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Oraarige County Health Department TMBL: 3.55..4 <br /> En%ironmental Health Division CA# CA05-00133 <br /> P.O.Box 8181,306-C Revere Road PIN: 9843137930 <br /> Hillsborough,N.C.27278 <br /> Fax 919-644-3006 <br /> Phone:245-2360 WASTEWATER SYSTEM INSTALLATION RECORD <br /> Applicant: NC UNITED METHODIST CAMPProperty Description: S/O SR 1120 <br /> System Installer: System Type: Conventional(Shallow) <br /> SIB MANU. Its PT MANU. EFFLUENT FILTER PUMP REQUIREMENTS <br /> STB- "L 5"7 PT- BRAND �R ' BRAND <br /> �ti5� GAL GAL MODEL MODEL <br /> DATE 11g v5 DATE ✓ PIPE SEALS OK ALARM OK <br /> PSI PSI PULL ROPE <br /> LEAK TEST LEAK TEST SUPPLY LINE FLOAT SUPPORT <br /> PRETEST# PRETEST# SIZE: FLOAT ADJUSTED <br /> INLET RISER INLET RISER OK TO COVER ENCLOSUREICONDUIT <br /> OUTLET RISER_ OUTLET RISER _PRESSURE TEST DUCT SEALJGROUT <br /> GPI= PDR INITIAL: TIME <br /> ENDING: TIME <br /> RESULT: "/ MINUTE= GPM <br /> DATE EHS NOTES YET TO DO <br /> Wig_ TI L r L..O Zu, -N�'A.(.t c'A N.A) ,iU a 11 <br /> ���f•I 7 03 7� ( SAS.�1c. �� !�:�'� ba�'�„.adCs �- Yw''.�� !�-.s-eT %�/11 <br /> `V-1 y!-45- TL C. f►Qj <br /> t14 <br /> 1�01��1w„Qdon.,,.r,il,i• �I,�,�i ��c�r1l f S�o1� <br /> _FINAL INSPECTION COMPLETED <br /> DIAGRAM <br /> crops <br /> -- -- <br /> t ti s fie l(AA ! 3Ud t 4 Sit Y ��+`� �_ n <br /> Sal r--Y ,A ! ,yy / t acf JL�7f1 �l. <br /> cA�:-fug Inu 4 <br /> 167 <br /> CA-4/301f12 Pick up Mail_ File_ Reviewed <br />