OP RHTE# Harnett County Department of Public Health
PERMIT # a41~113 Operation Permit 2 2 71 2
New Installation X Septic Tank X Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: L-C..y~.t~ tat mac;
Name: (owner) V-lo,rr G..~ w A2yS SUBDIVISION G a E ~t r; LOT # a 5
System Installer: So"Gs '5 E9 ~L Registration #
Basement with plumbing: ❑ Garage -f( Number of Bedrooms 3
Type of Water Supply: ❑ Community 'K Public ❑ Well Distance from well l d 0 feet
System Type: = C7, Types V and VI Systems expire in 5 years.
(In accordance with Table V a) Owner must contact Health Department 6 months prior to expiration for permit renewal.
This system has been installed in compliance with applicable North Carolina General Statutes, Rules for Sewage Treatment and Disposal, and all conditions of the Improvement Permit and Construction Authorization
PERMIT CONDITIONS:
1. Performance:
II. Monitoring:
III. Maintenance:
IV. Operation:
System shall perform in accordance with Rule .1961.
As required by Rule .1961.
As required by Rule .1961. Other:
Subsurface system operator required? Yes ❑ No
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
V. Other:
❑ D-Box ❑
Following are the specifications for the
Type of system: ❑ Conventional
Subsurface No f
Drainage Field ditches
French Drain Reauired:
Pump ❑ Alarm ❑ H201-ine ❑
sewage disposal system on the above captioned P?~perty.
Other ~,~~Q+s~~SL C t%% 1 Septic Tank: 1 Odd gallons Pump Tank:
exact length width of depth of
of each ditch e SU feet ditches 3 feet ditches
PWR Line
gallons
inches
Authorized State Agent ~+5 Date
ANA
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