OPHTE #1G_5 251/36 Harnett County Department of Public Health
PERMIT # i 7 �'� ® ep ration Permit 22468
L J' New Installation Septic Tank 5 Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION:`
Name: (owner) V444ax SUBDIVISION LOT # D
System Installer: sue-, Registration #
Basement with plumbing: ❑ Garage L3� Number of Bedrooms
Type of Water Supply: ❑ Community Public ❑ Well Distance from well feet
System Type: %' e Types V and VI Systems expire in 5 years.
(In accordance with Table V a) s t�tent 6 months prior to expiration for permit renewal.
This system has been installed in compliance with applicable North Carolina Gen ral Statutes, �Sewage ment and Dis po I, and all conditions of the
,
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.
Permit and Construction Authorization.
❑ D -Box ❑ Pump ❑ Alarm ❑ H2OLine ❑ PWR Line
Following are the specifications for the sews disposal system on the above captioned property.
Type of system: ❑ Conventional 5r Other y — Septic Tank: 1600 gallons Pump Tank: _ gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches 2, of each ditch i s% feet ditches feet ditches r `b inches
French Drain Required: Linear feet
Authorized State A ent - � Date 1 D — 1° 1
12 -5 -29430 (1)
12 -5 -29430 (2)
12 -5 -29430 (3)
12 -5 -29430 (4)
12 -5 -29430 (5)
12 -5 -29430 (6)
12 -5 -29430 (11)
12 -5 -29430 (7)
12 -5 -29430 (8)
12 -5 -29430 (9)
12 -5 -29430 (10)