OPHTE# A - Z-3 1V/ Harnett County Department of Public Health
PERMIT Operation Fle ,ri it 2 2 0 9 9
New Installation L✓J Septic Tank Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: 1-203 l" 42 (
Name: (owner) C/fl~l1 SUBDIVISION LOT #
System Installer: 3 ~ Registration #
Basement with plumbing: ❑ Garage ❑ Number of Bedrooms
Type of Water Supply: ❑ Community Public ❑ Well Distance from well feet
System Type: i✓ S - ypes Y and I stems 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
PERMIT CONDITIONS:
1. Performance:
II. Monitoring:
III. Maintenance:
IV. Operation:
V. Other:
with applicable North Carolina General Statutes, Rules for Sewage Treatment and Disposal, and all conditions of the Improvement Permit and Construction Authorization.
System shall perform in accordance Oh 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.
❑ D-Box ❑ ump ❑ Alarm ❑ H20Line ❑ PWR Line
Following are the specifications for the sews d- stem on the above captioned property. ar riv
Type of system: ❑ Conventional Z Oth r 50/6~%+}t.'t Septic Tank: C% gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches 3 of each ditch feet ditches 5 feet ditches Zinches
French Drain Required: Linear feet
Authorized State t ~;?1 Date / 1 Z-
10-5-23941 (8) 10-5-23941 (9) 10-5-23941 (10) 10-5-23941 (11)
mow. p
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a ,T
10-5-23941 (13) 10-5-23941 (14)
10-5-23941(15)
{
Al" ` a
10-5-23941 (12)
10-5-23941 (23)
10-5-23941 (24)
10-5-23941 (25) 10-5-23941 (26)
10-5-23941 (27)