OPHTE# 07-533- 01(-XI Harnett County Department of Public Health 2 0 5 7 8
PERMIT # X53 6 `-f Operation Permit
❑ New Installation Septic Tank ❑ Repair; Nitrification Line ❑ Expansion
Name: (owner) PROPERTY LOCATION: I~
SUBDIVISION LOT #
System Installer. > F 0 . t ~ f~, Registration #
Basement with plumbing: ❑ Garage ❑ Number of Bedrooms
y _
Type of Water S I : Communi Public ❑ Well Distance from well -S feet
System Type: ll-e ~SnTr 14.,, {'tr
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.
ims 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.
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PERMIT CONDITIONS:
I. Performance: System shall perform in accordance with Rule .1961.
II. Monitoring. As required by Rule .1961.
III. Maintenance: 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.
Following are the specifications for the sew ge disposal stem on the above captioned property.
Type of system: ❑ Conventional ' Other l Qty l}n Septic Tank:
Subsurface No. of exact gallons Pump Tank: gallons
act length width of depth of
Drainage field ditches of each ditch feet ditches feet ditches inches
French Drain Required: Linear feet
Authorized State Agentt Date
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