OPHTE # /2- .s°- 2T7ZZ, Harnett County Department of Public Health
PERMIT
Operation Permit
22462
[/New Installation R Septic Tank 12 "'Nitrification Line
❑ Repair ❑ Expansion
PROPERTY LOCATION: 15-15-7
—0.6
Name: (owner) C
ZJjaZC:5
SUBDIVISION
LOT #
System Installer:
Registration #
Basement with plumbing: ❑ Garage
❑ Number of Bedrooms
3
Type of Water Supply: ❑ Community
Z" Public ❑ Well
Distance from well feet
System Type: %5%
5
46 45 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
PERMIT CONDITIONS:
I. Performance:
11. 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 ❑ H2OLine ❑ PWR Line
Following are the specifications for the sewa disposal s stem on the above captioned Property.
Type of system: ❑ Conventional Other � �/ i�tiCrI � :%' �, Septic Tank: 6� gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches of each ditch 1 ZO feet ditches IF 5 feet ditches 2° f inches
French Drain Required: Linear feet
Authorized Stat Date t Z,