OPHTE# a(, /S76d Harnett County Department of Public Health 2 0 4 2 4
PERMIT # 7-3318 Operation Permit
/New Installation EZ Septic Tank ❑ Repair ~ Nitrification Line ❑ Expansion
PROPERTY LOCATION:~yif~l4:.c.,,
Name: (owner) -i 6 SUBDIVISION Zep LOT # t z-
System Installer: /W-'az;tc Registration #
Basement with plumbing: ❑ Garage ❑ Number of Bedrooms 3
Type of Water Supply: ❑ Community V Public ❑ Well Distance from well feet
System Type: IS% f1 UC ~ isit,,t,.. Z z ~ G- Qt cosy Types V and VI Systems expire in 5 years.
(In accordance with Table Y a) T' Owner must contact Health Department 6 months prior to expiration for permit renewal.
Inn system nas peen mstaneu in compuance wim applicable Borth Larolma General
op /Z-/7-00 '
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Rules for Sewage Treatment and
V
and all conditions of the Improvement Permit and Construction Authorization.
t LI\1111 LVI\VIIIVI\J.
1. Performance:
II. Monitoring:
III. Maintenance:
System shall perform in accordance with Rule .1961.
As required by Rule .1961.
As required by Rule .1961. Other.
IV. Operation:
Subsurface system operator required? Yes ❑ No ❑
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
V. Other.
Following are the specifications for the sew $e disposal system on the above captioned property.
Type of system: ❑ Conventional Other ZS%s (LHt a 3&)) Septic Tank: / ck-')C) gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches Z of each ditch feet ditches- feet ditches °I inches
French Drain Required: Linear feet
Authorized State
Date 12 -1-7- G
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