HomeMy WebLinkAboutSDP201500051 Action Letter 2015-11-10Pagel of 3
T'DHOF VIRGINIA Albemarle County Health Department
DEPARTMENT PO BOX 7546
HEALTH Charlottesville, VA 22906
(434) 972 -6219 Voice
Protecting You and Your Environment 972 -4310 Fax
OSE Construction Permit
Well and Sewage Contractors: Please notify Health Department and OSE or PE 49 hours prior to installation to arrange for inspection
November 10, 2015
All Saints Episcopal Chapel
3929 Stony Point Road
Keswick, VA 22947
Tax Map: 48 -16
HDID: 101 -15 -0490 Reserve: 100% reserve area provided
System Capacity: Non - Residential, 250 gallons per day
Well Class: Class IIIB (Cased and Grouted 50' minimum)
Usage Description: SDS for kitchen and bathroon for 50 person chapel
Dear All Saints Episcopal Chapel:
This letter and the attached drawings, specifications, and calculations (9 pages) dated October 05, 2015,
constitute your permit to install a sewage disposal system andClass IIIB Well on the property referenced above.
Your application for a permit was submitted pursuant to §32.1 -163.5 of the Code of Virginia, which requires the
Health Department to accept private soil evaluations and designs from an Onsite Soil Evaluator(OSE) or a
Professional Engineer working in consultation with an OSE for residential development VDH is not required to
perform a field check to verify the private evaluations of OSEs or PEs and such a field check may not have been
conducted for the issuance of this permit
The soil absorption area ( "site "), sewage system design, and the well location and construction were
certified by William Jefferson Loth, IV Private OSE as substantially complying with the Board of Health's
regulations (and local ordinances if the locality has authorized the local health department to accept private
evaluations for compliance with local ordinances). This permit is issued in reliance upon that certification VDH
hereby recognizes that the soil and site conditions acknowledged by this permit are suitable for the installation of an
onsite sewage system. The attached plat shows the approved area for the sewage disposal systems there are additional
records on file with the Albemarle County Health Department pertaining to this permit including the Site and Soil
Evaluation Report. This construction permit is null and void if any substantial physical change in the soil or site
conditions occurs where a sewage disposal system is to be located
If modifications or revisions are necessary between now and when you construct your dwellingplease
contact the OSE/PE who performed the evaluation and design on which this permit is based Should revisions be
necessary during construction, your contractor should consult with the OSE/PE that submitted the site evaluation or
site evaluation and design. The OSE /PE is authorized to make minor adjustments in the location or design of the
system at the time of construction provided adequate documentation is provided to the Albemarle County Health
Department.
The OSE/PE that submitted the certified design for this permit is required to conduct a final inspection of
this sewage system when it is installed and to submit an inspection report and completion statement As the owner,
you are responsible for giving reasonable notice to the OSEPE of the need for a final inspection. If the designer is
unable to perform the required inspection, you may provide an inspection report and
Tax Map /GPIN: 48 -16
HDID: 101 -15 -0490
Page 2 of 3
completion statement executed by another OSE/PE. The Albemarle County Health Department is not required to
inspect the installation but may perform an inspection at its sole discretion No part of this installation shall be
covered until it has been inspected by the OSF/PE as noted herein. The sewage system may not be placed into
operation until you have obtained an Operation Permit from the Albemarle County Health Department
This Construction Permit is null and void if conditions are changed from those shown on your application
or if conditions are changed from those shown on the Site and Soil Evaluation Report and the attached construction
drawings, specifications, and calculations. VDH may revoke or modify any permit it at a later date, it finds that the
site and soil conditions and/or design do not substantially comply with the Sewage Handling and Disposal
Regulations, 12 VAC 5- 610 -20 et seq., or if the system would threaten public health or the environment
This permit approval has been issued in accordance with applicable regulations based on the information
and materials provided at the time of application There may be other local, state, or federal laws or regulations that
apply to the proposed construction of this onsite sewage system The owner is responsible at all times for complying
with all applicable local, state, and federal laws and regulations. If you have any questions, please contact me.
This permit expires: May 11, 2017. This permit is not transferable to another owner or location
Sincerely,
Josh Kirtley
Environmental Health Technical Specialist
Albemarle County Health Department
Cc: Loth, William Jefferson, IV Private OSE
Tax Map /GPIN #: 48 -16
HDID #: 101 -15 -0490
WHAT YOU WILL NEED TO GET YOUR
SEPTIC SYSTEM OPERATION PERMIT
Page 3 of 3
• Your system must have asatisfactory inspection at the time of installation. This will be done by either a
representative of the local Health Department, a private OSE, or a PE, depending on the designer of your permitted
system. If your system is designed'inspected by an OSE or PE, they must submit a copy of the inspection result$
complete with an as -built diagram, to the Health Department.
• Please ensure that your contractor turns in aCompletion Statement to the local Health Department after installation.
IF YOUR PERMIT IS FOR BOTH A SEPTIC SYSTEM
AND WELL YOU WILL ALSO NEED
• Your well must have satisfactory inspection results after installation. Please give the Health Department several
days notice to schedule this inspection before your Operation Permit will be requested
• The Health Department must receive a copy of yourwater sample test result being negative./satisfactory for
coliform bacteria. You are responsible for performing this test and ensuring the results are received at the Health
Department
• Please ensure that your Well Driller submits a Uniform Water Well Completion Statement or GW -2 to the Health
Department, including documentation of a proper well abandonment if required by permit
Allow 5 business days after the last piece of documentation is received for the Operation Permit to be issued To
avoid delays, clearly label each piece of documentation with the property Tax Map'GPIN number and HDID number
shown above and on your construction permit Please note that due to the individual circumstances ofyour permit
there may be additional required items not covered by this checklist.
If you have any questions about any of the items on this list please do not hesitate to contact the Albemarle County
Health Department at (434) 972 -6219.