OPHTE #12 - �s-- 191'37 Harnett County Department of Public Health
PERMIT # Zc0501 Operation Permit
2/New Installation ..,y Septic Tank Z Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION:
Name: (owner) LJ t .o SUBDIVISION ?"r LOT # Zt
System Installer: 1Z_Z_ .+►4s.. •-t-. Registration
Basement with plumbing: ❑ Garage � umber of bedrooms 3
Type of Water Supply: ❑ Community Z Public ❑ Well Distance from well feet
System Type: 2`M 7-4sesV and VI Systems expire in 5 years.
(In accordance with Table V a) Owner must contact Heilth 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:
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 ❑ H2OLine ❑ PWR Line
Following are the specifications for the sew a disposal
system on the above captioned property.
Type of system: ❑
Conventional 9 Other
7'9� "Z
Septic Tank: gallons Pump Tank: gallons
Subsurface
Drainage Field
No. of
ditches t
exact length 1
of each ditch %L feet
width of depth of
ditches feet ditches inches
French Drain Required:
—
Linear feet
Authorized State A Date _
i L) L£b8Z -9 -Z 6 (L) L£t78Z-9-Z 6
(9) L£t78Z-9-U (9) L£78Z-9-U ib) L£t,8Z-9 -Z6 (£) L£178Z-9 -Z6 (Z) L£68Z-9 -Z6