155 Wood Ln Lot 8 NN, �.
''u DAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
'NOTE:Issued in Compliance With Article II of G.S.Chapter 130a
�S)anitary Sewa a Systems ,�� L.�),J �c� Permit Number
Named " ,re Date Z: N2 8090
Location �L�� �� %vr,-�. , d ,. .E; r,✓�_ l,/i`' !n
Subdivision Name -r� - r' %� . Lot No. Sec. or Block No.
Lot Size ' — House Mobile Home ---_ Business —_ Industry
No. Bedrooms —?—.No. Baths -- No. in Family _ Public Assembly Other
Garbage Disposal YES ❑ NO D'-*' Specifications for System:
Auto Dish Washer YES NO ❑
Auto Wash Ma^hine YES NO ❑ /�� �� F`
Type Water Supply
•This permit Void if sewage system described below is not installed within 5 years from date of issue.
This permit is subject to revocation if site plans or the intended use change
ATTENTION: YOUR SEPTIC SYSTEM CONTRACTOR MUST SEE THIS PERMIT/LAYOUT BEFORE INSTALLING THIS
SYSTEM.
P
ger'.'.__
L-,
1
Improvements permit by
`Contact a representative of the Davie County Health Department for final Inspection of this system between 8:30-9:30 A.M.,
1:00-1:30 P.M.or 4:30-5:00 P.M.on day of completion.Telephone Number: 704-634-5985.
Final Installation Diagram: System Installed by —
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Certificate of Completion -- Date a _
'The signing of this certificate shall indicate that the system described above has been installed in compliance with
the standards set forth in the above regulation, but shall in NO way be taken as a guarantee that the system will function
satisfactorily for any given period of time.
DAVIE COUNTY HEALTH DEPARTMENT �J
Environmental Health Section �6,✓
Soil/Site Evaluation
NAME ��/7��YSOr✓ DATE EVALUATED
ADDRESS PROPERTY SIZE _ 116
PROPOSED FACIILTY LOCATION OF SITE �Zl
Water Supply: On-Site Well _ Community Public L---
Evaluation By: Auger Boring Pit Cut
FACTORS 1 1 2 3 4
Landscape position L L
Sloe Z -%
HORIZON I DEPTH
Texture groupt4
Consistence
Structure
MineralogX
HORIZON II DEPTH 'Z16—
Texture group 0 G
Consistence
Structure S
Mineralogy
HORIZON III DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON IV DEPTH
Texture group
Consistence
Structure
Mineralogy
SOIL WETNESS
RESTRICTIVE HORIZON
SAPROLITE
CLASSIFICATION
LONG-TERM ACCEPTANCE RATE
SITE CLASSIFICATION: �/ EVALUATED BY:
LONG-TERM ACCEPTANCE RATE: y OTHER(S) PRESENT:
REMARKS:
LEGEND
Landscape Position
R-Ridge S•-Shoulder L-Linear slope FS-Foot slope N-Nose slope
CC-Concave slope CV-Convex slope T-Terrace FP-Flood plain H-Head slope
Texture
S-Sand LS-Loamy sand SL-Sandy loam L-Loam SI-Silt
SICL-Silty :lay loam, SIL-Silty loam CL-Clay loam SCL-Sandy clay loam
SC-Sandy clay SIC-Silty clay C-Clay
CONSISTENCE
Moist
VFR-V+--.-y friable FR-Friable FI-Firm VFI-Very firm EFI-Extremely firm
Wet
NS-Non sticky SS-Slightly sticky S-Sticky VS-Very Sticky
NP-Non plastic SP-Slightly plastic P-Plastic VP-Very plastic
Structure
3C--Single grain M-Massive CR-Crumb GR-Granular ABK-Angular blocky
SBK-Subangular blocky PL-Platy PR-Prismatic
Mineralogy
1:1, 2:1. Mixed
Notes
horizon depth - In inches
Depth of fill - In inches
Restrictive horizon - Thickness and inches from land surface
Saprolite - S(suitable), U(unsuitable)
Soil wetness - Inches from land surface to free water' or inches from land surface to soil colors
with chroma 2 or less
Classification - S(suitable), PS(provisionally suitable), U(unsuitable)
LTAR - Long-term acceptance rate - gal/day/fu
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