OP RHTE# ZS 705A-Z Harnett County Department of Public Health
PERMIT # Z & '16'I Operation Permit 22469
New Installation Y Septic Tank C� Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION::_-;,taq�c
Name: (owner) ;t5'L�r J �5r SUBDIVISION 91) � ` � LOT # �_
System Installer: Registration #
Basement with plumbing: Y Garage El' Number of Bedrooms 57
Type of Water Supply: ❑ Community V Public ❑ Well Distance from well feet
System Type: �"Fypes V and VI Systems expire in 5 years.
(If accordance witlfTable V a) Owner must contact Health Department 6 months prior to expiration for permit renewal.
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 ❑ H2OLine ❑ PWR Line
Following are the specifications for the sewage disposal system on the above captioned property.
Type of system: ❑ Conventional GY Other ZJ Of — Septic Tank: 1 Z C)() gallons Pump Tank: /060 gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches IL of each ditch Z =a t� feet ditches 3 feet ditches ! IF ? inches
French Drain Required: Linear feet
Authorized State A�_� :�-, Date I I — t, ° f 'Z
10- 5- 25709R (1)
10- 5- 25709R (2)
10- 5- 25709R (3)
10- 5- 25709R (4)
10- 5- 25709R (5)
10- 5- 25709R (6)
10- 5- 25709R (7)
10- 5- 25709R (8)
10- 5- 25709R (9)
10- 5- 25709R (11)
10- 5- 25709R (12)
10- 5- 25709R (13)
10- 5- 25709R (14)
10- 5- 25709R (10)