SW8080521_COMPLIANCE_20080417

STORMWATER DIVISION CODING SHEET
POST -CONSTRUCTION PERMITS
PERMIT NO.
SW8 () $ 0521
DOC TYPE
❑ CURRENT PERMIT
❑ APPROVED PLANS
❑ HISTORICAL FILE
I COMPLIANCE EVALUATION INSPECTION
DOC DATE
20ogp�}1-�
YYYYMMDD

DIVISION OF WATER QUALITY
/2
INFILTRATION SYSTEM INVESTIGATION
Complete and email this. form to Vincent. Lewis @ncmait.net. If there are more than 7 areas to be tested,
attach a second sheet.
Scheduled Site Visit Date: �/710A Time: 00 = 3 n
Project Name: U.SMGR L6SEu"jk-26Con/County: ON.SLOvV
Street Address: 4V4f9r9VWr_ W. AM) A/C 112 cAm,, LE r6umo_ Cm& Mao s 3AY
Directions from the nearest intersection of two major roads:
FROM
SNEp05
65,elc
'ndtcE
NC /72
FMr
to USMG
4A76
'TW AI
(MrtN"C
a2.-7 mi
to y riEcT-
sv-E
/tr z
� ITW 4o421'NouE£
RD,
>1 acre being disturbed? LRYES [:]NO CAMA Major required? DYES YNO
Consultant Name: -B93AW DICK Phone: 9!9-957q-b;�52 (gcu�r�'rYGS}
Consultant Firm Name: E/}2T4 Tic H
Dre'n© � ,4si/v .�: I S I 3 I 1 I fo rum A ASAv) 7 I .2
Bore Number
1
2
3
4
6
7
a ExistingGround Elevation
q.2p
/o.
t.� '
o'
. 0,
2
/Z.O'
/0, /0
!O.
b Proposed Bottom Elevation
c Difference a minus b
O,t,
O,rop'
a o
d.2
1.
a
!• '
d Add 2 ft. Min. Bore De th
4.0
2
>
e Depth? S A
O
d
36
L
d
f Infiltration Rate OK?
y
y
yy
Approx. Elev. Of SHWT
(p,S'
&',
715
(o,
h Max. lowest bottom elev.
8 • S'
6.1
8. 9
8.
9. 5
op0-a
Comm
Required Attachments:
1. • Legible vicinity map.
2. Complete Soils Report..
3. PDF formatted site plan with the boring locations to be tested. Site plans should
be emailed or hand -delivered only. Illegible faxed maps will not be accepted.
All proposed infiltration areas and existing, active utility lines located within the proposed
basin/trench must be marked and flagged. If these areas are not flagged, the Soils Scientist
reserves the right to decline to do the investigation. If the proposed infiltration system will be
located in an area of existing pavement and there is no open area nearby, equipment capable of
breaking through the impervious layer must be provided. The soils investigation does not take
the place of a soils report prepared by an appropriate professional. The Soils Scientist will only
verify the soil conditions that are reported in the Soils Report, and make a determination as to
the suitability of the site to meet the infiltration design requirements under NCAC 2H.1000, and
assumes no liability should the system fail.
S:\WQS\STORMWATER\FORMS\infiltration site visit.for Revised 8.07

DIVISION OF WATER QUALITY Z1Z
INFILTRATION SYSTEM INVESTIGATION.
Complete and email this form to [e-mail]. If there are more than 7 areas to be tested,
attach a second sheet.
Scheduled Site Visit Date: '-I(11T¢, Time: 0R,'30
Project Name: USy I(6 (_ESEun.E - k1!(o&1County: AV5"VJ
Street Address:
Directions from the nearest intersection of two major roads:
>1 acre being disturbed?OYES ONO CAMA Major required? ❑YES ❑NO
Consultant Name: Phone:
Consultant Firm Name:
E 16N
Bore Number
sr 2
$'
a) Existing Ground Elevation
20
b Proposed Bottom Elevation
c Difference a minus b
0.G
d Add 2 ft. Min. Bore Depth)
e Hardpan Depth?
f) Infiltration Rate OK?
I-
Approx. Elev. Of SHWT
5.11
h Max. lowest bottom elev.
-7. 1
Comments
Required Attachments:
1._ Legible vicinity map.
2.. Complete Soils Report.
3. PDF formatted site plan with the boring locations to be tested. Site plans should
be emailed or hand -delivered only. Illegible faxed maps will not be accepted.
All proposed infiltration areas and existing, active utility lines located within the proposed
basin/trench must be marked and flagged. If these areas are not flagged, the Soils Scientist
reserves the right to decline to do the investigation. If the proposed infiltration system will be
located in an area of existing pavement and there is no open area nearby, equipment capable of
breaking through the impervious layer must be provided. The soils investigation does not take
the place of a soils report prepared by an appropriate professional. The Soils Scientist will only
verify the soil conditions that are reported in the Soils Report, and make a determination as to
the suitability of the site to meet the infiltration design requirements under NCAC 2H.1000, and
assumes no liability should the system fail.
S:\WQS\STORMWATER\FORMS\infiltration site visit.for Revised 8.07

DENR/DE11
ON -SITE WASTEWATER SECTION
Sheet _ of
PROPERTY ID---:
COUNTY:
SOIL/SITE EVALUATION
for ON -SITE WASTEWATER SYSTEM
OWNER:
LOCATION OF SITE:
WATER SUPPLY: • Private Public • Well Springy Other
FVALI!ATT0%' MFTH0r)- • Anaer Rnrino • Pit Gro TYPF OF WASTFWATFR-
/3<5 � 4 3/3-14y
`718 3/a7/dB
APPLICATION DATE
DATE EVALUATED
PROPERTY SIZE:
PROPERTYRECORDED:
Sewaee • Industrial Process • Mixed
o
P
I
SOIL MORPHOLOGY
(.1941)
I OTHER
1 PROFILE FACTORS
.1940
L
- LANDSCAPE
HORIZON
I
I
I .1941
' STRUCTURE/
TEXTURE
CONS35TE5CE/
MINERALOGY
.1942 I I I
SOIL I .943 119>6 ! .1944
�i'ETIESS/ SOIL , SAPRO RESTR
COLOR j DEPTH --LASS HORIZ
POSITION/
SLOPE %
DEPTH
(IN.)
PROFILE
CLASS
&LTAR
n
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DESCRIPTION
Available Space I. 194:)
S\zten Type(,)
Size LIAR
FNITIAL SYSTEM[ 1 R7­oA1R SYST=hI I OTHER FACTORS (.; 946): _
SITE CLASSIFICATION(.1943):
EVALUATED BY-
OTHER(S) PRESE!

Sheer_ of
DEPARTMENT OF ENVIRONMENT
AND NATURAL RESOURCES
DIVISION OF ENVIRON'MENI'AL HEALTH
SOIL/SITE EVALUATION
(Conlim mian Sheet)
I If
PROPERTY ID r:
DATE OF EVALUATION: 3 S
COUNTY:
P
0
E
1
I
SOIL MORPHOLOCY
(.1941)
OTHER
PROFILE FACTORS
L
E
x
1949
LANDSCAPE
POSITION
SLOPE %
I HORIZ
ON
DEPTH
PROFILE
CLASS
& LTAR
.1941
STRUCTURE/
TEXTURE
.1941
CONSISTENCE/
MINERALOGY
.1943
SOIL
WETNESS/
COLOR
.1943
SOIL
DEPTH
i
I .195
SAPRO
CLASS
.1944
RESTR
HORIZ
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