OP RHTE# /Z-.5-- Z Z5~5-/Z. Harnett County Department of Public Health
PERMIT # Z&0-U- /Operation Pe it 2 2 2 5 7
d New Installation Seatic Tank Nitrification Line ❑ Reuair ❑ Exuansion
PROPERTY LOCATION:." 4170 d
Name: (owner) 67#4 / SUBDIVISION G5b LOT # :7
System Installer: Registration #
Basement with plumbing: ❑ Garage Number of Bedrooms q,
Type of Water Supply: ❑ Community Y Public ❑ Well Distance from well feet
System Type: Jildni-t4a, z v f.7" Types V and VI Systems expire in 5 years.
(In accordance with Table V a) 0 er must contact Health Department 6 months prior to expiration for permit renewal.
This system has been installed in compliance with applicable North Carol General Statutes, Rules for e~ewage TrEatment and Disposal, and all conditions of the Improvement Permit and Construction Authorization.
PERMIT CONDITIONS:
1. Performance: System shall perform in accordance wit Rule .1961.
ll. Monitoring: As required by Rule .1961. f 7v~ V d i
III. Maintenance: As required by Rule .1961. Other:
Subsurface system operator required? Yes ❑ No ❑
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
IV. Operation:
V. Other:
❑ D-Box ❑ Pump ❑ Alarm ❑ H20Line ❑ PWR Line
Following are the specifications for the seewwaa disposal system on the above captioned property.
Type of system: ❑ Conventional L~f Other 541, + u st 3 lam. rL'U~ '3 eptic Tank: l 0 0 gallons Pump Tank: 1006 gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches of each ditch 1~ feet ditches 3 feet ditches Zq L3
'I inches
French Drain Required: Linear feet
Authorized State A nt Date
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12-5-28255R (6)
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12-5-28255R (16)
12-5-282551:
12-5-28255R (18)
12-5-28255R (19)
12-5-28255R (20)
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12-5-28255R (21)
12-5-28255R (22)
12-5-28255R (23)
12-5-28255R (24)
12-5-28255R (25)
12-5-28255R (26)
12-5-28255R (27)
12-5-28255R (28)