2131 Hwy 601S (3)DAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PEWIT Datedp
Oi+mer/Occupant �` 9� N To: l
Address Address
Building Contractor Address
i
Cal . D O r�anuf turer's Name Address i3 -
�to. of lines �_ Width in. Total length � . No. sq. ft.
Type of filter material '# /b e��� Total tons sed 130
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 specificatioi
Signed: -�
Septic n tractor
Note: Make sketch of disposal system on back of sheet and mail o Davie County Health
Center, Box 57, Mocksville, North Carolina 27028.`
M