OPHTE# r 7 _ 5;-_ Z&P1 z Harnett County Department of Public Health
PERMIT Operation Permit 2 2 2 8 7
2/ New Installation 5?/ Septic Tank [?/Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: U,t7SZ.. j
Name: (owner) SUBDIVISION LOT #
System Installer: O/L4,.. ~~c- _ Registration #
Basement with plumbing: ❑ Garage D?r mber of Bedrooms
Type of Water Supply: ❑ Community Public ❑ Well Distance from well 166 feet
System Type: ~~sr~ •~c 6 &2-40L7 Types V and VI Systems expire in 5 years.
(In accordance with Table V a) Owner must co act Health Department 6 months prior to expiration for permit renewal.
ina system nas ueen inscauea in compuance wan applicable norm t,arobna beneral Statutes, Rules for Sewage Treatment and Disposal, and all conditions of the Improvement Permit and Construction Authorization.
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1 LI11111 -11VMVI\).
1. Performance:
II. Monitoring:
III. Maintenance:
System shall perform in accordance with Rule .1961.
As required by Rule .1961.
As required by Rule .1961. Other:
IV. Operation:
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 seeww,go disposal system on the above captioned property. G~
Type of system: ❑ Conventional L~ Other ~ &:W CSZ6 5 5 Seppticf Tank: 1 ~a gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches 2- of each ditch feet ditches 3 feet ditches 1i " inches
French Drain Required: Linear feet
Authorized State Age Date
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12-5-28652 (1)
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12-5-28652 (5)
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12-5-28652 (6)
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12-5-28652 (8)
12-5-28652 (9)
12-5-28652 (10)
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12-5-28652 (11)
12-5-28652 (12)
12-5-28652 (13)