OPHTE# is -5a~19 Harnett County Department of Public Health
PERMIT # Oteration Permit 2 2 41 Q
New Installation Septic Tank X Nitrific Ion Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: Mc.ovcoio
Name: (owner) Mpg om t5 SUBDIVISION CRc~ovc~AL~ QL hC-4. LOT #
System Installer: La,-4", E ONA,,S®tJ Registration #
Basement with plumbing: ❑ Garage ❑ Number of Bedrooms 3
Type of Water Supply: ❑ Community X Public ❑ Well Distance from well !~O feet
System Type: 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
i
f
f k2~s*
T
5d
~d usE
st
v
E
PtRMII CUNDIIIUNS:
1. Performance: System shall perform in accordance with Rule .1961.
II. Monitoring: As required by Rule .1961.
III. 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 ❑ H201-ine ❑ PWR Line
Following are the specifications for the sewage disposal system on the above captioned property.
Type of system: ❑ Conventional Other EZ V)-OW Septic Tank: 1000 gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches _ of each ditch 211~4 0 feet ditches feet ditches inches
French Drain Reauired:' 'oLut
Authorized State Agent___ \q- ~5 Date __71j