OPHTE# 1 Z.— !5 - Z7312 Harnett County Department of Public Health
PERMIT # Z70l Operation Per it 2 2 4 5 4
E;' New Installation 9 Septic Tank Nitrification Line ❑ Repair ❑ Expansion
Name: (owner) (ej_ i4vN_ -,
System Installer: - _ai�� �
Basement with plumbing: ❑ Garage Egr umber of Bedrooms
Type of Water Supply: ❑ Community I j'" Public ❑ Well
System Type: ? ¢o 75 'L Lbw
(In accordance with fable V a)
This system has been installed in
PROPERTY LOCATION: 1`gLi f8
SUBDIVISION ") LOT # '1�L
Registration #
Distance from well feet
t' p stems expire in 5 years.
Owni must contact Health Department 6 months prior to expiration for permit renewal.
with applicable North Carolina General Statutes, Rules for Sewage Treatment and
t
V
i
Zg61 -
� 150. "r►�
4
Permit and Construction Authorization.
PERMIT CONDITIONS:
I. Performance:
II. Monitoring:
III. Maintenance:
IV. Operation:
and all conditions of the
s
O i
System shall perform in accordance wrt 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 ❑ H2OLine ❑ PWR Line
Following are the specifications for the s disposal system on the above captioned property.
Type of system: El Conventional Conventional other ZS%XbUaf a... `a+_.5r -."ry6 + Septic Tank: gallons Pump Tank: 1 0 0 gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches of each ditch feet ditches 3 feet ditches inches
French Drain Reouired: Linear feet
Authorized State Ag nn ° ..—. ,2 62Q .i Date '9 — LA 1
12 -5 -29347 (1)
12 -5 -29347 (6)
12 -5 -29347 (2)
12 -5 -29347 (7)
12 -5 -29347 (3)
12 -5 -29347 (8)
12 -5 -29347 (4)
12 -5 -29347 (9)
12 -5 -29347 (5)
12 -5 -29347 (10)