HomeMy WebLinkAbout2023.06.02 Submittal to HRW
2023.06.02 Submittal to HRW/2022.05.31 Birchwood Ph3 Applicant Certification (Water).doc
State of North Carolina
Department of Environmental Quality
Applicant Certification Form
In accordance with 15A NCAC 18C .0303 (c), a signed applicant certification must be submitted to the Department, stating that the Operation and Maintenance (O&M) Plan and the Emergency
Management Plan requirements have been satisfied and that the system will have a certified operator as required by Section .1300. No construction, alteration, or expansion of a community
or non-transient, non-community public water system shall be placed into final service or made available for human consumption until the applicant has submitted the certification and
has received Final Approval from the Department.
Certification must be provided by the following individual or their duly authorized representative:
For a corporation, limited liability company, home owner association or non-profit organization: a president, vice president, secretary, or treasurer.
For a partnership or sole proprietorship: by a general partner or the proprietor.
For a municipality, State, Federal or other agency: by either a principal executive officer or ranking elected official.
By the signature below I certify, under penalty of law:
The following actions have been completed for the construction, alteration, or expansion of the water system, as defined in the project documents:
I, or personnel under my direct supervision, have completed an O&M Plan and an Emergency Management Plan in accordance with 15A NCAC 18C .0307(d) and (e). Based on my evaluation of
the plans, or my inquiry of the person or persons directly responsible for preparing the O&M Plan and Emergency Management Plan, the information contained in the plans is, to the best
of my knowledge and belief, true, accurate, and complete.
The following actions will be completed before the construction, alteration, or expansion of the water system, as defined in the project documents, is placed into final service or made
available for human consumption:
In accordance with 15A NCAC 18C .0307(d), the O&M Plan will be made accessible to the operator on duty at all times and available to the Department upon request.
In accordance with 15A NCAC 18C .0307(e), the Emergency Management Plan will be made accessible to the system operator on duty at all times and available to the Department upon request.
In accordance with 15A NCAC 18C .0303(c), the system will have a certified operator as required by 15A NCAC 18 C. 1300.
Signature:
Name (Print):
Title:
Date:
Project Name:
Birchwood Grove S/D Phase 3
System Name:
Harnett Regional Water
Serial No: 22-01054______________ Water Sys. ID: NC0343045
Certifications can be sent by mail, fax (919-715-4374), or attachment to an e-mail message to PWSSection.PlanReview@ncdenr.gov
2023.06.02 Submittal to HRW/2022.05.31 Birchwood Ph3 Engineers Cost Statement.pdf Microsoft Word - 2022.05.31 Birchwood Ph3 Engineers Cost Statement.docx
1149 Executive Circle – Suite C-1, Cary, NC 27511 919.576.9733 | NCBELS C-3847 Forward Thinking. Grounded Design. www.underfootengineering.com May 31, 2023 Harnett Regional Water
(HRW) 700 McKinney Parkway Lillington, NC 27546 Re: Birchwood Grove Subdivision Phase 3 Engineers Cost Statement To whom it may concern: The following cost information is for the
waterline and all associated appurtenances for Phase 3 and is based directly from the construction contract with Terrahawk. There is no sanitary sewer for the project, so the total
cost is for waterline only. Phase 3 03.07 Phase 3 Water Distribution System $ 260,063.41 19.01 CO #15 C-900 Water Escalation $ 107,197.74 Total $ 367,261.15 If you
have any questions or require additional information, please feel free to contact me directly at 919.244.0494 or llovelace@underfootengineering.com. Respectfully:
Landon M. Lovelace, PE Principal 2023.05.31
2023.06.02 Submittal to HRW/2022.05.31 Birchwood Ph3 Engineers Statement of Testing.pdf Microsoft Word - 2022.05.31 Birchwood Ph3 Engineers Statement of Testing.docx
1149 Executive Circle – Suite C-1, Cary, NC 27511 919.576.9733 | NCBELS C-3847 Forward Thinking. Grounded Design. www.underfootengineering.com May 31, 2023 Harnett Regional Water
(HRW) 700 McKinney Parkway Lillington, NC 27546 Re: Birchwood Grove Subdivision Phase 3 Engineers Statement of Testing To whom it may concern: Observation of pressure testing for
the internal Phase 3 waterline as shown in the Construction Plans titled, “Construction Plan Phase 3 for Birchwood Grove Subdivision”, prepared by Hugh J. Gilleece and Associates (dated
2022.10.14) and approved by HRW was observed on March 29, 2023 These tests were performed by Site Specific Contractors as a sub-contractor to TerraHawk and were completed in accordance
with Harnett Regional Water Water Standards as follows: • Waterlines were pressure tested in accordance with HRW Water Distribution Specification 400.16.4 (L) and maintained a minimum
200 psi for at least three hours. The Phase 3 waterline was tested on March 29, 2023. A PE representative from Underfoot (Landon Lovelace) witnessed the test. The HRW inspector was
available for the test (Chad Everette). • Waterlines were chlorinated in accordance with HRW Water Distribution Specification 400.16.4 (M). Water samples were subsequently pulled and
tested by HRW and all were found to be negative for E Coli and Coliform, as required. If you have any questions or require additional information, please feel free to contact me directly
at 919.244.0494 or llovelace@underfootengineering.com. Respectfully: Landon M. Lovelace, PE Principal 2023.05.31
2023.06.02 Submittal to HRW/2023.03.29 Testing Pics/PXL_20230329_134451762.jpg
2023.06.02 Submittal to HRW/2023.03.29 Testing Pics/PXL_20230329_135230832.jpg
2023.06.02 Submittal to HRW/2023.03.29 Testing Pics/PXL_20230329_135856484.jpg
2023.06.02 Submittal to HRW/2023.03.29 Testing Pics/PXL_20230329_154109532.jpg
2023.06.02 Submittal to HRW/2023.03.29 Testing Pics/PXL_20230329_154118271.jpg
2023.06.02 Submittal to HRW/2023.03.29 Testing Pics/PXL_20230329_154125106.jpg
2023.06.02 Submittal to HRW/2023.03.29 Testing Pics/PXL_20230329_154340787.jpg
2023.06.02 Submittal to HRW/2023.03.29 Testing Pics/PXL_20230329_154347415.jpg
2023.06.02 Submittal to HRW/2023.03.29 Testing Pics/PXL_20230329_204654763.jpg
2023.06.02 Submittal to HRW/2023.05.31 Birchwood Ph3 Engineers Certification (Water).pdf Microsoft Word - 2023.04.24 Birchwood Ph3 Engineers Certification (Water).docx
1149 Executive Circle – Suite C-1, Cary, NC 27511 919.576.9733 | NCBELS C-3847 Certifications can be sent by mail, fax (919-715-4374), or attachment to an e-mail message to PWSSection.PlanReview@ncd
enr.gov PUBLIC WATER SYSTEM PROJECT ENGINEER CERTIFICATION FORM By the signature below I certify: The referenced public water system project was completed in substantial compliance
with the approved engineering plans and specifications, including any provisions stipulated in the Department’s plan approval letter or authorization to construct letter, and revised
only in accordance with the provisions of Rule .0306. This is a __X_Full certification, covering Phase 3 ___ Partial certification, _______________________ This certification
is based upon inspections conducted (select one): ____ Daily ____ Continuously __X_ Periodically By (select one): __X_ Myself __X_ Another under my responsible charge Seal
here: Engineer Signature: Engineer Name(Print): Landon M. Lovelace PE Project Name: Birchwood Grove S/D Phase 3 Date: 2023.05.31 Serial No: 22-01054
Water System Name: NC0343045, Harnett County 2023.05.31
2023.06.02 Submittal to HRW/22-01054 Ward.pdf
North Carolina Department of Environmental Quality Division of Water Resources 512 North Salisbury Street 1634 Mail Service Center Raleigh, North Carolina 27699-1634 919.707.9100
December 1, 2022 Harnett Regional Water Attention: Steve C. Ward, Director of Public Utilities P.O. Box 1119 Lillington, North Carolina 27546
Re: Engineering Plans Approval
Distribution Extension Birchwood Grove Subdivision Phase 3 Harnett Regional Water Water
System No.: NC0343045; Harnett County Serial No.: 22-01054 Dear Applicant: Enclosed please find one copy of the "Application for Approval..." together
with one copy of the referenced engineering plans bearing the Division of Water Resources stamp of approval for the referenced project. These engineering plans are approved under the
Division of Water Resources Serial Number 22-01054, dated December 1, 2022. Engineering plans prepared by John R. Harman, P.E, call for the installation of approximately 4,010 feet
of 8-inch water main, 270 feet of 2-inch water main, fire hydrants, valves, and associated appurtenances along Saint Clair Drive, Thomas Gage Drive, Tarleton Drive, John Stark Drive,
Robert Howe Drive, and Putnam Street to serve proposed 50 single-family lots within Phase 3 of Birchwood Grove Subdivision located north of the intersection of US 401 and Ballard Road,
across from Mill Branch Circle in Hectors Creek, Harnett County. The proposed 8-inch water main will connect to existing 8-inch water mains along Saint Clair Drive, Tarleton Drive,
John Stark Drive, and Thomas Gage Drive (approved under PWSS serial number 20-00988, Phase 2 of Birchwood Grove Subdivision). Construction of this project must be in accordance with
the Harnett Regional Water’s standard specifications. Please note that in accordance with 15A NCAC 18C .0309(a), no construction, alteration, or expansion of a water system shall
be placed into service or made available for human consumption until the Public Water Supply Section has issued Final Approval. Final Approval will be issued and mailed to the applicant
upon receipt of both an Engineer’s Certification and an Applicant’s Certification submitted in accordance with 15A NCAC 18C .0303 (a) and (c). These plans in the foregoing application
are approved insofar as the protection of public health is concerned as provided in the rules, standards and criteria adopted under the authority of Chapter 130A-317 of the North Carolina
Department of Environmental Quality Division of Water Resources 512 North Salisbury Street 1634 Mail Service Center Raleigh, North Carolina 27699-1634 919.707.9100 Harnett
Regional Water Attention: Steve C. Ward, Director of Public Utilities Page 2 of 2 December 1, 2022 General Statutes. This approval does not constitute a warranty of the design,
construction, or future operation of the water system. One copy of the "Application for Approval..." and a copy of the plans with a seal of approval from the Department are enclosed.
One copy of the approved documents in a digital format (USB) is being forwarded to our Fayetteville Regional Office. The second copy of the USB is being retained in our office. If
the Public Water Supply Section can be of further service, please call (919) 707-9100. Sincerely, Jay Frick Deputy Section Chief Public Water Supply Section Division of Water Resources
JF/MH Enclosures: Approval Documents cc: Heidi Cox, Fayetteville Regional Office Harnett County Health Department American Engineering
2023.06.02 Submittal to HRW/Authorization to Construct Ph3.PDF
December 01, 2022 PO BOX 1119 HARNETT CO. DEPT OF PUBLIC UTILITIES STEVE WARD, DIRECTORATTN: Re: LILLINGGTON, NC 27546 BIRCHWOOD GROVE SUBDIVISION PHASE 3 Authorization to Construct
(This is not a Final Approval) Issue Date: December 01, 2022 Harnett County NC0343045Water System No.:22-01054Serial No.: Dear Applicant: This letter is to confirm that a complete
Engineer’s Report and a Water System Management Plan have been received, and that engineering plans and specifications have been approved by the Department for BIRCHWOOD GROVE SUBDIVISION
PHASE 3, Serial No.: 22-01054. The "Authorization to Construct" is valid for 36 months from the issue date. Authorization to construct may be extended if the Rules Governing Public
Water Supplies and site conditions have not changed (see Rule .0305). The "Authorization to Construct" and the engineering plans and specifications approval letter shall be posted
at the primary entrance of the job site before and during construction. Upon completion of the construction or modification, and prior to placing the new construction or modification
into service, the applicant must submit an Engineer’s Certification and Applicant's Certification to the Public Water Supply Section. · Engineer's Certification: in accordance with
Rule .0303 (a), the applicant shall submit a certification statement signed and sealed by a registered professional engineer stating that construction was completed in accordance with
approved engineering plans and specifications, including any provisions stipulated in the Department’s engineering plan and specification approval letter. · Applicant's Certification:
in accordance with Rule .0303 (c), the applicant shall submit a signed certification statement indicating that the requirements for an Operation and Maintenance Plan and Emergency Management
Plan have been satisfied in accordance with Rule .0307 (d) and (e) and that the system has a certified operator in accordance with Rule .1300. The “Applicant's Certification” form is
available at http://www.ncwater.org/ (click on Public Water Supply Section, Plan Review, Plan Review Forms). Certifications can be sent by mail, fax (919-715-4374), or attachment to
an e-mail message to PWSSection.PlanReview@ncdenr.gov. If this "Authorization to Construct" is for a new public water system, the owner must submit a completed application for an Operating
Permit and the appropriate fee. For a copy of the application for an Operating Permit please call (919) 707-9085. Once the certifications and permit application and fee (if applicable)
are received and determined adequate, the Department will issue a Final Approval letter to the applicant. In accordance with Rule .0309 (a), no portion of this project shall be placed
into service until the Department has issued Final Approval. Please contact us at (919) 707-9100 if you have any questions or need additional information. Jay Frick Deputy Section Chief
Public Water Supply Section Division of Water Resources cc: HEIDI COX, Regional Engineer AMERICAN ENGINEERING Sincerely, North Carolina Department of Environmental Quality Division
of Water Resources Authorization to Construct Public Water System Name and Water System No.: Project Name: Serial No.: Issue Date: Expiration Date: In accordance with NCAC 18C .0305,
this Authorization to Construct must be posted at the primary entrance to the job site during construction. 36 Months after Issue Date HARNETT REGIONAL WATER NC0343045 BIRCHWOOD GROVE
SUBDIVISION PHASE 3 22-01054 Project Applicant: HARNETT CO. DEPT OF PUBLIC UTILITIES December 01, 2022 JOHN R. HARMAN, PE 4020 WESTCHASE BLVD. SUITE 450 RALEIGH, NC 27607 AMERICAN ENGINEERING
2023.06.02 Submittal to HRW/bacteria report 2017-1.xls Bacti
Color_ON_OFF
dd_DisinfectantUsed
rng_FreeChlorineResidual
rng_TotChlorineResidual
Water System Number:
-
Name of Water System:
Sample Point:
/
:
,
m
Mail Results to (water system representative):
Responsible Person’s email:
Laboratory ID Number:
Repeat Samples Required from Client
CONTAM CODE
CONTAMINANT
METHOD
CODE
Absent
Total Coliform
(Print and sign name)
COMMENTS:
3014
3028
Coliphage
3002
Enterococci
3013
RESULTS
INVALID CODES:
NC
County:
Certified By:
Phone #:
Routine (RT)
Repeat (RP)
Special / Non-compliance (SP)
Additional/Confirmation (CO)
" Positive Laboratory Log Number:
Previous Positive Laboratory ID Number:
" Positive Location Code:
" Positive Collection Date:
mg/L
GWR
Laboratory Log Number:
Assessment (RT)
DATE:
Analyses Completed —
Analyses Begun —
TIME:
(Date as: mm/dd/yy)
BY:
Collected –
Disinfectant Used:
cfu/mL or MPN
E. coli
Invalid
Code
Confluent Growth /
No Coliform Growth Found
Turbid Culture /
No Coliform Growth Found
Over 30 Hours Old
(Time as: h:mm am/pm)
Routine Original (RTOR)
Repeat-Original Tap (RPOR)
Repeat-Upstream (RPUP)
TNTC/No Coliform Growth Found
Fax #:
Repeat-Downstream (RPDN)
RULE
Source Water — Ground Water Rule (GWR)
Facility ID:
Sample Point:
— OR —
Sample Type:
Resample Required from Client
System Type:
Water Source:
Triggered (TG)
Public Water Supply Section
NCDEQ
Location Code: _ _ _ _
Tap Location: ____________________
3001
RTCR/GWR
2016
Note: All applicable information must be supplied for compliance credit.
Triggered/Distribution Repeat (TD) *
* for systems with a population < 1,000
Complete for Repeat, Triggered, or Additional / Confirmation Samples:
Total Chlorine Residual (chloramines):
Free Chlorine Residual (chlorine):
Present 1, 2
Heterotrophic P.C.3
Improper Sample or Analysis 4
1If E. coli, enterococci or coliphage is present, lab must report results to State on day test completed. 2If total coliform bacteria is present, lab must report results
to State within 48 hours. 3If HPC is absent, enter a "0" left of the "cfu/mL or MPN" units; if present, enter a whole number. 4Explain invalid code below in comments.
Distribution System — Revised Total Coliform Rule (RTCR) Facility ID: D01
City: _______________
Check (√) if sample site is owned or controlled by water system.
Check (√) if sample site is a daycare or a K-12 school.
X
TRACY TANT
Street Address: _____________________________
HARNETT
C
SW
HARNETT REGIONAL WATER
Chloramines
Blowoff
Harnett Regional Water
PO Box 1119
Lillington, NC 27546
P
Chad Everette
Birchwood Grove 3
Thomas Gage Dr
Lillington
3-23-133
0.00
3.00
4.00
3.00
0.00
4.00
5.00
0.00
3.00
3.00
0.00
2.00
3.00
0.00
1.00
4.00
5.00
3.00
7.00
6.00
3.00
8.00
3100.00
1.00
2.00
3.00
4.00
5.00
0.00
3.00
3.00
0.00
2.00
3.00
0.00
3.00
1.00
5.00
0.00
3.00
3.00
1.00
2.00
3.00
0.00
3.00
1.00
5.00
2023.06.02 Submittal to HRW/bacteria report 2017-2.xls Bacti
Color_ON_OFF
dd_DisinfectantUsed
rng_FreeChlorineResidual
rng_TotChlorineResidual
Water System Number:
-
Name of Water System:
Sample Point:
/
:
,
m
Mail Results to (water system representative):
Responsible Person’s email:
Laboratory ID Number:
Repeat Samples Required from Client
CONTAM CODE
CONTAMINANT
METHOD
CODE
Absent
Total Coliform
(Print and sign name)
COMMENTS:
3014
3028
Coliphage
3002
Enterococci
3013
RESULTS
INVALID CODES:
NC
County:
Certified By:
Phone #:
Routine (RT)
Repeat (RP)
Special / Non-compliance (SP)
Additional/Confirmation (CO)
" Positive Laboratory Log Number:
Previous Positive Laboratory ID Number:
" Positive Location Code:
" Positive Collection Date:
mg/L
GWR
Laboratory Log Number:
Assessment (RT)
DATE:
Analyses Completed —
Analyses Begun —
TIME:
(Date as: mm/dd/yy)
BY:
Collected –
Disinfectant Used:
cfu/mL or MPN
E. coli
Invalid
Code
Confluent Growth /
No Coliform Growth Found
Turbid Culture /
No Coliform Growth Found
Over 30 Hours Old
(Time as: h:mm am/pm)
Routine Original (RTOR)
Repeat-Original Tap (RPOR)
Repeat-Upstream (RPUP)
TNTC/No Coliform Growth Found
Fax #:
Repeat-Downstream (RPDN)
RULE
Source Water — Ground Water Rule (GWR)
Facility ID:
Sample Point:
— OR —
Sample Type:
Resample Required from Client
System Type:
Water Source:
Triggered (TG)
Public Water Supply Section
NCDEQ
Location Code: _ _ _ _
Tap Location: ____________________
3001
RTCR/GWR
2016
Note: All applicable information must be supplied for compliance credit.
Triggered/Distribution Repeat (TD) *
* for systems with a population < 1,000
Complete for Repeat, Triggered, or Additional / Confirmation Samples:
Total Chlorine Residual (chloramines):
Free Chlorine Residual (chlorine):
Present 1, 2
Heterotrophic P.C.3
Improper Sample or Analysis 4
1If E. coli, enterococci or coliphage is present, lab must report results to State on day test completed. 2If total coliform bacteria is present, lab must report results
to State within 48 hours. 3If HPC is absent, enter a "0" left of the "cfu/mL or MPN" units; if present, enter a whole number. 4Explain invalid code below in comments.
Distribution System — Revised Total Coliform Rule (RTCR) Facility ID: D01
City: _______________
Check (√) if sample site is owned or controlled by water system.
Check (√) if sample site is a daycare or a K-12 school.
X
TRACY TANT
Street Address: _____________________________
HARNETT
C
SW
HARNETT REGIONAL WATER
Chloramines
Blowoff
Harnett Regional Water
PO Box 1119
Lillington, NC 27546
P
Chad Everette
Birchwood Grove 3
Lillington
John Stark Dr
3-23-134
0.00
3.00
4.00
3.00
0.00
4.00
5.00
0.00
3.00
3.00
0.00
2.00
3.00
0.00
1.00
5.00
0.00
3.00
7.00
6.00
3.00
8.00
3100.00
1.00
2.00
3.00
4.00
5.00
0.00
3.00
3.00
0.00
2.00
3.00
0.00
3.00
1.00
5.00
0.00
3.00
3.00
1.00
2.00
3.00
0.00
3.00
1.00
5.00
2023.06.02 Submittal to HRW/bacteria report 2017-3.xls Bacti
Color_ON_OFF
dd_DisinfectantUsed
rng_FreeChlorineResidual
rng_TotChlorineResidual
Water System Number:
-
Name of Water System:
Sample Point:
/
:
,
m
Mail Results to (water system representative):
Responsible Person’s email:
Laboratory ID Number:
Repeat Samples Required from Client
CONTAM CODE
CONTAMINANT
METHOD
CODE
Absent
Total Coliform
(Print and sign name)
COMMENTS:
3014
3028
Coliphage
3002
Enterococci
3013
RESULTS
INVALID CODES:
NC
County:
Certified By:
Phone #:
Routine (RT)
Repeat (RP)
Special / Non-compliance (SP)
Additional/Confirmation (CO)
" Positive Laboratory Log Number:
Previous Positive Laboratory ID Number:
" Positive Location Code:
" Positive Collection Date:
mg/L
GWR
Laboratory Log Number:
Assessment (RT)
DATE:
Analyses Completed —
Analyses Begun —
TIME:
(Date as: mm/dd/yy)
BY:
Collected –
Disinfectant Used:
cfu/mL or MPN
E. coli
Invalid
Code
Confluent Growth /
No Coliform Growth Found
Turbid Culture /
No Coliform Growth Found
Over 30 Hours Old
(Time as: h:mm am/pm)
Routine Original (RTOR)
Repeat-Original Tap (RPOR)
Repeat-Upstream (RPUP)
TNTC/No Coliform Growth Found
Fax #:
Repeat-Downstream (RPDN)
RULE
Source Water — Ground Water Rule (GWR)
Facility ID:
Sample Point:
— OR —
Sample Type:
Resample Required from Client
System Type:
Water Source:
Triggered (TG)
Public Water Supply Section
NCDEQ
Location Code: _ _ _ _
Tap Location: ____________________
3001
RTCR/GWR
2016
Note: All applicable information must be supplied for compliance credit.
Triggered/Distribution Repeat (TD) *
* for systems with a population < 1,000
Complete for Repeat, Triggered, or Additional / Confirmation Samples:
Total Chlorine Residual (chloramines):
Free Chlorine Residual (chlorine):
Present 1, 2
Heterotrophic P.C.3
Improper Sample or Analysis 4
1If E. coli, enterococci or coliphage is present, lab must report results to State on day test completed. 2If total coliform bacteria is present, lab must report results
to State within 48 hours. 3If HPC is absent, enter a "0" left of the "cfu/mL or MPN" units; if present, enter a whole number. 4Explain invalid code below in comments.
Distribution System — Revised Total Coliform Rule (RTCR) Facility ID: D01
City: _______________
Check (√) if sample site is owned or controlled by water system.
Check (√) if sample site is a daycare or a K-12 school.
X
TRACY TANT
Street Address: _____________________________
HARNETT
C
SW
HARNETT REGIONAL WATER
Chloramines
Blowoff
Harnett Regional Water
PO Box 1119
Lillington, NC 27546
P
Chad Everette
Birchwood Grove 3
Lillington
Robert Howe Dr
3-23-135
0.00
3.00
4.00
3.00
0.00
4.00
5.00
0.00
3.00
3.00
0.00
2.00
3.00
0.00
2.00
1.00
0.00
3.00
7.00
6.00
3.00
8.00
3100.00
1.00
2.00
3.00
4.00
5.00
0.00
3.00
3.00
0.00
2.00
3.00
0.00
3.00
1.00
5.00
0.00
3.00
3.00
1.00
2.00
3.00
0.00
3.00
1.00
5.00
2023.06.02 Submittal to HRW/bacteria report 2017-4.xls Bacti
Color_ON_OFF
dd_DisinfectantUsed
rng_FreeChlorineResidual
rng_TotChlorineResidual
Water System Number:
-
Name of Water System:
Sample Point:
/
:
,
m
Mail Results to (water system representative):
Responsible Person’s email:
Laboratory ID Number:
Repeat Samples Required from Client
CONTAM CODE
CONTAMINANT
METHOD
CODE
Absent
Total Coliform
(Print and sign name)
COMMENTS:
3014
3028
Coliphage
3002
Enterococci
3013
RESULTS
INVALID CODES:
NC
County:
Certified By:
Phone #:
Routine (RT)
Repeat (RP)
Special / Non-compliance (SP)
Additional/Confirmation (CO)
" Positive Laboratory Log Number:
Previous Positive Laboratory ID Number:
" Positive Location Code:
" Positive Collection Date:
mg/L
GWR
Laboratory Log Number:
Assessment (RT)
DATE:
Analyses Completed —
Analyses Begun —
TIME:
(Date as: mm/dd/yy)
BY:
Collected –
Disinfectant Used:
cfu/mL or MPN
E. coli
Invalid
Code
Confluent Growth /
No Coliform Growth Found
Turbid Culture /
No Coliform Growth Found
Over 30 Hours Old
(Time as: h:mm am/pm)
Routine Original (RTOR)
Repeat-Original Tap (RPOR)
Repeat-Upstream (RPUP)
TNTC/No Coliform Growth Found
Fax #:
Repeat-Downstream (RPDN)
RULE
Source Water — Ground Water Rule (GWR)
Facility ID:
Sample Point:
— OR —
Sample Type:
Resample Required from Client
System Type:
Water Source:
Triggered (TG)
Public Water Supply Section
NCDEQ
Location Code: _ _ _ _
Tap Location: ____________________
3001
RTCR/GWR
2016
Note: All applicable information must be supplied for compliance credit.
Triggered/Distribution Repeat (TD) *
* for systems with a population < 1,000
Complete for Repeat, Triggered, or Additional / Confirmation Samples:
Total Chlorine Residual (chloramines):
Free Chlorine Residual (chlorine):
Present 1, 2
Heterotrophic P.C.3
Improper Sample or Analysis 4
1If E. coli, enterococci or coliphage is present, lab must report results to State on day test completed. 2If total coliform bacteria is present, lab must report results
to State within 48 hours. 3If HPC is absent, enter a "0" left of the "cfu/mL or MPN" units; if present, enter a whole number. 4Explain invalid code below in comments.
Distribution System — Revised Total Coliform Rule (RTCR) Facility ID: D01
City: _______________
Check (√) if sample site is owned or controlled by water system.
Check (√) if sample site is a daycare or a K-12 school.
X
TRACY TANT
Street Address: _____________________________
HARNETT
C
SW
HARNETT REGIONAL WATER
Chloramines
Blowoff
Harnett Regional Water
PO Box 1119
Lillington, NC 27546
P
Chad Everette
Birchwood Grove 3
Lillington
Robert Howe Dr
3-23-136
0.00
3.00
4.00
3.00
0.00
4.00
5.00
0.00
3.00
3.00
0.00
2.00
3.00
0.00
2.00
1.00
5.00
3.00
7.00
6.00
3.00
8.00
3100.00
1.00
2.00
3.00
4.00
5.00
0.00
3.00
3.00
0.00
2.00
3.00
0.00
3.00
1.00
5.00
0.00
3.00
3.00
1.00
2.00
3.00
0.00
3.00
1.00
5.00
2023.06.02 Submittal to HRW/BG Phase 3 for As-builts.dwg
2023.06.02 Submittal to HRW/BIRCHWOOD-PH 3 PLAT-FINAL SUB 1-3 MAY0123.pdf PH 3 PLAT
17 24 25 26 27 18 29 30 31 32 3334353637383940414243 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 124 125 126 127 129 130131 132 133 134 135 136 137 138 139 140
141142143144145 146 147 148 149 150151152153154 155 156 157 158 159 160 161 162 163 164 165 166 167 168169 170 171172173174 175 176 177 178 179 189 1920 21 22 23 28 180R TARLETON DRIVE
SAINT CLAIR DRIVE THOMAS GAGE DRIVE THOMAS GAGE DRIVE PUTNAM STREET BRODHEAD DRIVE ROBERT HOWE DRIVE PHASE 2 PHASE 1 DEKALB COURT ETHAN ALLEN CT ARTEMAS WARD DRIVE JOHN STARK DRIVE
McINTOSH COURT MILL BRANCH CIRCLE SAINT CLAIR DRIVE US 401 N (NCDOT PROJECT # 8.14421) BIRCHWOOD GROVE PHASE 1 MB 2022 P 69-72 PHASE 2 PHASE 1 PHASE 2 PHASE 1 BIRCHWOOD GROVE PHASE
1 MB 2022 P 69-72 BIRCHWOOD GROVE PHASE 1 MB 2022 P 69-72 PHASE 2 PHASE 3 PHASE 2 PHASE 3 PHASE 2 PHASE 3 BIRCHWOOD GROVE FUTURE PHASE 4 MAIL KIOSK BIRCHWOOD GROVE PHASE 2 MB 2022 P
313-315 ARTEMAS WARD DRIVE MÆRSTAN, PLLC Land Surveyors 2411 US 64 BUS. W., PITTSBORO, NC 27312 PH: 919.545-7001 NC LIC: P-1408 KB HOME RALEIGH-DURHAM, INC. 4506 S. MIAMI BLVD.,
SUITE 100 DURHAM, NC 27703 . REB-RW SUBDIVISION PLAT BIRCHWOOD GROVE, PHASE 3 US 401 N FUQUAY-VARINA, NC 27526 HECTORS CREEK TOWNSHIP, HARNETT COUNTY 08.23.22 1 of 3 BIRCHWOOD GROVE
21471 REB 1"= 400' 1 0 0 400' 800' THIS IS A 3-SHEET PLAT SEE SHEETS 2&3 FOR LOT DETAILS SITE 401 210 NC GRID NAD 83 (2012B) PRELIMINARY PLAT NT R RERATIN NEYANE R ALE
2023.06.02 Submittal to HRW/BIRCHWOOD-PH 3 PLAT-FINAL SUB 2-3 MAY0123.pdf PH 3 PLAT
PHASE 2 PHASE 1 TARLETON DRIVE 50' PUBLIC R/W & UTILITY JOHN STARK DRIVE 50' PUBLIC R/W & UTILITY SAINT CLAIR DRIVE 50' PUBLIC R/W & UTILITY THOMAS GAGE DRIVE 50' PUBLIC R/W & UTILITY
PUTNAM STREET 50' PUBLIC R/W & UTILITY BRODHED DRIVE 50' PUBLIC R/W & UTILITY ROBERT HOWE DRIVE 50' PUBLIC R/W & UTILITY THOMAS GAGE DRIVE 50' PUBLIC R/W & UTILITY PHASE 2 PHASE 3 PHASE
2 PHASE 3 PHASE 2 PHASE 3 PHASE 3 PHASE 2 SAINT CLAIR DRIVE 50' PUBLIC R/W & UTILITY ROBERT HOWE DRIVE 50' PUBLIC R/W & UTILITY 48 49 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 93
94 95 96 124 125 126 127 128 129 130 131 132 133 134 135 136 137 157 158 159 160 161 162 163 164 165 166 167 168 169 170 171 172173174 175 176 177 178 179 182 183 184 186 187 188 189
21 22 181 67 92 185 OS 5 102 FH WM WM WM WM WM WM WM FH WM WM WM WM WM WM WMWM WM WM WMWM WMWM WM WM TARLETON DRIVE 50' PUBLIC R/W & UTILITY 180R OS 3R BO BLOW OFF ASSEMBLY WM WM WMWM
WMWM WM WM WM WM WM FH WM WM WM WM WM WM WM WM BO TEMP BLOW OFF WM WM WM FH WMWM WMWM WMWM WMWM WM WM BO TEMP BLOW OFF WM WM FH WM WM WM RIP RAP WM C1 C2 C3 C4 C5 C6 C7 C8 C9 C10 C11
C12 C13 C14 C15 C16 C17 C18 C19 C20 C21 C22 C23 C24 C25 C26 C27 C28 C29 C30 C31 C32 C33 C34 C35 C36 C37 C38 C39 C40 C41 C42 C43 C44 C45 C46 C47 BLOW OFF ASSEMBLY WM WM WM WM WM WM FH
WM PUTNAM STREET 50' PUBLIC R/W & UTILITY 3/4" IPF 3/4" IPF CONTROL CORNER 15' WITNESS IRON SET 15' WITNESS IRON SET 15' WITNESS IRON SET (2) 3/4" IPF 15' WITNESSES IPS-15OS IPS-15OS
(3) 3/4" IPF 15' WITNESSES 3/4" IPF FLUSH CONTROL CORNER AXLE FOUND AT 1" IPF CONTROL CORNER 1-3/4" IPF 0.4' AG WITH GUARD POST IPF 3/4" 0.1' BG 3/4" IPF FLUSH CONTROL CORNER IPF 3/4"
FLUSH 3/4" IPF FLUSH 3/4" IPF CONTROL CORNER 3/4" IPF 0.2' BG CONTROL CORNER (2) 3/4" IPF 15' WITNESSES IPF 1.25" 1.3' AG IN CONCRETE CYLINDER 1-3/4" IPF 0.6' AG 0.11' SOUTH IPS 3/4"
ON LINE IPS 3/4" 5' FROM PC IPS 3/4" 10' ON LINE IPS 3/4" 10' ON LINE IPS 3/4" 10' ON LINE IPS 3/4" FLUSH 10' O-S PHASE 2 PHASE 3 MAG SET MAG SET MAG SET MAG SET NC GRID NAD 83 (2012B)
MÆRSTAN, PLLC Land Surveyors 2411 US 64 BUS. W., PITTSBORO, NC 27312 PH: 919.545-7001 NC LIC: P-1408 KB HOME RALEIGH-DURHAM, INC. 4506 S. MIAMI BLVD., SUITE 100 DURHAM, NC 27703
. REB-RW SUBDIVISION PLAT BIRCHWOOD GROVE, PHASE 3 US 401 N FUQUAY-VARINA, NC 27526 HECTORS CREEK TOWNSHIP, HARNETT COUNTY 08.23.22 2 of 3 BIRCHWOOD GROVE 21471 REB 1"= 100' SEE SHEET
3 of 3 SEE SHEET 1 of 3 FOR NOTES, CERTIFICATES AND SIGNATURES FUTURE PHASE 4 0 100' 200' SYMBOL LEGEND WM BO PRELIMINARY PLAT NT R RERATIN NEYANE R ALE BIRCHWOOD GROVE PHASE 2 MAP
2022 PG 313-315 BIRCHWOOD GROVE PHASE 2 MAP 2022 PG 313-315 FUTURE PHASE 4 CURVE TABLE SHEET 2 of 3 CURVE # C1 C2 C3 C4 C5 C6 C7 C8 C9 C10 C11 C12 C13 C14 C15 C16 C17 C18 C19 C20 C21
C22 C23 C24 C25 C26 C27 C28 C29 C30 C31 C32 C33 C34 C35 C36 C37 C38 C39 C40 C41 C42 C43 C44 C45 C46 C47 ARC 59.40' 77.79' 136.65' 38.19' 100.66' 100.35' 36.01' 40.35' 36.62' 41.92'
85.72' 41.81' 136.34' 100.05' 100.05' 100.22' 185.63' 100.05' 111.76' 34.84' 148.72' 89.81' 41.93' 177.94' 102.27' 95.17' 37.39' 132.56' 181.26' 172.11' 100.32' 78.05' 34.72' 80.78'
270.48' 43.90' 52.28' 21.03' 47.45' 42.54' 45.56' 45.56' 60.08' 21.03' 71.21' 38.31' 81.26' RADII 475.00' 475.00' 475.00' 25.00' 525.00' 525.00' 525.00' 25.00' 25.00' 25.00' 925.00'
875.00' 875.00' 925.00' 925.00' 875.00' 875.00' 925.00' 925.00' 25.00' 425.00' 375.00' 25.00' 925.00' 925.00' 925.00' 25.00' 365.00' 315.00' 315.00' 365.00' 365.00' 25.00' 875.00' 875.00'
25.00' 375.00' 25.00' 50.00' 50.00' 50.00' 50.00' 50.00' 25.00' 425.00' 25.00' 315.00' BEARING N52°59'52"W N61°16'19"W N74°12'19"W S53°47'08"W N62°04'22"W N73°02'28"W N80°28'55"W N36°12'52"W
N51°58'49"E S38°01'11"E S88°42'44"E S87°25'33"E N86°44'29"E N85°32'04"E N79°20'14"E N78°59'47"E N69°38'16"E N73°08'24"E N66°34'48"E S76°57'07"E S47°02'50"E N45°55'33"W N08°58'47"E N51°30'49"E
N42°50'07"E N36°43'14"E N76°36'56"E S70°56'45"E N65°34'43"W N33°26'28"W S25°39'50"E S39°39'47"E S06°00'28"E S36°25'04"W S47°55'06"W N72°55'33"W N18°37'55"W N09°32'27"E N06°26'49"E N45°06'50"W
S84°24'37"W S32°12'09"W S28°19'21"E S38°38'56"E S19°25'59"E N19°39'49"E N10°23'55"W CHORD CURVE # ARC RADII BEARING CHORD CURVE TABLE SHEET 2 of 3 SD2 SD3 SD4 SD5 SD6 SD7 SD8 SD9 SD11
SD12 SD13 SD14 SD15 SD16 SD17 SD20 SD21 SD22 SD23 10.03' 160.33' 224.71' 7.00' 340.93' 7.00' 19.45' 7.07' 20.00' 4.50' 6.62' 20.00' 6.62' 6.42' 23.91' 135.76' 131.99' 196.11' 150.20'
N88°32'43"W N05°52'00"E N82°26'49"W S79°58'56"E S10°01'04"W N79°58'56"W S82°26'49"E N07°33'11"E N82°26'49"W N07°33'11"E N20°11'23"W N69°48'37"E N20°11'23"W S29°55'35"E S60°08'11"W S52°35'58"W
S43°34'37"W S34°41'20"W N73°56'00"W DRAINAGE EASEMENT TABLE SHEET 2 of 3 BEARING LENGTHLABEL
2023.06.02 Submittal to HRW/BIRCHWOOD-PH 3 PLAT-FINAL SUB 3-3 MAY0123.pdf PH 3 PLAT
PHASE 3 PHASE 1 JOHN STARK DRIVE 50' PUBLIC R/W & UTILITY JOHN STARK DRIVE 50' PUBLIC R/W & UTILITY THOMAS GAGE DRIVE 50' PUBLIC R/W & UTILITY PHASE 3 PHASE 2 THOMAS GAGE DRIVE 50' PUBLIC
R/W & UTILITY 27 18 29 30 31 36 123 124 134 135 136 137 19 20 21 22 28 17 WM WM FH FH WM WMWM 13 14 16 PHASE 2 OS2 42,921.2 SF 0.9853 AC OS1 684,490 SF 15.7137 AC BO TEMP BLOW OFF WM
WM FH WM WM WM WM WM WM FH WM WM BO TEMP BLOW OFF PHASE 1 PHASE 3 C26 C27 C28 C29 C30 C31 C32 C33 C34 C47 C48 C49 C50 C51 C52 C53 C54 C55 WM PUTNAM STREET 50' PUBLIC R/W & UTILITY PHASE
2 CONCRETE MONUMENT 4"x7" 1.8' AG 1-1/4" IPF BENT 63267MAG 63268 287.39 3/4" IPF FLUSH CONTROL CORNER 3/4" IPF FLUSH CONTROL CORNER 3/4" IPF FLUSH CONTROL CORNER 3/4" IPF BENT 3/4"
IPS CONTROL CORNER IPS 3/4" FLUSH 10' O-S MAG SET MÆRSTAN, PLLC Land Surveyors 2411 US 64 BUS. W., PITTSBORO, NC 27312 PH: 919.545-7001 NC LIC: P-1408 KB HOME RALEIGH-DURHAM, INC.
4506 S. MIAMI BLVD., SUITE 100 DURHAM, NC 27703 . REB-RW SUBDIVISION PLAT BIRCHWOOD GROVE, PHASE 3 US 401 N FUQUAY-VARINA, NC 27526 HECTORS CREEK TOWNSHIP, HARNETT COUNTY 08.23.22 3
of 3 BIRCHWOOD GROVE 21471 REB 1"= 100' SEE SHEET 2 of 3 NC GRID NAD 83 (2012B) 0 100' 200' FUTURE PHASE 4 BIRCHWOOD GROVE PHASE 1 MAP 2022 PG 69-72 PRELIMINARY PLAT NT R RERATIN NEYANE
R ALE BIRCHWOOD GROVE PHASE 2 MAP 2022 PG 313-315 FUTURE PHASE 4 CURVE TABLE SHEET 3 of 3 CURVE # C27 C28 C29 C30 C31 C32 C33 C47 C48 C49 C50 C51 C52 C53 C54 C55 ARC 37.39' 132.56'
181.26' 172.11' 100.32' 78.05' 34.72' 81.26' 195.11' 157.90' 227.02' 37.41' 100.25' 100.25' 100.75' 309.60' RADII 25.00' 365.00' 315.00' 315.00' 365.00' 365.00' 25.00' 315.00' 425.00'
425.00' 425.00' 475.00' 475.00' 475.00' 475.00' 475.00' BEARING N76°36'56"E S70°56'45"E N65°34'43"W N33°26'28"W N25°39'50"W S39°39'47"E E06°00'28"E N10°23'55"W N04°25'37"W N28°13'19"W
N54°10'04"W S67°12'50"E S58°54'42"E S46°49'09"E S34°41'47"E S09°56'51"E CHORD SD23 SD24 SD25 SD26 SD27 SD28 SD29 SD30 SD31 SD32 SD33 SD34 SD35 SD36 SD37 150.20' 117.92' 95.68' 110.14'
166.27' 5.17' 10.08' 7.65' 10.70' 41.41' 26.71' 60.00' 28.00' 53.68' 24.78' N73°56'00"W S69°19'33"W N10°29'14"E N10°28'11"E N70°36'37"E S16°13'03"E N77°39'33"E S16°13'03"E N71°29'42"E
N74°45'50"E N15°03'53"W N26°19'50"E N63°40'10"W N26°19'50"E N74°45'50"E DRAINAGE EASEMENT TABLE SHEET 3 of 3 BEARING LENGTHLABEL SYMBOL LEGEND WM BO SEE SHEET 1 of 3 FOR NOTES, CERTIFICATES
AND SIGNATURES