OPHTE# ; -'~5_- 25 23 Harnett County Department of Public Health
PERMIT / Operation Pe mit 2 2 2 5 6
EONew Installation Septic Tank Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: 143q Jo- hr,-~ _-i ~
Name: (owner) 5 'tN- r SUBDIVISION 6tg:r_ LOT # 53
System Installer: !A--/ A-b[ tSc l,_ , Registration #
Basement with plumbing: ❑ Garage umber of Bedrooms 3
Type of Water Supply: ❑ Community Public ❑ Well Distance from well feet
System Type: Z errl t 'am Z_° Q ' 6 C 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.
PERMIT CONDITIONS:
1. Performance:
ll. 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 ❑
Pump ❑
Alarm ❑ H20Line ❑ PWR Line
Following are the spe
cifications for the sewage disposal rem on the above captioned property.
'
_
Type of system: ❑
Conventional Other 1~ /
V L6
2u•a +
os f
Septic Tank: 100 (D gallons Pump Tank: gallons
Subsurface
No. of
exact length
width of depth of
(
2
Drainage Field
ditches
of each ditch feet
inches
ditches feet ditches -
1-5
French Drain Required: Linear feet
Authorized State Age Z /IfeN E-74 r ~ Date 3°- ! '12-