1440 N Main St 4 DAVIE COUNTY ENVIRONMENTAL HEALTH � N
P.O.Box 848/210 Hospital Street �
Mocksville,NC 27028 � ,�\
(336)753-6780/Fax# (336)753-1680 ,J�\
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REPAIR OPERATION PERMIT
Acct�u�t #: 990005905 � - �"�x�I�€:EH#: 1502060018
Biflcd 7'0: Barry Sechrest Su�ar�ivisiorz In���: '
R�fer�r�ce P�ta��e: . LocationrAddr�ss: 1440 N Main-27028
Pro�os�;c� Fa�:i€ity: Repair , , ; ��o��r�y S�iz�: 0.75 AC ,
a�TC Nurnb�r: 5955 ;. .
**NOTE** The issuance of this Operation Permit shall indicate the system described on the ATC has been installed
in compliance with Article 11 of G.S.Chapter 130A, Section.1900"Sewage Treatment and Disposal Systems,"
but shall in NO WAY be taken as a guarantee that the system will function satisfactorily for any given period of
time.
System Type: S.T.Manufacturer -� Tank Date � Tank Size /
Pump Tank Size � Bedrooms 3
System Installed By: �Q(/� �{�d GTS Installer#: Date: 7 � a o�2
GPS Coordinate:
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�nvironmental Health Specialist: Date: �d��Z
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DCHD 11/06(Revised) �-�Z��
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DAVIE COUNTY ENVIRONMENTAL HEALTH
P.O.Box 848/210 Hospital Street
Mocksville, NC 27028
(336)753-6780/Fax# (336)753-1680 .
� AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRIJCTIOIv �
Account #: 990005905 Tax PIN/EH #: 1502060018
Billed To: Barry Sechrest Subdivision Info:
Address: 1440 North Main Street Location/Address: 1440 N Main-27028
City: Mocksivlle Prope�j��'�'�e: qj�ljcy�epair ❑Expansion
Reference Name:
�i ��} rization to Construct(ATC)MUST BE ISSUED by the Davie County Environmental
Propo����iec�on pribr�fo.issuance of any building permit(s),(in compliance with Article 11 of G.S.Chapter 130A
Wastewater Systems,Section.1900 Sewage Treatment and Disposal Systems). THIS AUTHORIZATION TO
CONSTRUCT IS VALID FOR A PERIOD OF FIVE YEARS. This ATC is subject to revocation if site plans,plat
or the intended use change.
Residential Specifications: #Bedrooms�#Bathrooms #People '2 Basement❑ Basement plumbing❑
Non-Residential Specifications: Facility Type # People #Seats �
Square Footage(or Dimensions of Facility)�
Lot Size -�� Type of Water Supply: OCounty/City �1We11 ❑Comrnunity Well
System Specifications: Design Wastewater Flow(GPD) C-dTank Siz�AL.Pump Tank GAL.
Trench Width� Max. Trench Depth�Q� Rock Depth_��t`_` Linear Ft.�o�cSv�� .
Site Modifications/Conditions/Other. ���"' ���
Contact the Davie County Environmental Hefilth Section for final inspection of this system between
8:30—9:30a.m.on the da of installation. Tele hone# 336 751-8760.
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Environmental Health Specialist C� , • Date: 7 a����
DCHD 11/06 (Revised)