OPHTE# VZ--s a~►~-,~-) Harnett County Department of Public Health
PERMIT #-ao6 Operation Permit 2 2 4 4 0
X New Installation 'K Septic Tank Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: C)b c-,s V_o
Name: (owner) a✓1LL ~ ~o SAES SUBDIVISION 9~, ors5 9c,-\v S LOT #
System Installer: V•la __ZSc v4e_5 Registration #
Basement with plumbing: ❑ Garage Number of Bedrooms
Type of Water Supply: ❑ Community X Public ❑ Well Distance from well t oQ 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
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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 captioned4roperty.
*X CAP016'C4 I!.)
Type of system: El Conventional Other ~Q Septic Tank: C bOCJ gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
of each ditch feet ditches 3 feet ditches i inches
Drainage Field ditches- I
French Drain Reauired: _ a ~Sk+ eat eet
Authorized State Agent ~ ec__ i Date