P82172 Hwy 801Smm� ��ef DIV -L COUNTY I E ^�fi D y i SVT,
-?i
, N.C..
,L- .1, 1ecfi.ion a'1 been made of your premises and sanitation deficiencies have been
noted a s checked. Please correct the checked items.
-� Sei,.a o Septic `rank .— Privy ar
_ Yd nee cleaning too eliminate mos--
_ _ „ w:9`a r Ais r• ,1 quito breeding sources (such as old
Garbage (food or other animal or tires, tin cans, bottles, etc.)
a' vel eta.ble v;aste) not properly drained Yard needs cleaning to eliminate rat
,,nc wrapred, harborage.
Csa.rba e not stored in proper container. T� Lumber should be stacked lis inches
- ;-arba o ca.n lid does not fit tightly. off ground.
�M Ga,'.Ibage :,an needs washing. Animal or fowl shelter needs to be
- . 7.yrba. e c; needs
to be replaced. cleaned daily to prevent fly breeding
G''x"bage spilled on ground, and rodent attraction.
. . 111 k4 f� /'�5 � e- �, ;��1 ,,...
Do needs cleaning
'R,era,rl.,�`f-�f�Q� r uct1�- f� ��
.:Ef you ha.v^ cu.es'ions about items checked above or others not checked call the County
Iieai:�•h Crt:t _ r, Tolephone 534-2012. ;9 2 cgPr 71--l; b
Pate �� r_/ � _Tj-me �0 1 Signed _
County Health Department
DAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT Date
JHmer/OccupantL; Cr��I_ To: coq �c� coo F77
Address &4�_ o Ola Address i g_�d LICA' 04
Building Contractor
Building t -S Address
Cal. Manufacturer's Name -Pay -ie S', 7, LA , Address 4! Art) C_ ' _s
No. of lines Width _in. Total length ft. No. sq. ft.
Type of filter material Total tons used
Minimum REquirements: House Trailer Tank cap. 800 Sq. ft. line ,400
'Two' -bedroom house 800 600
Three-bedroom house 900 900
No one shall install a septic tank in Davie County without a permit from the Health Offic
or his agent.
Date of Final Approval
Signed:
Sanitarian
I hereby certify that the above septic tank has been installed according to specification
Signed:
Septic Tank Contractor
Note: Make sketch of disposal system on back of sheet and mail to Davie County Health
Center, Box 57, Mocksville, North Carolina 27028.
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