OPHTE# Viz.-l zf08 Harnett County Department of Public Health
PERMIT # 26600 Operation Pe a 2 2 2 5 8
New Installation Septic Tank M /Nitrification Line El Repair El Expansion
PROPERTY LOCATION: M'5 , z 4 .
Name: (owner) 1 . SUBDIVISION`/63 LOT # ~J
System Installer: r ~ Registration #
Basement with plumbing: El Garage Zamber of Bedrooms
Type of Water Supply: ❑ Community Lit Public ❑ Well Distance from well feet
System Type: Z516 s 4(,T` 'Z Types V and VI Systems expire in 5 years.
(In accordance with Table V a) Owner must costa 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
rtltrnl t.UnUlllUn):
1. Performance: System shall perform in accordance with Rule .1961.
IL Monitoring: As required by Rule .1961.
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 sewaIsposal system on the above captioned property.
Type of system: ❑ Conventional 1?Other 2~~~pAcc++~.sLa. Septic Tank: j6d_ gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches- of each ditch feet ditches feet ditches ' inches
French Drain Reauired: Linear feet
Authorized State nt < C - Date 5 ""z- (_-17-
,,n
1
12-5-28208 (2)
12-5-28208 (3)
12-5-28208 (4)
12-5-28208 (5) 12-5-28208 (6)
:
v
3
12-5-28208 (7)
12-5-28208 (8)
12-5-28208 (9)
12-5-28208 (1)