OPHTE# 11 Harnett County Department of Public Health
PERMIT # 2-6`ltlt'1 Operation Permit 2 2 4 3 6
New Installation ~q Septic Tank X Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: ~aQ,6o~t ~zy Lit
Name: (owner)ct,EO SUBDIVISION LOT #
System Installer: 1.- V-,g L--i S~paQ'< Registration #
Basement with plumbing: ❑ Garage ❑ Number of Bedrooms c~-
Type of Water Supply: ❑ Community Public ❑ Well Distance from well feet
System Type: l 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
TO
dF_ 9aA60>4Fz-4 L"4
rtnmlI LUNVIIIUN):
1. Performance: System shall perform in accordance with Rule .1961.
11. Monitoring: As required by Rule .1961.
III. Maintenance: As required by Rule .1961. Other:
Subsurface system operator required? Yes ❑ Nox
If yes, see attached sheet for additional operation conditions maintenance and reporting.
IV. Operation: Na'A 6_2.L. \v ks;-> ~ 0&)) A C C;UN 0 WAKI;f2
V. Other:
❑ D-Box ❑ Pump ❑ Alarm ❑ H20Line ❑ PWR Line
Following are the specifications for the sewage disposals system on the above a4 ptione roperty.
Type of system: El Conventional Other C, t~ W~ Septic Tank: 0 gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches --)L- of each ditch o feet ditches feet ditches ZO inches
French Drain Reauired:~`--_ 1. line ~fee1~
Authorized State Agent cz. 'oS Date