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SUB202000186 Assessment - Environmental 2020-12-10
Page 1 of 7 OSE/PE Report For: Construction ❑ Repair ❑ Voluntary Upgrade 0 Certification ® Subdivision Permit Permit Permit Letter Approval Property Identification: 911 Address: City: � �� L� joioliarti Subdivision: Old Dominion Cl c_i GPIN or Tax Map#: 126-21D9 Health Department ID#: Latitude: Longitude: Applicant or Client Mailing Address: Name: Greg Baldwin,Core Real Estate Street: 600 E.Water St.,Ste.H City: Charlottesville State: VA Zip Code: 22902 Prepared by: OSE Name: William J. "Jeff'Loth,IV License Number: 1940001316 Address: 222 Sycamore Lane City: Afton State: Virginia Zip Code: 22920 PE Name: License Number: Address: City: State: Zip Code: Date of Report: 12/10/20 Date of Revision 1: OSE/PE Job Number: Date of Revision 2: Contents/Index of this report(e.g.,Site Evaluation Summary,Soil Profile Descriptions,Site Sketch,Abbreviated Design,etc.) 1. Cover Page 2. Application 3. Soil Summary Report 4. Soil Profile&Design Calculations 5. 1"= 100'Drainfield with Sanitary Survey(to 200'radius) 6. Plat of Lots 1 and 2 7. Total Subdivision Plat Certification Statement I hereby certify that the evaluations and/or designs contained herein were conducted in accordance with the applicable provisions of the Sewage Handling and Disposal Regulations(12 VACS-610),the Private Well Regulations(12 VAC5-630),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 Commonwealth that have been duly issued by the applicable agency charged with licensure to perform the work contained herein. ❑ The 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 54.1-402.A.11 I recommend that a(select one): ❑Construction Permit,❑Certification Letter,® Subdivision Approval,❑Repair Permit,❑ Voluntary Upgrade be(select one): ® Issued, enied PE/OSE Signature: Date: 12/10/20 Page 2 of 7 VDH Use Only Commonwealth of Virginia Health Department ID# Application for:® Sewage System®Water Supply Due Date: Owner: Iris Realty Holdings LLC Phone: ( ) - Mailing Address: 502 Willoughby Ln. Phone: ( ) - Staunton,VA 24401 Fax: ( ) - Agent: Greg Baldwin,Core Real Estate Phone: (434)422-5050 Mailing Address: 600 E.Water St.,Ste.H Phone: ( ) - Charlottesville,VA 22902 Fax: ( ) - Site Address: Email: Directions to Property: south of Rt.721,0.25 mile east of Rt.630 Subdivision: Old Dominion Section: Block: Lot: 1 Tax Map: 126-21D9 Other Property Dimension/Acreage of Property: 13.240 Identification: Sewage System Type of Approval:Applicants for new construction are advised to apply for a certification letter to determine if land is suitable for a sewage system and to apply for a construction permit(valid for 18 months)only when ready to build. For New Construction: ❑ Certification Letter 0 Construction Permit ® Subdivision Review For Existing Construction: ❑ Repair ❑ Modification ❑ Expansion 0 Replacement Proposed Use: ® Single Family Home(Number of Bedrooms 4) ❑ Multi-Family Dwelling(Total Number of Bedrooms,J ❑ Other(describe) WM there be a basement: ® Yes ❑ No If yes,will there be fixtures in the Basement? ® Yes 0 No Are any conditions proposed on this construction permit? ❑ Yes ® No If yes,please check or describe all proposed Conditions that apply: ❑ Reduced Water Flow ❑ Limited Occupancy 0 Intermittent or seasonal use 0 Texn.1 use not to exceed 1 ear 0 Other describe Water Supply Will the water supply be❑ Public or®Private Is the Water supply 0 Existing or® Pro osed If proposed,is this a replacement well? 0 Yes ElNo Will the old well be abandoned 0 Yes No Will any proposed or existing buildings within 50'of the proposed or existing water supply have termite treatment?❑ Yes ® No Borate termiticide required All Applicants Is this an AOSE/PE application?®Yes ❑ No If yes,is the AOSE/PE package attached? ® Yes ❑ No In order for VDH to process your application you must attach a site sketch and plat of the property.The site sketch should show your property lines,actual and/or proposed buildings and the desired location of your well and/or sewage system.When the site evaluation is conducted the property lines,building location and the proposed well and sewage system sites must be clearly marked and the property sufficiently visible to see the topography,otherwise this application will be denied. I give permission to the Virginia Department of Health(VDH)to enter onto the property described during normal business hours for the purpose of processing this application and to perform quality assurance checks of evaluations and designs certified by an Authorized Onsite Soil Evaluator(AOSE)or a Professional Engineer(PE) as necessary until the sewage disposal system has been constructed and approved Signature of Owner/Agent Date Page 3 of 7 Soil Summary Report General Information Date: 1/19/18 Submitted to Albemarle County Health Department Applicant: Greg Baldwin,Core Real Estate Telephone: (434)422-5050 Address: 600 E.Water St.,Ste.H,Charlottesville,VA 22902 Owner: Iris Realty Holdings LLC Address: 502 Willoughby Ln.,Staunton,VA 24401 Location: south of Rt.721,0.25 mile east of Rt.630 Tax Map: 126-21D9 Subdivision:Old Dominion Property Size: 13.240 ac. I Section: Lot: l Soil Information Summary 1. Position in landscape satisfactory? Yes ® No ❑ Describe: shoulder&sideslope 2. Slope 15%(max) 3. Depth to Rock or impervious strata: Max. 41 Min.30 4. Depth to seasonal water table(gray mottling or gray color): No ® Yes ❑ Inches 5. Free water present: No ® Yes 0 range in inches - Yes® Texture Group I 0 II 0 III ® I V ❑ 6. Soil percolation rate estimated? No ❑ Estimated rate 75 min/inch 7.Permeability test performed Yes ❑ No If yes,note type of test performed and attach Drainfield to be placed at 18"depth at site designated on site sketch utilizing a pretreatment unit capable of providing TL-3 to the drainfield. Reserve ® Site Approved Area(lower portion)would require TL-3 and pressurized subsurface dispersal. 0 Site Disapproved Reason for Rejection 1. 0 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. 0 Insufficient area of acceptable soil for required drainfield,and or reserve area 6. ❑ Proposed system too close to well 7. ❑ Other Specify Page 4 of 7 TM 126-2I D9 Old Dominion Subdivision,Lot 1 Albemarle County,Virginia Soil Profiles Hole Hrzn Depth Material Description Txt (in) Grp 1 Ap 0-2 10yr3/3 dark brown Loam 2 AB 2-6 5yr5/4 reddish brown Silt Loam,granular 3 Bt 6-30 10r4/6 red Clay Loam,weak fine SBK,with common fine mica flakes 3 R 30 Auger refusal on soapstone 2 Ap 0-1 10yr3/3 dark brown Loam 2 BA 1-4 5yr4/4 reddish brown Clay Loam,granular 3 Bt 4-30 10r4/6 red Clay Loam,weak fine SBK,with common fine mica flakes 3 R 30 Auger refusal on soapstone 3 Ap 0-2 10yr3/3 dark brown Loam 2 B 2-6 5yr5/4 reddish brown Silt Loam,granular _ 3 Bt 6-30 2.5yr4/8 red Clay Loam,weak fine SBK,with many fine mica flakes 3 R 30 Auger refusal on soapstone 4 Ap 0-1 10yr3/3 dark brown Loam 2 B 1-5 5yr5/4 reddish brown Silt Loam,granular 3 Bt 5-41 2.5yr4/8 red Clay Loam,weak fine SBK,with many fine mica flakes 3 R 41 Auger refusal on soapstone Design Calculations Design Basis for Primary Drainfield A. Estimated Percolation Rate 75 @ 18 in. B. Effluent loading rate from Table 1 of 12 VAC 5-613 0.47 gpd/sf C. Number of bedrooms 4 D.Gallons per day(Number of bedrooms X 150 gpd/bedroom) 600 E. Total trench square footage required for T113 effluent(600gpd/0.57gpd/ft2),as per 12 VAC 5-613) 1277 Area Calculations for Primary Drainfield A. Length of trench(ft.) 100 B Length of available area(ft.) 100 C. Width of trench(ft.) 3 D. Number of trenches 5 E. Center-to-center spacing(ft.) 9 F. Width required(ft.) 39 G. Width of available area(ft.) 100 H. Total square footage required 1277 I. Square footage provided 1500 J. Is a reserve area required? Yes, 100%Reserve Area provided Design Basis for Reserve Dripficld A. Estimated Percolation Rate 75 @ 12 in. B. Effluent loading rate from Table 1 of 12 VAC 5-613 .25 gpd/sf C. Gallons per day(Number of bedrooms X 150 gpd/bedroom) 600 Area Calculations for Reserve Dripfield A. Length of run(ft.) 100 B Length of available area(ft.) 100 C. Width of available area(ft.) 61 D. Total footprint required for drip dispersal(600gpd/.25gpd/sf),as per 12 VAC 5-613) 2400 E. Square footage provided 6100 r Michael Ray Goin Land Surveyor ZO 0 ti �65 5g ") eki �9co ,1 N 5 O • 63.15�'' , of rey o 5et •ran N 2���.3 Q c proposed drainfie/d O3 • Z.. .„. O o s e d ft. ti— — --9-8- "-- i P ° j s site - — 9� , 3bUild,n9 _. 44.9 I1 05 16 •16 Z,oPos, ► 1 , il 1 .�y`l 0,, 0, 5 i) !DAc. set lion — • • — • • • • — drain b Po GC) 9 6g. 0a 86 „W '' n DICKERSON SURVEYING LLC -_" •'b''f' DRAINFIELD WORKING PLAT 9,f�°" ',�� 500 Court SUeet P.0 6ox 712 FOR HEALTH DEPT. USE ONLY Moo nattoo,Yrglnio z4522 -�7 NOT TO BE RECORDED560 a to,eI Roy Go ULchoel Roy Coin Land Surveyor NOTE 1 ELEYATKWS SrpNN ARE ASSOW/ED FOR 1244T OW/1022D (NYY AW NOT FROM DR NFIE 0 IO PRI4NF/ELO. 2 SEE P/AT RJR LOr d,4EN9'OA& 3 T.4L NO. ,26--21O9 Cp,59 fi 31"1� I. A XX7 J 9490474447E 12LW X:ES A ' SG41E0 h 504 o FRL'U/FIRM. 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NO 126-25CJ D d• OmahaLYNanee FAAMY TRUST • N 26750JC1'E 36.2.5' OBJl2J P.46 S00 �� N 5921'0.r F 5652' a 0.4r6492/P.J21 alcrc ' TAL NO 126-25C2 r N Ql'/6'19'E /1.54' - J16. f •.', A 2-`,AJAr ooF a/nol N J4I7'J9'W 51..54' CO;= / N SS48'4/'E 77 f2' 600 5 - J I N OT57:16'E JO.Al' • y y, N 1/I2:50'W 69.8p' N .rr(�5£ `� b'1 ,.., `� A/11,42:#"f 5>.79' r.07' r 1 Bf �lYer • S 50Y7/7?7Y S 125't6:17'E 6:519' _ 6•p961' N 69:5716`E 40.97' t ' 96'5y \ ;s5g rd \ 7fLe I1D 61E Ph LLC I�/l'° ' S 4576147r TA/. Na 125-2442'LYJ'f B7.19' PA7AJCr J. HUM: C A 152.54' Oy,,47 a P 18! O s'e IxAr V /9/J•449 e ' *Cf \ ' e+zi f 0 TO E ALONG CREEK .pv AV /26- I Yy t•��,� (••. �= Ae.) ,,,p \ °a • Beanvq LhsMnce �`C-+-`�6� d I ` ?S� N 1266'25'10'E 89,74' Q,.% *��` •��a A •a PRELIIIEVf1RY _ N 017J39'W 80.@7' '13 sa+� '1'' !"/b '' I N TS'49:14"E 65..9J' "" 4. "'>r-\ �., r SiS2iNTZ�? N Qr1955"E 74.89' • ,Sej, C S J OM C. tDMISN SCALE• 1 AY. ..T00 FT S 4i5pzs2 zaps-na • ) Qs45a5 PS5/ OLDL�l7'LIlMO1Y 44 Jd.7Maa 1. � / HAT D.B.9415 P.748 "^tip NAY o/ac+,. �' * / T.Y. NO /25-J2 SairiVMR W Y� r (0.146 Ac.) t:�"4 - 'J sums',£v,r3 AaAs REALTY JAxa.,ts LLc � ,z, O #20'r", `� N 1r4 9•Ce 7449-bo SCO/755110E 0/S76/CT ,K0.5N-RYE COW?' iron - . Ax/Y4s set � �v NOtt7490?7 20/7 Ay 7�„pr u\ -o `S._ LOW C. 69667.91 OB.RSAS P351 300 0 ?Oa 600 IU) CIO CD Puy O.51945 P748"4- GRAPHIC SCALD-FELT 7.AC NO >16-J1 FB LJ64A736 KKKryryry J Page 1 of 7 OSE/PE Report For: ❑ Construction 0 Repair 0 Voluntary Upgrade 0 Certification ® Subdivision Permit Permit Permit Letter Approval Property Identification: 911 Address: City: / e m..) Section: Subdivision: Old Dominion GPIN or Tax Map#: 126-21D9 Health Department ID#: ' lO Latitude: Longitude: Applicant or Client Mailing Address: Name: Greg Baldwin,Core Real Estate Street: 600 E.Water St.,Ste.H City: Charlottesville State: VA Zip Code: 22902 Prepared by: OSE Name: William J. "Jeff"Loth,IV License Number: 1940001316 Address: 222 Sycamore Lane City: Afton State: Virginia Zip Code: 22920 PE Name: License Number: Address: City: State: Zip Code: Date of Report: 12/14/20 Date of Revision 1: OSE/PE Job Number: Date of Revision 2: Contents/Index of this report(e.g.,Site Evaluation Summary,Soil Profile Descriptions,Site Sketch,Abbreviated Design,etc.) l. Cover Page 2. Application 3. Soil Summary Report 4. Soil Profile&Design Calculations 5. 1"= 100'Drainfield with Sanitary Survey(to 200'radius) 6. Plat of Lots 1 and 2 7. Total Subdivision Plat Certification Statement I hereby certify that the evaluations and/or designs contained herein were conducted in accordance with the applicable provisions of the Sewage Handling and Disposal Regulations(12 VAC5-610),the Private Well Regulations(12 VAC5-630),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 Commonwealth that have been duly issued by the applicable agency charged with licensure to perform the work contained herein. ❑ The 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 54.1-402.A.11 I recommend that a(select one): ❑Construction P it,❑ Certification Letter,® Subdivision Approval,❑Repair Permit,❑Voluntary Upgrade be(select one): ® Issued, El D 'ed PE/OSE Signature: _ Date: 12/10/20 • Page 2 of 7 Commonwealth of Virginia Ha H Use Only lth Department ID# 1 Application for:® Sewage System® Water Supply Due Date: Owner: Iris Realty Holdings LLC Phone: ( ) Mailing Address: 502 Willoughby Ln. Phone: ( ) - Staunton,VA 24401 Fax: ( ) - Agent: Greg Baldwin,Core Real Estate Phone: (434)422-5050 Mailing Address: 600 E.Water St.,Ste.H Phone: ( ) - Charlottesville,VA 22902 Fax: ( ) - Site Address: Email: Directions to Property: south of Rt.721,0.25 mile east of Rt.630 Subdivision: Old Dominion Section: Block: Lot: 12 Tax Map: 126-21D9 Other Property Dimension/Acreage of Property: 26.968 Identification: Sewage System Type of Approval:Applicants for new construction are advised to apply for a certification letter to determine if land is suitable for a sewage system and to apply for a construction permit(valid for 18 months)only when ready to build. For New Construction: ❑ Certification Letter ❑ Construction Permit ® Subdivision Review For Existing Construction: ❑ Repair ❑ Modification ❑ Expansion ❑ Replacement Proposed Use: ® Single Family Home(Number of Bedrooms 4) ❑ Multi-Family Dwelling(Total Number of Bedrooms ) ❑ Other(describe) Will there be a basement: ® Yes ❑ No If yes,will there be fixtures in the Basement? ® Yes ❑ No Are any conditions proposed on this construction permit? ❑ Yes ® No If yes,please check or describe all proposed Conditions that apply: ❑ Reduced Water Flow ❑ Limited Occupancy ❑ Intermittent or seasonal use ❑ Temporary use not to exceed 1 year ❑ Other(describe) Water Supply Will the water supply be❑ Public or®Private Is the Water supply❑Existing or® Proposed If proposed,is this a replacement well? ❑ Yes ® No Will the old well be abandoned❑ Yes ❑ No Will any proposed or existing buildings within 50'of the proposed or existing water supply have termite treatment?❑ Yes ® No Borate termiticide required MI Applicants Is this an AOSE/PE application?®Yes ❑ No If yes,is the AOSE/PE package attached? ® Yes ❑ No In order for VDH to process your application you must attach a site sketch and plat of the property.The site sketch should show your property lines,actual and/or proposed buildings and the desired location of your well and/or sewage system.When the site evaluation is conducted the property lines,building location and the proposed well and sewage system sites must be clearly marked and the property sufficiently visible to see the topography,otherwise this application will be denied I give permission to the Virginia Department of Health(VDH)to enter onto the property described during normal business hours for the purpose of processing this application and to perform quality assurance checks of evaluations and designs certified by an Authorized Onsite Soil Evaluator(AOSE)or a Professional Engineer(PE) as necessary until the sewage disposal system has been constructed and approved. Signature of Owner/Agent Date Page 3 of 7 Soil Summary Report General Information Date: 1/19/18 Submitted to Albemarle County Health Department Applicant: Greg Baldwin,Core Real Estate Telephone: (434)422-5050 Address: 600 E.Water St.,Ste.H,Charlottesville,VA 22902 Owner: Iris Realty Holdings LLC Address: 502 Willoughby Ln.,Staunton,VA 24401 Location: south of Rt.721,0.25 mile east of Rt.630 Tax Map: 126-21D9 Subdivision:Old Dominion Property Size: 26.968 ac. Section: Lot: 2 Soil Information Summary 1. Position in landscape satisfactory? Yes ® No ❑ Describe: shoulder&sideslope 2. Slope 16%(max),23%in Reserve Area 3. Depth to Rock or impervious strata: Max. 43"(32"in Reserve Area) Min.34"(14"in Reserve Area) 4. Depth to seasonal water table(gray mottling or gray color): No ® Yes ❑ Inches 5. Free water present: No ® Yes ❑ range in inches - Yes® Texture Group I ❑ II ❑ III ® IV ❑ 6. Soil percolation rate estimated? No ❑ Estimated rate 75 min/inch 7.Permeability test performed Yes El No El If yes,note type of test performed and attach Drainfield to be placed at 22"depth at site designated on site sketch utilizing a pretreatment unit capable of providing TL-3 to the drainfield. Reserve ® Site Approved Area(lower portion)would require TL-3 and pressurized subsurface dispersal at a depth of 0"—2". El Site Disapproved Reason for Rejection 1. El Position in landscape subject to flooding or periodic saturation 2. El Insufficient depth of suitable soil over hard rock 3. ❑ Insufficient depth of suitable soil to seasonal water table 4. El Rates of absorption too slow. 5. El Insufficient area of acceptable soil for required drainfield,and or reserve area 6. El Proposed system too close to well 7. ❑ Other Specify TM 126-21D9 Page 4 of 7 Old Dominion Subdivision,Lot 2 Albemarle County,Virginia Soil Profiles Hole Hrzn Depth Material Description Tat (in) Grp 1 Ap 0-1 3/3 dark brown Loam 2 BA 1-4 5yr4/4 reddish brown Clay Loam,granular 3 Bt 4-43 10r4/6 red Clay Loam,weak fine SBK,with common fine mica flakes 3 jR 43 Auger refusal 2 Ap 0-1 10yr3/3 dark brown Loam 2 E 1-10 2.5y5/4 light olive brown Sandy Loam,weak granular 2 BtC 10-34 5yr5/8 yellowish red Clay Loam,weak fine SBK,with many fine mica flakes and very highly 3 weathered sandstone fragments R 34 Auger refusal on sandstone 3 Ap 0-3 10yr3/3 dark brown Loam 2 E 3-8 2.5y5/4 light olive brown Sandy Loam,weak granular 2 B 8-23 5yr5/4 reddish brown Sandy Clay Loam,granular 2 BtC 23-36 5yr5/8 yellowish red Clay Loam,weak fine SBK,with many fine mica flakes and very highly 3 weathered sandstone fragments R 36 Auger refusal on sandstone 4 Ap 0-2 10yr3/3 dark brown Loam 2 RSV E 2-14 2.5y5/4 light olive brown Sandy Loam,weak granular 3 R 14 Auger refusal 5 Ap 0-3 10yr3/3 dark brown Loam 2 RSV E 3-11 2.5y5/4 light olive brown Sandy Loam,weak granular 2 BtC 11-32 5yr5/8 yellowish red Clay Loam,weak fine SBK,with many fine mica flakes and very highly 3 weathered sandstone fragments R 32 Auger refusal on sandstone Design Basis for Primary Drainfield A. Estimated Percolation Rate 75(0,22 in. B. Effluent loading rate from Table 1 of 12 VAC 5-613 0.47 gpd/sf C. Number of bedrooms 4 D.Gallons per day(Number of bedrooms X 150 gpd/bedroom) 600 E. Total trench square footage required for TL-3 effluent(600gpd/0.57gpd/ft7),as per 12 VAC 5-613) 1277 Area Calculations for Primary Drainfield A. Length of trench(ft.) 100 B Length of available area(ft.) 100 C. Width of trench(ft.) 3 D. Number of trenches 5 E. Center-to-center spacing(ft.) 9 F. Width required(ft.) 39 G. Width of available area(ft.) 100 H. Total square footage required 1277 1. Square footage provided 1500 J. Is a reserve area required? Yes, 100%Reserve Area provided Design Basis for Reserve Dripfield A. Estimated Percolation Rate 75 @ 0-2 in. B. Effluent loading rate from Table 1 of 12 VAC 5-613 .25 gpd/sf C. Gallons per day(Number of bedrooms X 150 gpd/bedroom) 600 Area Calculations for Reserve Dripfield A. Length of run(ft.) 100 B Length of available area(ft.) 100 C. Width of available area(ft.) 61 D. Total footprint required for drip dispersal(600gpd/.25gpd/sf),as per 12 VAC 5-613) 2400 E. Square footage provided 6100 O 1121OAc. >00' stream se, iron buffer • Rood Zone X 6, 965'8 "1N ,I 1 O oppror/mote 5 68•4 6 flood /47e ° 26.968Ac• proposed 0 _ — O> droinfie/d a i --— , ce , - i/ � / / / / i / 05 0,9 / • �/ o5ed q ft. �p °� 5 site n izoo r 5Eat, b P (IQ CD 0 26" wh/te oak chopt o DICKERSON:t:Ultvir94,7241722 G LLC 1 t , DRAINFIELD WORKING PLAT sR Gout set PBox 5e� %%ice FOR HEALTH DEPT. USE ONLY Appomott / NOT TO BE RECORDED 434-352-eyor � Michael Roy Gorr Land Surveyor AV1E• 1 ELEY.ISt7N5 SHOWN ARE ASSUMED RAP THAT LRA/09820 OM Y AHD NOT M'OV 06NIELO 10 LYZVNI7EZO 2 SET PLAT FOR for O4t4RS016 S TM. At2 I76-2109 A65 5 ,441 4 ARRR2/5i441E R000 ZOALrS A et X•SL^4LED Ir' FROM/F.LP.4/. 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