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OSE/PE Report For:
Construction Repair Voluntary Upgrade Certification Subdivision
Permit El Permit Permit D Letter Approval
Property Location:
911 Address:
Lot 4 Section
GPIN or Tax Map # 31-7
Latitude
Applicant or Client Maifing Address:
Name: Barry Wood
Street: 4180 Earlysville Rd.
Subdivision
Health Dept ID #
Longitude
City:
City: Earlysville State VA Zip Code 22936
Prepared by:
OSL Name Thomas G. Hogge License # 1940-001091
Address PO Box 418
City Ruckersville State VA zip Code 22968
PE Name License #
Address
City State Zip Code
Date of Report %2- / Date of Revision #1
OSE/PE Job # Date of Revision #2
Contents/Index of this report (e.g., Site Evaluation Summary, Soil Profile Descriptions, Site Sketch, Abbreviated Design, etc.)
1-Cover
2,3-Site and Soil Evaluation Report
4-Site Sketch
5,6-Design Calculations
Certification Statement
I hereby certify that the evaluations and/or designs contained herein were conducted in accordance with the opplicable provisions of
the Sewage Handling and Disposal Regulations (12 VAC5-610), the Private Well Regulations (12 VACS-630), the Regulations for
Alternative Onsite Sewage Systems (12VAC5-613) and all other applicable laws, regulations and policies implemented by the Virginia
Department of Health. I further certify that I currently possess any professional license required by the laws and regulations of the
Comm onwealt(,i-that have been duly issued by the applicable agency charged with licensure to perform the work contained herein.
he work attached to this cover page has been conducted under an exemption to the practice of engineering, specifically
the exemption in Code of Virginia Section S4.1-402.A11
I recommend that a (select one): construction permit [ certification letter Q subdivision approval Elbe (select one) Issued 0
j'r'�pair perm [] voluntary upgrade 0 Denied
OSE/PE Signature Date z
This form contains personal information subject to dosure under the Freedom of Information Act. Revised 12/ 1 /2014
Site and Soil Evaluation Report
Page of
VDH Use Only
HD1N:
General Information
Date: ,' Albemarle County Health Department
Owner: Barry Wood PhQRe: 434-806-8808
Owner Address: 4180 Earlysville Rd., Earlysville, VA 22936
Property Address:
Tax Map/GPIN 4: 31-7
Subdivision: Section: Block: Lot:4
Soil Information Summary
1. Position in landscape satisfactory: 8 Yes ❑ No Describe landscape position: Sideslope
2. Slope: 5 % (26" in Reserve)
3. Depth to rock/impervious strata: Max. 72+ in. Min. 60 in. ❑ Not observed
4. Free Water Present: ❑ Yes ® No Range in inches:
5. Depth to seasonal water table (gray mottling or gray color): 16-36 inches IN Not observed (40" in Reserve)
6. Soil. percolation rate estimated: 8 Yes ❑ No Estimated rate: 80 min/in at 42 inches depth
Texture Group: ❑ 1 ❑ It 8 [11 ❑ IV (65 @ 12" in Reserve)
7. Percolation test performed: []Yes 2 No If yes, provide additional data on percolation test results.
Name and title of evay Thomas Graham Hogge, OSE
Signature: .
El Site approved: fAbsorptiontrenches (describe dispersal area, e.g. absorption trenches) dispersing
Septic tank effluent (proposed level of treatment at time of evaluation) to be placed at 42 (inches) depth at
site designated on permit. Site provides a total of 10000+ square feet of absorption area for primary and
reserve (if applicable).
Site disapproved: Reasons for rejection (check all that apply)
I. ❑ Position in landscape subject to flooding or periodic saturation.
2. ❑ Insufficient depth of suitable soil over hard rock.
3. ❑ Insufficient depth of suitable soil to seasonal water table.
4. ❑ Rates of absorption too slow.
5. ❑ Insufficient area of acceptable soil for required absorption area, and/or reserve area.
6. ❑ Proposed system too close to well.
7. ❑ Other (specify)
This form contains personal information subject to disclosure under the Freedom of Information Act. Revised 12/l/2014
Parses of ('
Date of Evaluation: 7-13-17 Profile Description
SOIL EVALUATION REPORT
Property ID: T_M. 31-7, "Lot 4"
Where the local health department conducts the soil evaluation the location of profile holes may be shown on the schematic
drawing on the construction permit or the sketch submitted with the application. If soil evaluations are conducted by a
private Onsite Soil Evaluator or Professional Engineer, location. of profile holes and sketch of the area investigated including
all structural features (i.e. sewage disposal systems, wells, etc.) within 100 feet of the site and reserve site shall be shown on
the reverse side of this page or prepared on a separate page and attached to this forth.
AUGER BORINGS
❑ See application sketch ❑ See Construction Permit N See sketch on reverse side or page attached to this form.
Hole #
Horizon
Depth
(inches)
Description of color, texture, etc.
Texture
Group
1
A
0-4
10 YR 5/4 yellowish brown loam; organics
2
E
4-11
10 YR 5/6 light yellowish brown gravelly loam
2
Bt
11-30
2.5 YR 418 red clay loam
3
BCt
30-44
5 YR 4/6 yellowish red, light clay loam, saprolitic, wl 5 YR 718 reddish yellow
3
C
44-72
7.5 YR 714 pink, friable sandy loam saprolite; variegated wl 10 YR 8/3 very pale brown, 5 YR 518 yellowish red
2
2
A
0-4
10 YR 514 yellowish brown loam; organics
2
E
4-14
10 YR 516 light yellowish brown,,gravelly loam
2
Bt
14-42
2.5 YR 418 red clay loam, mottles 5 YR 718 reddish yellow
3
2Ct
42-72
5 YR 7/8 reddish yellow, friable sandy clay loam to loam saprolite wl
2
5 5YR 4/6 yellowish red, 10 YR 7/8 yellow, few sub -rounded quartz pebbles
3
A
0-4
10 YR 514 yellowish brown loam; organics
2
E
4-15
10 YR 516 light yellowish brown, gravelly loam
2
Bt
15-46
2.5 YR 4/8 red clay loam, mottles 5 YR 7/8 reddish yellow
3
C
46-60
5 YR 518 yellowish red, sandy clay loam to loam w/ round quartz, AIR on quartz cobble @ 60"
2
4
AE
0-12
10 YR 6/4 light yellowish brown, gravelly loam
2
Bt
12-48
2.5 YR 418 red clay loam, variegated wl 10 YR 7/8 yellow, 10 YR 416 dark yellowish brown
3
C
48-72
5YR 416 yellowish red, 10 YR 7/8 yellow, few sub -rounded quartz pebbles
5
AE
0-12
10 YR 6/4 light yellowish brown, gravelly loam
2
Bt
12-26
7.5 YR 5/8 strong brown clay foam w/ sub -rounded quartz, AIR @ 26" on quartz pebble
3
REMARKS:
This form contains personal information subject to disclosure under the Freedom of Information Act. Revised 12/1/2014
Page of (l
SITE SKETCH SHOWING PROPOSED PRIMARY
AND RESERVE SEPTIC, PROPOSED DIVISION OF
TAX MAP # 31-7, ALBEMARLE COUNTY, VA
�$
/ PROPOSED \
SEPTIC (2' CONrOiJRS
4 ARE SHOWN ON
5 SUBDIVLSION PLAT)
/
&3C \ �"
21'FRONT SETBACK
/ )----
Lot_may
t o a._ - -- o...... - - �_-
N°t n /
2.10 Acres//
i
V / ETBACK
1- IF,
Vdam Ali
PROPOSED
SEPTIC (2' CONTOURS
o ARE SHOWN ON '
Lot 4 SUBDIVISION PLAT) /
2.91 Acres
' - FI
�•.
WOODS03;' .... •-' �pgrr;
• 46' r1940CP tir
\\ iS `-`;ca : 1 LT i €e
LTSI t 0-1-1 R ��.i FOR TI� � f =r3� Cl SIT �I; �i�'R�.c c.
�t�Oy�P.�OSEfD/�(�;�ry����r ,' �rs�9glB�I3I'aISJOpN..t 3I]Fa YO-u !�z's( l',-AD-'-.0331.1p',`�.`:�,r�Jy-', TI-fl5 € €�'r, P .�,A,w � CALL
IPTIC(21 CONTOURS /// y's.. ��V S��2�v�'?[v 5a\.rA��?rCri ,Y^: .Ei^3'VE1-Ai OR: 'J'9b ��'�'�l"
RE SHOWN ON
LEGEND
® Backhoe Pit
0 Auger Boring
&3C Proposed Well Spot
• Drainfiel.d/Reserve Corner Stake
Proposed House Site
SCALE: 1" = 100'
BLUE RIDGE
SOIL CONSULTING, INC.
AUTHORIZED ONSITE SOIL EVALUATORS �-AOSEs)
PO. Box 4 i8 RuckersviHc, W, 22968
Design Basis
A. Estimated Percolation Rate
(Minutes per inch)
B. Trench bottom square feet
Required per Bedroom
(from Table 5.4) based on
dGravity ❑ LPG ❑ other:
C. Number of Bedrooms
Area Calculations:
D_ Length of Trench (ft.)
E. Length of Available Area (ft.)
F. Width of Trench (ft.)
G. Number of Trenches
H. Center -to -center spacing (ft.)
I. Width required (ft.)
J. Width of available area (ft.)
K. Total square footage required
L. Square footage in design
M_ Is a reserve area required?
Design Calculations
Proposed Division of
Tax Map 31-7
"Lot 4"
Albemarle County, VA
PRIMARY DRAINFIELD
656
95
ss
u
�! 1
C�
66
66
1968
1995
Y� See next page
Page_�of f `
Page 6,of
Reserve Area Design Calculations
Proposed Division of T.M. 31-7
°Lot 4"
Albernarle County, VA
DRIP DISPERSAL WITH TL-3 EFFLUENT
Design Basis
A. Estimated Percolation Rate 65 @ 12"
B. Square footage 556 (150GPD/ 0.27GPD PER SQ..FT.)
Required per bedroom
Based on _Gravity LPD x Other:
TL-3 EFFLUENT TO DRIP DISPERSAL, PER 12 VAC 5-613-10, REGULATIONS FOR
ALTERNATIVE ONSITE SEWAGE SYSTEMS_
C. Number of Bedrooms 3
Area Calculations
D. Length of lines (ft.) 100
E. Length of available area (ft.) 100
F. Width of trench (ft.) n/a
G. Number of lines 10
H. Center -to -center spacing (ft.) 2
I. Width required (ft.) 20
J. Width of available area (ft.) 49
K. Total square footage 1668 (556ft2 x 3BR)
required
L. Square footage in design 2000