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" Orange County Health Department <br /> Environmental Health Division <br /> P.O.Box 8181,306-C Revere Road <br /> Hillsborough,NC 27278 <br /> Phone 245-2360 Fax 644-3006 <br /> www.co.orange.nc.us <br /> WASTEWATER SYSTEM CONSTRUCTION AUTHORIZATION <br /> Parcel Pin: 9843137930 TMBL: 3.55-4 <br /> Application Date: 06/07/2005 Permit#: CA05-00228 <br /> Applicant: CAMP CHESTNUT RIDGE Owner: NC UNITED METHODIST CAMP <br /> Address: P O BOX 10955 Address P O BOX 10955 <br /> RALEIGH NC RALEIGH NC <br /> 27605 27605 <br /> Phone: 304-39001 Phone: 1 <br /> Property Desc.: S/O SR 1120 Lot Size: 201.05 <br /> Prop Address: 4300 CAMP CHESTNUT RIDGE RD4300 CAMP CHESTNUT RIDGE RD <br /> Pemut Type: RESIDENTIAL NEW SYSTEM <br /> Facility Type: EDUCATIONAL IP Number: 003-00278 Expires: 04/21/2008 <br /> Water Supply: Private Well <br /> YSTEM SPECIFICATION <br /> Wasteflow: 360 GPD Primary System Type: Conventional(Shallow) System Class: 11c <br /> No.of Bedrooms: 3 Nitrification: 400 Ft.X 317t.Wide <br /> Septic Tank: OExisting TankGAL Maximum T-ench Depth: 18 In. <br /> Min.Pump Tank: 0 GAL Horiz.Trench Separation: 9 Ft. <br /> Other: Innovative System Type: <br /> Repair System Type: Pump-Other Trench System Class: HIbg <br /> COMMENTS: <br /> 1: GRAVITY DISTRIBUTION DEVICE RE UIRED—Flow-0iversion/s litter valve <br /> 2: NOT DESIGNED FOR GARBAGE DISPOSAL <br /> 3: Svstem desi ed to accomodate 12 caml2ers @ 30 als/dav/cam er <br /> PERMIT CONDITIONS <br /> * REFER TO THE ATTACHED SITE PLAN SHOWING THE SYSTEM AND FACILITY LOCATIONS AND OTHER SYSTEM SPECIFICATIONS <br /> * THIS AUTHORIZATION SHALL BECOME INVALID AND MAY BE REVOKED IF: <br /> * THE INFORMATION SUBMrLTED ON THE APPLICATION IS INCORRECT,FALSIFIED,OR CHANGES. <br /> * THE SITE IS ALTERED,OR <br /> THE SYSTEM INSTALLATION IS NOT COMPLETED BEFORE THE EXPIRATION DATE. <br /> * THE SYSTEM SHALL BE INSTALLED IN ACCORDANCE WITH: <br /> * ORANGE COUNTY RULES FOR WASTEWATER TREATMENT AND DISPOSAL SYSTEMS AS ADOPTED BY THE ORANGE <br /> COUNTY BOARD OF HEATH <br /> * ORANGE COUNTY WASTEWATER SYSTEM SPECIFICATIO,' AND OCHD POLICIES. <br /> SYSTEMS WITH A CLASSIFICATION OF III OR R WILL REQ P RIODIC AT <br /> ONS BY THE O_C.HEALTH DEPARTMENT <br /> ISSUED: 06/15/2005 l EXPIRES: 04/21/2008 <br /> avi mental Health Specialist <br /> 212 <br /> C4-4130102 Pick up Mail_ File Reviewed <br />