OPHTE# Harnett County Department of Public Health
PERMIT # 0'\ R% Operation Permit 2 2 3 2 0
New Installation 'K Se~tic Tank ~ Nitrification Line ❑ Repair ❑ Expansion
Name: (owner) Nl c•C ~1 PROPERTY LOCATION: csc
SUBDIVISION ~A~~d+aa1 LOT # 8
System Installer: atatzEn. Registration #
Basement with plumbing: ❑ Garage Number of Bedrooms
Type of Water Supply: ❑ Community Public ❑ Well Distance from well t 00
System Type: feet
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:
I. Performance:
II. Monitoring:
III. Maintenance:
IV. Operation:
V. Other:
System shall perform in accordance with Rule .1961.
As required by Rule .1961.
As required by Rule .1961. Other:
Subsurface system operator required? Yes ❑ N
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
❑ D-Box ❑ Pump ❑ Alarm ❑
H20line ❑ PWR Line
Following are the specifications for the sewage disposal system on the above captioned property.
Type of system: ❑ Conventional Other (Se tic Tank: t U~t~
Subsurface No. of exact l P gallons Pump Tank: gallons
Drainage Field 3 length width of depth of
ditches of each ditch &44 n 3
feet ditches feet ditches-~_ inches
French Drain Required: _N:z, ear fd*t
Authorized State Agent
Date
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