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ORANGE COUNTY HEALTH DEPARTMENT <br /> IMPROVEMENTS PERMIT No. <br /> Dare: r � <br /> �7 <br /> r <br /> ❑caner: �J� r� � �t �" � � �' `! �" <br /> T I/�J r' ►Y <br /> caa Location: <br /> � f <br /> Contractor: -`y � - �' Z <br /> CL Water Supply: Private Public <br /> Sewage Disposal Facilities: No. bedrooms Dishwasher, Disposal, <br /> washing machine, other automatic appliances <br /> Size of tank: ,_ ,,.. Nitrification line with yndisturbed earth <br /> dam each 50 feet / r .t�•c <br /> 7-7- <br /> Other disposal facility: <br /> Water supply and sewage disposal facilities location, installation,and protection must <br /> meta state and local regulations. <br /> Septic tank should be pumped out every 3 to 5 years and shall be maintained by owner <br /> in such a manner as not to create a public health hazard. Septic tank and nitrification <br /> line MUST BE INSPECTED AND APPROVED BY A MEMBER OF THE ORANGE <br /> COUNTY HEALTH DEPARTMENT STAFF BEFORE ANY PORTION OF THE <br /> INSTALLATION IS COVERED AND PUT INTO USE. <br /> Remarks: <br /> Counter- <br /> Signed signed <br /> Sanitarian (Owner or his representative) <br /> CERTIFICATE OF COMPLETION <br /> Date Approved: � ~�� � �� By <br /> Sanitarian 255 <br /> (OVER) <br />