OPHTE#; - zaf~ Harnett County Department of Public Health
PERMIT # Z6t i Operation Pe a / 2 2 2 8 0
New Installation Septic Tank Q Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION~801t_fl^e
Name: (owner) i /k . _ SUBDIVISION Q - Pztc,,~c.. _LOT #
System Installer: b40A-).z-- 0h4 Registration #
Basement with plumbing: ❑ Garage / Number of Bedrooms 3
Type of Water Supply: ❑ Community Q Public n w-,,..l -;stone -from w feet
System Type: 6 0-7 Typez.V and VI Systems expire in 5 years.
(In accordance with Table V a) Owner must c to Health Department 6 months prior to expiration for permit renewal.
This system has been installed in compliance with applicable North Cara$a General Statutes, Rules for Sewage ITeatnent)d D4osal, and allAonditions of the Improvement Permit and Construction Authorization.
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PERMIT CONDITIONS:
1. Performance: System shall perform in accordance with Rule .1961.
II. Monitoring: As required by Rule .1961.
111. 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 sewage disposal system on the above captioned property.
Type of system: ❑ Conventional [Zr Other 75"Fa /14.7 Septic Tank: gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of ,
Drainage Field ditches of each ditch feet ditches feet ditches f4a inches
French Drain Required: Linear feet
Authorized State AQ nt / Date L- `J 1 12-
12-5-28186 (1) 12-5-28186 (2) 12-5-28186 (3) 12-5-28186 (4) 12-5-28186 (5)
12-5-28186 (6) 12-5-28186 (7) 12-5-28186 (8) 12-5-28186 (9) 12-5-28186 (10)