OP RHTE# fZ- —2JWfk Harnett County Department of Public Health
PERMIT #7Z!`5 Operation Per it ZINitrification 2 2 4 8 3
New Installation Septic Tank Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: -6ju7o -7 ,sue 'X-S
Name: (owner) SUBDIVISION LOT # I_
System Installer: Z41e Registration #
Basement with plumbing: ❑ Garage ❑ liumber of Be ooms
Type of Water Supply: ❑ Community ❑ Public Rr Well Distance from well IVZ)' feet
System Type: a 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.
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: System shall perform in accor
II. Monitoring: As required by Rule .1961.
III. Maintenance: As required by Rule .1961. 0
Subsurface system operator re
If yes, see attached sheet for
IV. Operation:
Rule .1961.
❑No❑
operation conditions, mainter�,nctend reporting.
f 11--��
r
P
V. Other: _ !-
❑ D -Box ❑ ump ❑ Alarm ❑ H2OLine ❑ PWR Line
Following are the speftcations for the sewage disposal n the above captioned property.
F VO
Type of system: L� Conventional ❑ Other �1000 gallons Pump Tank: f �" gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches x of each ditch f r 'f feet ditches feet ditches C--f— inches
French Drain Required: Linear feet
Date 1
Authorized State Are a `� 13
y
Rule .1961.
❑No❑
operation conditions, mainter�,nctend reporting.
f 11--��
r
P
V. Other: _ !-
❑ D -Box ❑ ump ❑ Alarm ❑ H2OLine ❑ PWR Line
Following are the speftcations for the sewage disposal n the above captioned property.
F VO
Type of system: L� Conventional ❑ Other �1000 gallons Pump Tank: f �" gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches x of each ditch f r 'f feet ditches feet ditches C--f— inches
French Drain Required: Linear feet
Date 1
Authorized State Are a `� 13
12- 5- 29604R (1)
12- 5- 29604R (2)
12- 5- 29604R (3)
12- 5- 29604R (4)
12- 5- 29604R (5)
12- 5- 29604R (6)
12- 5- 29604R (7)
12- 5- 29604R (8)
12- 5- 29604R (11)
12- 5- 29604R (12)
12- 5- 29604R (13)
12- 5- 29604R (9)
12- 5- 29604R (10)