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HomeMy WebLinkAboutSUB202200047 Certified Engineer's Report 2022-02-16 Page I of R • OSE/PE Report for: Construction Permit Certification Letter I I Subdivision Approval f 4'......--. Property Location: 911 Address- 397 Goa„Jam lama City Seef}s4 le Lot /y Section Subdivision GPIN or Tax Map# /ZZ ficrkf /Z0 Health Dept ID# Latitude Longitude Applicant or Client Mailing Address: Name AtarJan! ;,, Street- /7/a /9//WW��4r..L}`J; Sa-lc 2,94 City L1`,1° %✓'pe. State ✓j,4 Zip Code 12903 Prepared by: OSE Name /(:1/14v►nA 5071405,AIto qiy 2yh_DL' License# /1 Y60,9133.7 Address P-0- She City east../ca State VA Zip Code 2,2?1/7 PE Name License# Address City State_ . Zip Code Date of Report QLAG/Zo2L Date of Revision#1 OSE/PE Job# Date of Revision#2 Contents/Index of this report(e g._Site Evaluation Summary,Soil Profile Desert loons,Site Sketch,Abbreviated Design etc) • firs, no. - L.5W;Ie Rea 6. 1 cwf/`a s) r p se, ZZc.yM 646 ; 44k.,%.4.a34,7., .• Certification Statement I hereby certify that the evaluations and/or designs contained herein were conducted in accordance with the Sewage Handling and Disposal Regulations(12 VAC5-610).the Private Well Regulations(12 VAC5-630)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 re. tions of the Commonwealth that have been duly issued by the applicable agency charged with licensure to perform the -contained herein. The work attached to this cover page has been conducted under an exemption to the practice of engmeenne.specifically the . exemption in Code of Virginia Section 54.1-402.A.11 I recommend that a(select • constructio permit❑ certification letters subdivision approval be(select one) issued enied❑ / R.•-***°'-**--......... OSE/PE Signature Date UL/ yy / 1°` Commonw_y3lth of Virginia VDH Use only Health Department 1D# Application for: Sewage System❑Water Supply Due Date Owner lAga t,�,.il y <�Gevor:/IbJG Tarr- 4 LthvL y/4 ,na.. 44r3,r.t Phone Mailing Address 37.7 (sLA,„kr ,Qami J Phone 54e su,//.4 V/41'I54D Fax Agent Res: v:n I Su,r iY.g.s y Phone 11'Zt/S—g71/�/ Mailing Address l7/07 A/L.A 6,,4 r 5. i 20A Phone e wiONeAvi/!G al 21103 Fax Site Address 3/7 6/4.1 r A'Ai , ra 16✓,//c. (/4 21s"9D / pEm'Email Directions to Property: ,,,,}}4;� Aea 7i, /� Et 1ftth l /- 04 /►irtv. 713" Subdivision /ydLnQJJ ichni(, Section Block Lot /el Tax Map /ZZ - I. Df Other Property Identification Dimension/Acreage of Property 2,O84ery 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. ()Certification Letter()Construction Permit 0 Voluntary Upgrade 0 Repair Permit 0 Minor Modification S. w+sa 7.. I Proposed Use: Single Family Home(Number of Bedrooms Z. ) Multi-Family Dwelling(Total Number of Bedrooms ) Other(describe)Basement.�O Ye o Walkasement. Ye o Fixtures in BasementOYes Conditional permit desired`.0YeO. If yes,which conditions do you want? educed water flow ['Limited Occupancy DIntermittent or season e 0 Temporary use not to exceed 1 year Do you wish to apply for a betterment loan eligibility letter`0re o*There is a$50 fee for determination of eligibility. Water Supply Will the water supply beCPublic o *vate? Is the water suppl xisting or 0'roposed? If proposed,is this a replacement well?QesONo If yes,will the old well doned?OYesONo Will any buildings within 50'of the proposed well be termite treated?()Yes o Well Type(e.g.domestic use,agricultural,irrigation,etc.) ,itr,o,;.t.;L All Applicants Is this property intended to serve as your(owners)principal place of residence?OYes All applications must be accompanied by private sector evaluati and designs,unless a petition for VDH services is approved. Is a Petition for Service form attached?()Yes o In order for VDH to process your application for a sewage system you must attached a plat of the property and a site sketch. For water supplies,a plat of the property is recommended and a site sketch is required. 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 sites must be clearly marked and the property sufficiently visible to see the topography. I give permission to the Virginia Department of Health 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 a private sector Onsite Soil Evaluator or Professional Engineer as necessary until the sewage disposal system and/or private water supply has been constructed and approved. Signature of Owner/Agent Date This form contains personal information subject to disclosure under the Freedom of Information Act Revised 7/1/2019 pl 3.' , VDH Use Onh Health Department ID[2 Due Date Site and Soil Evaluation Report (For certification letters and subdivisions) General Information Date: OL / R ,,,rle, County Health Department Applicant : /Pe.5.- lit+i civ(vf,,ry �✓Vru�t / J Telephone Number y,31/-ZYS Y7941 Address • /7/0 •V/r 5i,.m � ,�iu,(�2/4 a /�ji olla al &Z9o3 Owner. (j{rlw,I l S Vffn bnD flohe ,rt Address: 39 7Glei �io ii, lisoila 024 'k Location : 50u,ii at /g,u4G 71..3 ; #'' ,4iw./ Mali. 04 RBtr4.6 776- Subdivision 4,11 1�,,,iii Block/Section Lot A/ Soil Inform on Summary 1.Position in landscape satisfactory Yes_ No_ Describe 5A6v a 2. Slope I( % 3.Depth to rock/impervious strata Max. 74, Min. 75/ None_ 4.Free water present No ✓ Yes Range in inches 5. Depth to seasonal water table(gray mottlin gray color) 4/14 inches 6 Soil percolation rate estimated Yes_✓ Texture group EI EII II OW No_ Estimated rate (min/m 7. Percolation test performed Yes_ umber of percolation test holes— No _ Depth of percolation test holes Average percolation rate mpi Name and title of evaluator: -3711'6041_ ,. . .., G:£1,O. Signatur • Depart t Use - ite approved: Drainfield trench ttoms to be p ed at '(inches)depth at site designated on permit _ Site disapproved: Reasons for rejection: (check all t apply) 1. _Position in landscap subject to oding or periodic saturation 2. _Insufficient depth 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 drainfield,and/or Reserve Area. 6. _Proposed system too close to well. 7. _Other(Specify) OSE Form G(pg 1)ReN tied 7/02/2009 Page 4 of 9 Date of Evaluation b 1//0492 Profile Descnpdon SOIL EVALUATION REPORT Property ID Tity A7 /ZZ pt✓e.1 /Zan 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 soil scientist. location of profile holes and sketch of the area investigated including all structural features t e sewage disposal systems,wells,etc within 100 feet of site(See section 4)and reserve site shall be shown on the reverse side of this page or prepared on a separate page and attached to form cc application sketch _ See construction permit _ See sketch on reverse side or page attached to this form. Hole# Horizon Depth Description of color,texture,etc. Texture (Inches) Group A d i 7,cww/ 151* C-34) SY,`rf6 e o . , s:Iy 441. a �"i 3lf �� 1•Pit VA.,..-4.„i Lr�M .�Ml n i xi sc k�+r �i0" & 7-AL 5110 fl��! sh A I�� �►,,,. fx,p 26-�l3 ,,,.�1 74 /cYeL2L MMfr..,.SYty/L — Gym :r4 G1rs- o, -3z 3z- U J T. j ygad � 1( 3lt 1-14 Hie', hew, mac. T REMARKS OSE Form G(pg 2)Revrsed7l02,2009 Page 5— of g Design Calculations Property ID: Ai jazp CLDs' Flow Type of use(residential, etc) Q,.,;k_ ,j Show Calculations Here' No. of bedrooms: Z At No. of employees: 41/00 Square Footage of building space:ihu. ,,,i.. Daily flow (peak design) in GPD:, 4r, Treatment No. of septic tanks: Show Calculations Here' Size of septic tank(s): fg ' fr.,-- Pretreatment required? _yes If yes, specify type of treatment device: Absorption area design Soil Texture Group:;jQ / If pump system, enhanced flow, or LPD show Reserve area required?Eyes_no calculations here or on a separate sheet. _ 50%_ 100% ✓d her(check one) (dosing volume, head, pump design, etc.) Specify other �7 Water Supply Class of well: Well Describe(bored, drilled): E,yaborpaild 0,11 Distance between septic Lank(s) and well: Si4 Distance between absorption area and well: I0oii- - I Information and calculations required for commercial and/or conditional use applications only OSE Form I Revised 7/2/2009 Page Of g Abbreviated Design Form This form is for use with gravity,pump to gravity,enhanced flow,and low pressure distribution(LPD)sewage system designs and when applying for a certification letter or subdivision approval. This abbreviated design covers the 0 primary and reserve area, 0 only the primary area, g,6nly the reserve area(check one)for 'T.;1117 /22 fAilanZ D 1 (property ID). Design Basis Total length of available area: 9Q Total width of available area: Is Estimated Perc. Rate: ,Sat Ill in. (depth) Number of bedrooms(or GPD):Zig at 300 6fP 1 2 Conveyance Method : 6/4u,, Distribution method (specify): E,Z-fhw /203 H Dispersal system basis 131 57y r/ SNDR LGMI required? AA, (Ye•A� Effluent quality required: P,,,„,ct„� rims Secondary,Advanced Secondary) Square feet per bedroom: 3 71 Total trench bottom area required: 71/ Gravity.pump.siphon ,Enhanced flow,LPD,or Drip Dispersal ;Table 5.4 of SHDR or identify the GMP used Area Calculations Number of trenches_ 3 (Note if a pad is used) Length of pad or trenches: %I ' Width of pad or trenches: 3' Center to center spacing: 7 Reserve required? Y{,S Percent reserve area required: Zao Total width of absorption area required Z f Total trench bottom area provided: The required width is calculated by multiplying the center-to-center spacing by one less than the number of trenches and adding I trench width plus any required reserve area. If the topography is not uniform across the length of the site the trenches will need to flare apart on one end to maintain contour. When this occurs it is necessary to use a center-to-center spacing that accounts for the flair or the installer will not be able to fit the system within the approved area. It is perfectly acceptable to have more area available,especially up and down the slope,than is required. OSE Form E Revised 7/2/09 Page 7 of F System Specifications Property ID: "Tw,e A? /A7 fm,,,.*t /2pI Applicant In ormation Name ,�•I_��.MI��js. ,,i"s Phone lag-2f`S-g701 Address l.7In AMked 54e.4 , SLR 201# ej r j,,41ls VO Z24a3 Location Information Tax Map No. /2z far...., apt Property address GPIN No. Directions 60,41i,(, ,a 7#3 Subdivision / s,,,1,, / t�.G .s.1/.jea} sF�' TIC Section /Blockl Lot /4' General Information System Type Number of bedrooms2.Ble (e.g. septic tank, drainfield Daily flow 39494fD (gpd) Type of property s, (e.g.commercial,residential, etc.) Conditions Sewer Line Septic Tank—Inlet/Outlet Structure Schedule 40 PVC,4" or equivalent Capacity: Loa gallons (add check or describe equivalent below) 2"1 septic tank Moo gallons Per the 2000 Sewage Handling& Disposal Regulations, Check which option cho . Septic tank with inspection port Septic tank with effluent filter 44 "Aye Reduced maintenance septic tank Conve ance line/force main Information Distribution box Information Method No. of boxes / (e.g. gravity, pumping, dosing siphon) No. of outlets f If pumping, attach Pump Spec Sheet Surge or splitter required: Material 5 1,JJ Yo Ph- Yes_No Pipe diameter Z Sloe of pipe h/4 (in inches) Header line Information Percolation line Information/Absorption Area 1500 pound crush strength Yes / Center to center spacing 2_ft. Minimum slope is 2"/100 ft. Yes ,/ Required spacing j ft. Installation depth ti inches Aggregate depth,(g inches No. of Laterals i Lateral length Ufa ft. Lateral bottom slope ki nches I Lateral width 3 inches OSE _ Date d 2/ Abs." OSE Form J Revised 7/2/2009 0 50 100 200 Property Line Courses Along Or State Route 713 4141 z SCALE IN FEET ® S76°56'11"E 105.06' H N © S77'43'45"E 145.00' 0/ a en F- . N. k , 1. cc /©_ wa om Cry o • Ci CO w •CC o — — — 25' Hatching shows _ ` — _ Area 4 pub1 on fop Fde0 392Sq t• ic,,, N77.55, _ — 185 309..w — _ _ ` —N7�•55, St G1end0wer 1: ,../��✓/// 185 O- ',„ ate Rot) Road 40'/// — Varlab1a Widte 7/3 ,` -% /� UP O �4��_ — h RAW) �� a ti��a ©� '_, = — �, / ky GD o �9. S7j O9_ ti .o, el , // 55 E ticQti / Q , _ � 4e hI^ ' m ED 97'8, 00 / o m Q 0 f , DC 1 OFS well m DC 4 • 94 ge in FS DC 2 / 92 m reserve co drainfield DC 3 New Parcel 12D1 / 0 2.00 Acres N76 44 30.W I 250.04. 0 PLT H OF ' >.