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SUB201600020 Approval - Agencies 2016-02-22
• Napo -47.4.•--,\,- .,,, Nue v ;) ^ s COMMONWEALTH of VIRGINIA In Cooperation with the Thomas Jefferson Health District ALBEMARLE-CHARLOTTESVILLE State Department of Health FLUVANN TY(STAY(PALMYRA) 1138 Rose Hill Drive GREENE COUNTY(STA LOUISA COUNTY(LOUISA) Phone(434)972-6219 P. O. Box 7546 NELSON COUNTY(LOVINGSTON) Fax (434)972-4310 Charlottesville, Virginia 22906 2/22/2016 Paty Saternye, Senior Planner County of Albemarle 401 McIntire Road Charlottesville,VA 22902 RE: Review of Proposed Subdivision Plat as part of Tax Map 28, Parcel 30,located in Albemarle County,Virginia. Dear Ms. Saternye: On February 8,2016,the County of Albemarle requested the Virginia Department of Health (via the Albemarle County Health Department)review the proposed subdivision plat identified above.This letter is to inform you that the above referenced subdivision plat is approved for individual Onsite Sewage Systems in accordance with the provisions of the Code of Virginia,the Sewage Handling and Disposal Regulations, and local ordinances. This request for subdivision review was submitted pursuant to the provisions of§ 32.1-163.5 of the Code of Virginia which requires the Health Department to accept private soil evaluations and designs from an Authorized Onsite Soil Evaluator(AOSE)or a Professional Engineer working in consultation with an AOSE for residential development. This subdivision was certified as being in compliance with the Board of Health's Regulations by: Jason Kyser; Onsite Soil Evaluator Number 1940001357. This subdivision approval is issued in reliance upon that certification. Pursuant to § 360 of the Regulations this approval is not an assurance that Sewage Disposal System Construction Permits will be issued for any lot in the subdivision identified above unless that lot is specifically identified on the above referenced plat as having an approved site for an onsite sewage disposal system, and unless all conditions and circumstances are present at the time of application for a permit as are present at the time of this approval. This subdivision may contain lots that to do not have approved sites for onsite sewage systems. This subdivision approval does pertain to the requirements of local ordinances. Sincer- y, -phe,/ i. 'far!. Environmental Health Spec a ' r. Onsite Sewage and Wate rograms NIRO Page 1 of rid OSE/PE Report for: Construction Permit Certification Letter I Subdivision Approval Property Location: 911 Address: City: Lot Section Subdivision TULSI, LLC GPIN or Tax Map# 28 parcel 30 Health Dept ID# Latitude Longitude Applicant or Client Mailing Address: Name: Residential Surveying Services Street: 1701D-7 City:Charlottesville State VA7_ip Code 22903 Prepared by: OSE Name Rivanna Soil Cosulting, LLC 434-249-0298 License# 1940001357 Address P.O. Box 758 City Keswick State VA Zip Code 22947 PE Name: License# Address City State Zip Code Date of Report 11/10/2015 Date of Revision#1 OSE/PE Job# Date of Revision#2 Contents/Indexeyof/this report/ (e.g..Site Evaluation Summary.Soil Profile Descriptions,Site Sketch,Abbreviated Design.etc.) OSE Oe l.54,4.44. //1ikai`eu, por IL F141- -- -- ?7e 3 1•5Jrt C/4/,f _ r I t r Site. Suftabl W1%.5015;44 . ���� tf I) < / $ -ll S;�C S / Sa s /46br�..�4�� - Dh) - 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 VAC5-6I0).the Private Well Regulations(12 VACS-630)and all other applicable laws,regulations and policies implemented h} the Virginia Department of Health. I further certify that I currently possess an professional license required h) the laws and regulations of the Commonwealth that ha\e been duly issued b) the applicable agency charged with licensure to perform the work contained herein. ✓ The work attached to this cover pace has been conducted under an exemption to the practice of engineering.specificalk the exemption in Code of Virginia Section 54.1-402.A.11 1 recommend that a(select one): construe ion permit certification letter subdivision approval Z be(select one) issued denied❑. OSE/PE Signature sate / 11/10/2015 r �_ Aar • �nyc z Di lZ Commonwealth of Virginia 'VDH Use only e Health Department ID# Application for: ewage System ater Supply Due Date Owner �(��.$ LL C Phone Mailing Address 21V E,954 / J Phone CA/ia4csu:1/c (Jfl Z27dz Fax Agent Resile 4tm� �j,,,ruc ; Si✓V;�eS Phone V3y-ZYS-B'7V9 Mailing Address I 701 D -7 , lY e i . Phone �i�►r�rtc4cs✓1/e Of Z2 763 Fax Site Address Email Directions to Property: CA 54.6 iteJ /Co J 62/ j f/ .7 miles 5,A1 OJ % , Co? Subdivision Section Block Lot Tax Map 21 Pp}re,.I 30 Other Property Identification Dimension/Acreage of Property /O.11 /j►GireS 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 Q Voluntary Upgrade ©Repair Permit Proposed Use: Single Family Home(Number of Bedrooms ) Multi-Family Dwelling(Total Number of Bedrooms ) Other(describe) Basement? es :1No Walk-out Basement. e 3No Fixtures in Basement es:7No Conditional permit desired?®Yes If yes,which conditions do you want? ['Reduced water flow ❑Limited Occupancy ❑Intermittent or seasonal use ❑Temporary use not to exceed 1 year Do you wish to apply for a betterment loan eligibility letter`iYYes o *There is a$50 fee for determination of eligibility. Water Supply Will the water supoly be©Public orrivate? Is the water supply®Existing or roposed? If proposed,is this a replacement well?®Yes If yes,will the old well be abandoned?©Yes DNo Will any buildings within 50'of the proposed well be termite treated?©Yes 9 All Applicants Is this a private sector OSE/PE application? es DNo If yes,is the OSE/PE package attached? es©No Is this property indeed to serve as your(owners)principal place of residence?®Yes L' 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 12/1/2014 Page 3 of IZ Design Calculations Property ID: Tax Map 28 parcel 30 Flow Resicetial Type of use (residential_ etc) Show Calculations Here' No. of bedrooms: 4BR No. of employees:N/A Square Footage of building space:? Daily flow (peak design) in GPD: 600 GPD Treatment No. of septic tanks: 1 Show Calculations Here' Size of septic tank(s): 1250 Gallon Pretreatment required? yes ✓ no If yes. specify type of treatment device: Absorption area design Soil Texture Group: If pump system, enhanced flow, or LPD show Reserve area required? ✓ yes_ no calculations here or on a separate sheet. _ 50% ✓ 100%_other (check one) (dosing volume, head, pump design, etc.) Specify other Water Supply Class of well:1110 Well Describe (bored, drilled): IIIc Drilled or Bored Distance between septic tank(s) and well:50'+ Distance between absorption area and well: 100y+ Information and calculations required for commercial and'or conditional use applications only OSE Form I Revised 7 2 2009 Niue. Norio' p c 10Ha V7)H Use Only Health Department IDe Due Date Site and Soil Evaluation Report (For certification letters and subdivisions) General Information Date :04/23/2015 Albemarle County Health Department Applicant: Residential Surveying Services Telephone Number :434-245-8477 Address : 1701 D-7 Allied Street Charlottesville VA 22903 Owner: TULSI,LLC Address :214 East High Street Charlottesville VA 22902 Location : Eastside of Route 671,+/-.7 miles South of Route 609 Subdivision TULSI Block7Section Lot DF-1 Soil Information Summary 1. Position in landscape satisfactory Yes ✓ No Describe : Sideslope 2. Slope 17 3. Depth to rock/impervious:,trata Max. 72 Min. 51 None 4. Free water present No ✓ Yes Range in inches 5. Depth to seasonal water table(gray mottling or gray color) N/A inches 6. Soil percolation rate estimated Yes I Texture group t nil Qlii DIV No Estimated rate 50 min/in 7. Percolation test performed Yes _ Number of percolation test holes No ✓ Depth of percolation test holes Average percolation rate mpi Name and title of evaluator: Jason K.Kyser C. .O. Signature: Department Use ✓ Site approved: Drainfield trench bot is to be placed at 22 )rhes)depth at site designated on permit. _ Site disapproved: Reasons for rejection: (check all tha pply) 1. _Position in landscape subject to flooding or pel odic 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 drainfield.and/or Reserve Area. 6. _Proposed system too close to well. 7. Other(Specify) OSE Form G i P°I l Rei tsed 7 92 2909 Nage Page of 1Z- Date of Evaluation: 04/23/2015 Profile Description SOIL EVALUATION REPORT Property ID: TaxMap 28 parcel 30 DF1 \Vhei a the local health department :onducts the soil evaluation the location of profile holes nrt\ be sho\\n on the schematic drawing on the construction permit or the sketch submitted with the application If soil e\aluations are conducted bs a pi-Rate soil scientist. location of profile holes and sketch of the area investigated including all structural features i e sewage disposal s\stems.wells.etc within 100 feet of site(See section 4)and reser\e site shall he shown on the rex erse side of this page of prepared on a separate page and attached to this form See application sketch I See construction permit __ See sketch on rex erse side or page attached to this form Hole 4 Horizon Depth Description of color,texture,etc. Texture (Inches) Group 1 A 0-7 10YR4/3 Dark Brown Loam II BA 7-15 _7.5YR5/6 Strong Brown Clay Loam III Bt 15-38 5YR5/6 Yellowish Red Clay Light Clay Loam III C 38-72 5YR5/8 Yellowish Red Sandy Clay Loam II 2 A 0-6 _7.5YR5/4 Brown Loam _ II Bt 6-37 2.5YR4/6 Red Clay Loam III BC 37-51 5YR5/6 Yellowish Red Ligh Clay Loam III R 51"+ Rock-Granitic Schist 3 A 0-5 7.5YR5/4 Brown Loam II Bt 5-36 5YR5/8 Yellowish Clay Loam C 36-72 7.5YR5/8 Strong Brown Sandy Clay Loam II 4 A 0-7 10YR4/3 Dark Brown Loam II Bt 7-33 5YR5/6 Yellowish Red Clay Loam III CB 33-56 5YR4/6 Yellowish Red Light Clay Loam III C 56-72 7.5YR4/6 Strong Brown Sandy Clay Loam II REMARKS 050 Form G pg 2)Rex ued7(i2 201)0 Page V Of 12- Abbreviated ZAbbreviated 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 primary and reserve area. El only the primary area. ❑ only the reserve area(check one) for ,A, fl Zg ?„,,,e130 -- PF L_ (property ID). Design Basis Total length of available area: 130_ Total width of available area: t'Oly Estimated Perc. Rate: 5-0 at ZZ in. (depth) Number of bedrooms(or GPD): ge or 604 Ga Conveyance Method': (/,�.,�;1 Distribution method (specify): Dispersal system basis /41,1e $,'y_e1 SOR LGMI required? go (Ye all Effluent quality required: _ Pf_ yy P,Vrimar) Secondary, Advanced Secondary) Square feet per bedroom: _ 374 $7,24,4e Total trench bottom area required: /Sp V h, i Gray it)..pump.siphon Enhanced floe. LPD.or Drip Dispersal Table 5.4 of SHDR or identify the GMP used Area Calculations Number of trenches_ g (Note if a pad is used) Length of pad or trenches: Width of pad or trenches:• 3 I q1 _ Center to center spacing: / Reserve required? Percent reserve area required:__/DD/6 Total «idth of absorption area required 66 r_ Total trench bottom area provided: /5-40 ,/- The required width is calculated by multiplying the center-to-center spacing by one less than the number of trenches and adding 1 trench width plus any required reserve area. If the topography is not uniform across the length of the site the trenches Ni ill 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 1 of 1 Z System Specifications Property ID: Tax Map 28 panel 30-DF1 Applicant Information Name Residential Surveying Services Phone 434-248-8744 Address 1701D-7 Allied Street Charlottesville VA 22903 Location Information Tax Map No. Tax map 28 parcel 30-DF1 Property address GPIN No. Directions Eastside of Route 671;+/-.7 miles Subdivision TULSI South of Route 609 Section Block Lot DF-1 General Information System Type I Number of bedrooms 4BR (e.g. septic tank. drainfield) Daily flow 600 GPD (gpd) Type of property Residential (e.g. commercial. residential, etc.) Conditions Sewer Line Septic Tank—Inlet/Outlet Structure Schedule 40 PVC, 4" ✓ of equivalent Capacity: 1250 gallons (add check or describe equivalent below) 2nd septic tank N/A gallons Per the 2000 Sewage Handling& Disposal Regulations, Check which option chosen: Septic tank with inspection port_✓ Septic tank with effluent filter Reduced maintenance septic tank Conveyance line/force main Information Distribution box Information Method Gravity No. of boxes 1 (e.g. gravity, pumping, dosing siphon) No. of outlets 12 If pumping, attach Pump Spec Sheet Surge or splitter box required: Material Schedule 40 PVC Yes No _✓_ Pipe diameter 4" Slope of pipe 6"/100' (in inches) Header line Information Percolation line Information/Absorption Area 1500 pound crush strength Yes ✓ Center to center spacing 9 ft. Minimum slope is 2'7100 ft. Yes ✓ Required spacing 9 ft. Installation depth 22 inches Aggregate depth 13 inches No. of Laterals 8 Lateral length 65 ft. Lateral bottom slope inches Lateral width 36 inches OSE 1' Date f jA/ZOJS USE Form.1 Re ised 7/2/ •' VDI-1 Use Only Health Department ID= Due Date Site and Soil Evaluation Report (For certification letters and subdivisions) General Information Date :04/23/2015 Albemarle County Health Department Applicant: Residential Surveying Services Telephone Number :434-245-8477 Address : 1701 D-7 Allied Street Charlottesville VA 22903 Owner: TULSI,LLC Address:214 East High Street Charlottesville VA 22902 Location : Eastside of Route 671;+/-.7 miles South of Route 609 Subdivision TULSI Block/Section Lot Soil Information Summary I. Position in landscape satisfactory Yes / No Describe : Sideslope 2. Slope 14 3. Depth to rock/impervious strata Max. 72 Min. 72 None 4. Free water present No ✓ Yes Range in inches 5. Depth to seasonal water table(gray mottling or gray color) N/A inches 6. Soil percolation rate estimated Yes ✓ Texture group ❑I nu Du niv No Estimated rate 55 min/in 7. Percolation test performed Yes Number of percolation test holes No ✓ Depth of percolation test holes Average percolation rate mpi Name and title of evaluator: Jason K.Kyser C.O.O. Signature: Departure Use ✓ Site approved: Drainfield ch bottoms to.be pla d at 42 (inches)depth at site designated on permit. _ Site disapproved: Reasons for rejection: (che -all that apply) I. _Position in la scape subject to flo ing 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 drainfield,and/or Reserve Area. 6. _Proposed system too close to well. 7. Other(Specify) OSE Form G(pg 1)Re',ised 7 02 2009 *111110' NNW Page 1 of 11- Date tiDate of Evaluation: 04/23/2015 Profile Description Tax Map28 parcel 30 SOIL EVALUATION REPORT Propert} ID: Where the local health department conducts the soil evaluation the location of profile holes ma} he shown on the schematic drawing on the construction permit or the sketch submitted with the application if soil esaluanons are conducted b} a private soil scientist location of profile holes and sketch of the area investigated including all structural features i e sewage disposal systems,sells,etc within 100 feet of site(See section 4)and resers e site shall be shown on the revel se side of this page or prepared on a separate page and attached to this form __See application sketch I 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 1 A 0-7 10YR4/3 Dark Brown Loam II BA 7-13 7.5YR5/6 Strong Brown Light Clay Loam _Ill _ Bt 13-41 2.5YR4/8 Red Clay Loam Ill BC 41-72 2.5YR4/6 Red Light Clay Loam III 2 A 0-7 10YR4/3 Dark Brown Loam II Bt 7-39 2.5YR4/6 Red Clay Loam Ill BC 39-72 5YR5/6 Yellowish Red Light Clay Loam Ill 3 A 0-10 7.5YR5/4 Brown Loam II Bt 10-34 5YR5/8 Yellowish Red Sandy Clay Loam II CB 34-72 5YR4/6 Yellowish Red Sandy Clay Loam II 4 A 0-6 10YR4/3 Dark Brown Loam II Bt 6-39 2.5YR4/6 Red Clay Loam Ill BC 39-72 5YR5/6 Yellowish Red sandy Clay Loam II Il REMARKS OSE Form G i pg'_)Res ised7'02 2009 Niore Page 10 Of P- 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 prix-nary and reserve area, ❑ only the primary area, ❑ only the reserve area(check one) for_ Zg rotted 30 (property ID). Design Basis Total length of available area: Total width of available area: Estimated Perc. Rate: SSr at yL in. (depth) Number of bedrooms(or GPD): Viepe 6O0 GPD Conveyance Method'. Distribution method (specify):_ Dispersal system basis hibL 501Z. LGMI required?___g (Ye 451 Effluent quality required: / migry _ rimar ' Secondary. Advanced Secondary) Square feet per bedroom: L/SL 5f.4. /ie. Total trench bottom area required: /(o 1/ Gra it).pump.siphon ,Enhanced tlo«. LPD.or Drip Dispersal Table 5.4 of SHDR or identif\ the GMP used Area Calculations / Number of trenches to _(Note if a pad is used) Length of pad or trenches: ADO Width of pad or trenches: 3 Center to center spacing: 9 _ Reserve required? ye5 Percent reserve area required: IDOZ; Total width of absorption area required !o Total trench bottom area provided: 1 irpO �yf. 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 It of It System Specifications Property ID: Tax Map 28 parcel 30 A s licant Information Name Residential Surveying Services Phone 434-245-8744 Address 1701D-7 Allied Street Charlottesville VA 22903 Location Information Tax Map No. 28 parcel 30 Property address GPIN No. Directions Eastside of Route 671;+/-.7 miles Subdivision TULSI, LLC South of Route 609 Section Block Lot General Information System Type I Number of bedrooms 4BR (e.g. septic tank. drainfield) Daily flow 600 (gpd) Type of property Residential (e.g. commercial, residential, etc.) Conditions Sewer Line Septic Tank—Inlet/Outlet Structure Schedule 40 PVC, 4" ✓ or equivalent Capacity: 1250 gallons (add check or describe equivalent below) 2nd septic tank N/A gallons Per the 2000 Sewage Handling& Disposal Regulations, Check which option chosen: Septic tank with inspection port ✓ Septic tank with effluent filter Reduced maintenance septic tank Conveyance line/force main Information Distribution box Information Method Gravity No. of boxes 1 (e.g. gravity, pumping, dosing siphon) No. of outlets 12 If pumping, attach Pump Spec Sheet Surge or splitter box required: Material Schedule 40 PVC Yes No ✓_ Pipe diameter 4" Slope of pipe 6"/100' (in inches) Header line Information Percolation line Information/Absorption Area 1500 pound crush strength Yes ✓ Center to center spacing 9 ft. Minimum slope is 2"/100 ft. Yes ✓ Required spacing 9 ft. Installation depth 42 inches Aggregate depth 13 inches No. of Laterals 6 Lateral length 100 ft. Lateral bottom slope_ inches Lateral width 36 inches OSE / _ A Date ii /Po/ OSE Form J Re\ised 7/2/' 3 CO���' H ,,,,,,,,,,v,„ bv! CJ y ` rci 11 vesc or LI k)CI:t Q)4'; (4(j? °)/ n cn tWD ? D Z p�0 0 c� �fP � / -� m � l a�,h Q Oa/ �� _ _ \� rr a S �9 9 / �// / o o-moo \ - cp � \ 1�\h @ � /rt- ate . ?n CD ")u1 D 3 \� 6 \_/ O - � cl- c. rt e U �O� Q f 7. D; o \\ c1 o CD n 07 alCD XCO i'Y 71 N✓ m o� o L ry / CD ao: y � O � h3 QoD 7 01 \/®�h �� / / 0 r 0- rt NCO Dm- D r-r� GO 0 3 coo / <----- 7,- wD-m • trj N; _ co (n hdr 0 'r� o qmN ; 11 " ' , 1o - t (n6° / Zo — �'�� f'1'� bn ' `rr / io ' � OGS•gy ;my .�7 w � � -3^'�v , TH r / oOod om- '`L TiJ i�U c / m (1) D �it,4 / "'-n \ S2S. Cu� � 0j� Bfv Oa17J/ ss2l 42 /(TO4o m Q� � ___\_,\/, . CD cv 10 • ti ±a 01 �0 z�� VO o cil \ i WI) O U b < NW0, + to D D Co \ fQt Ort ti. CD 11.1 cn .13 V ,1 I- �C�� err-- f = 0 • n O• • D W ( ' � ll ca) .B, —{ � L,11•1:11 CO f `J W p D0 / = 300ti ' CD o X C s'c,/e z cz CD D � %QJ ' 73 -� rn ry