OPHTE# jZ -S'— 2r� Harnett County Department of Public Health
PERMIT # Operation PPeerm —it 22460
C� New Installation LJ Septic Tank [2/ Nitrification Line ❑ Repair ❑ Expansion
Name: (owner) 3i'tf s SUBDIVISION LOT #
System Installer: Registration #
Basement with plumbing: ❑ Garage /Number of Bedrooms
Type of Water Supply: ❑ Community Public ❑ Well Distance from well feet
System Type: ;?5% s e r 7-wlUr- EU G !Gz Cb� Types V and VI Systems expire in 5 years.
(In accordance with Table V a) ner must contact Health Department 6 months prior to expiration for permit renewal.
This system has been installed in compliance with applicable NJ Carolina General Statutes, Rules far Sewage Treatment and Disposal, and all condition of the Improvement Permit and Construction Authorization.
PERMIT CONDITIONS:
I. Performance:
II. Monitoring:
III. Maintenance:
IV. Operation:
V. Other:
System shall perform in accordance with 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.
❑ D -Box ❑ Pump ❑ Alarm ❑ 112OLine ❑ PWR Line
Following are the specifications for the sewadisposal system on the above captioned property.
Type of system: El Conventional [/Other Septic Tank: /°OC.> gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches 3 of each ditch , feet ditches s feet ditches inches
French Drain Reouired: Linear feet
Authorized State A nt._� -'___ Date �2�
12 -5 -28450 (2)
12 -5 -28450 (3)
12 -5 -28450 (4)
12 -5 -28450 (5) 12 -5 -28450 (6)
12 -5 -28450 (7)
12 -5 -28450 (8)
12 -5 -28450 (9)
12 -5 -28450 (1)