OPHTE#_o°►--s-a~-, CA c)i Harnett county Department of Public Health 2 p 7 7 3
PERMIT # a53 Operation Permit
New Installation 'X Septic Tank ❑ Repair Nitrification Line ❑ Expansion
PROPERTY LOCATION: Ma<za~S,
Name: (owner) Cu v q sx,t.^-,o SUBDIVISION Prs Fa¢o LOT # ~a1
System Installer: lE.o $aowr-1 Registration #
Basement with plumbing: ❑ Garage '1,5i' Number of Bedrooms 3
Type of Water Supply: ❑ Community -X Public ❑ Well Distance from well I feet
System Type: =:Zo-- ! Types V and VI Systems expire in S years.
(In accordance with Table V a) Owner must contact Health 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.
TS
{C i
!N P Q 1
N A
L
D
r
V
v"tgwGPME PQ„
PERMIT rt1NnITIAW.
1. Performance:
11. Monitoring:
III. Maintenance:
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.
IV. Operation:
V. Other.
Following are the specifications for the sewage disposals stem on the above captioned property.
Type of system: ❑ Conventional M Other Out 'q GsP,nQCxt_ Septic Tank: x400 gallons Pump Tank gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches 3 of earh ditrh 4•C) foot A;t,h- in ~iS?
- - IM UIRIMI inches
French Drain Required:
Authorized State Agent =QL Date 5 d
a
r
l`3 iaF.
-tW
.s
tz r pa yr x .s
+
k
77
:ter
s
t
t Fi
v-~
w`4Va
V
i
4*
NUNN
L
3 ~m
01
. s fps
f
olv,
` E
xR F