perrnit � � � System Type (In Accordance Witti Table Va): . r Q T4i1S SYSTIEM HAS BE��! INSTALLED IN COMPLL4NCE WITH APPLICABLE NORTH . CAROLlNA GEiVERAL STATUTES, RULES FOk� SEWAGE.TREA►TMEAIT AND DISPOSAL, : � AND ALL CaNDITi�NS ..OF THE IMPR01lEMENT PERMIT AND. CONS'Fl�UCTION . . -AUT O ZATION. � . . ��.... : � �.. ... ��.�� ''o2�-z'�s�' . �� Authorized State Agent �� . ' � Date '� instailed By. � �'. . �' . Date: �� . � . � �� . .... •�,�p� . �✓� �-, N � :.� � . . . . � �si : ��i�r/r✓� _ �r��G'�c.�: �;��,�. . .... .. . P - .... -. �o�� . �- -. -. �.: : .. . . _ . _ _ . . _ � �- � --:. •�.. : _ . — :i' f/�'�� a q. .aa . . . . _, . � .. .� .. . . _ _ . . . . . . . . .. . . . ... . . : _ . . . . . . . _ . .. � . �<� �jut�.p��+� ... . .. �, � . 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