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OPHTE# Harnett County Department of Public Health 20821 PERMIT # 53p°i Operation Permit I` New Installation `K Septic Tank ❑ Repair, Nitrification Line ❑ Expansion PROPERTY LOCATION: Roe>e_,z%S 9--v Name: (owner) CL-C-T-4 SUBDIVISION QUasA-,, CAZ_Et<-<_ LOT # S System Installer: r--..f~-t StiAAq-r" E Registration # Basement with plumbing. ❑ Garage ❑ Number of Bedrooms 3 Type of Water Supply: ❑ Community X Public ❑ Well Distance from well t OC~ feet System Type: -M b 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. [his 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. W ~d f GuTx 44 V ac 4z i c-s NE _ 0 6 P ad' ` o ~ ~P a / le' D ' b - l t . LPp L i t RET-DS1R ' ARF.r1 / ate' I RoeFSZrs ~ MMIT fA11111T1A11[. 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 ❑ Nox If yes, see attached sheet for additional operation conditions, maintenance and reporting. IV. Operation: V. Other.#+~>s<taL>~ ~'~s `,~.E n IEcz ~~ao pcz~nci 10 1as-rta<1aN Following are the specifications for the sewage disposal system on the above tioned property. Type of system: El Conventional Other Vu teQ76 \ QS- HNC Septic Tank: t ©oo gallons Pump Tank: t000 gallons Subsurface No. of exact length width of depth of Drainage Field ditches of each ditch `jC) feet ditches 3 feet ditches IZ inches French Drain Required: t line f.=r± Authorized State Agent Date r~:~1~:r~~1 ~;.~r~~i~t ifi~~;~i~~t~, _ ~-ic:~~.~~ xs ~~a~~i:;,'~ l A b M Out MLkr,~Aal wt h t.u_k t L{iPR, ,11AVT, f ,t i r: w U l 11 Iti N,-.,,ual bf t; t U ~t'(1ni4?Y'S dl)%~ha.~l_(li `t l `:ltEI'T I Ie't-,1 L t"rIf. T I,c_ I Ni..fltp l , M1 k1,~ f i -tiS r ; f-V Cl.id.+lFiVj I1+itt F', iltilvlt~it ETH D~riv>~rs' _ ~~p~.►tY t•~.igtar~~stcar~ Libby + 11 ZAb load of tits chips is from the Fuel Grade location and meets the Nc specification cW:; toted in Intiovatlve Wastswatsr system approval IWWS•204-UR for We chip foe Rock Aypreyrato in Nlfrt+ticottotl FWft r z^ \ Ai , P a s F. S~ ~ 4 s t r~'c r' ;'y r a" t ' a ~ it t~' ~ .t.~ , . ~ ~k.. if F r~: 1 14 fir, ar ~ 041 k T ~ G +s Al " r ~t- -41 erF F r f41 4 t 5 ,l m` i'~. ~ ~•1 i 1rµ,.,- - ' *y t 4,. k ~43z r ff .~yy vF_' ~ r~ i t m 3 a 0`1-5-ate-i ~ T "244 «t I ~ 'Z. r ~'aaee ~ ~ .B P f'" s s ~y 04}