OP RHTE# 6Z-s"--0y6-y2 Harnett County Department of Public Health
PERMIT # a~ c1 Operation Permit 2 2 3 6 4
L- New Installation 21""Septic Tank Or- Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: I~n
Name: (owner) u c-~- -1 . SUBDIVISION Coo p--l- ~ar-M LOT # 9
System Installer: Registration #
Basement with plumbing: ❑ Garage ❑ Number of Bedrooms .3
Type of Water Supply: ❑ Community [Public ❑ Well Distance from well feet
System Type: 7_: Gr 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 Lonstrucnon numorizacion.
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PERMIT CONDIIIUNN:
1. Performance:
II. 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 specifications for the sewage disposal system on the above captioned property.
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Septic Tank: 0'4 13 gallons Pump Tank: gallons
Type of system:
❑ Conventional Other
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width of depth of
Subsurface
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French Drain Required: Linear tees l
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