OP RRRHTE#C5~1-~ a,~96e Harnett County Department of Public Health
PERMIT #-')-677 Operation Permit 2 2 7 4 4
1 New Installation IN Septic Tank b< Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: S v~~tiA,~~►a >
Name: (owner) SUBDIVISION LOT #
System Installer: l -r try 5 t\ c Registration #
Basement with plumbing: ❑ Garage ❑ Number of Bedrooms D^
Type of Water Supply: ❑ Community X Public ❑ Well Distance from well SC?~ feet
System Type: 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
16"s
x~a
FLUM LVIIU iun.r.
1. Performance: System shall perform in accordance with Rule .1961.
11. Monitoring: As required by Rule .1961.
III. Maintenance: As required by Rule .1961. Other:
Subsurface system operator required? Yes ❑ Nox
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
IV. Operation: 5-is-V C--. \-5s c,':--D F=a2. 3 R:,V---OQ"5 '5
V. Other:
Note
N0-5
~Nc~ec.a; s, O*~ 1Q GQ
StiCE J~C°,GaS '3CL l
Ptafl hc- ~Qeu~ ~ tQu
❑
D-Box
❑
Pump ❑
Alarm ❑
H20Line ❑ PWR Line
Following are the specifications for
the sewage disposal system on the above capti
° ed property.
Type of system:
❑ Conventional
"i~ Other
,
G ,try CQ~ J
Septic Tank: tOOO
gallons Pump Tank: gallons
Subsurface
No. of
exact length
width of
depth of
Drainage Field
ditches
of each ditch C~ feet
ditches
feet ditches inrhpc
French Drain Required: Linear feet
Authorized State Agent P Date to i
y
~a
t ,
. 4
,
,
s -
}
~ y-
u
L
-a
-
r
'
4
r
i'
!JC
wo"
w i
>
r.
v.
h
.
-
Y .