OP RRFITE# a9-5 - Z2o3n zi? Harnett County Department of Public Health 2 0 4 6 9
PERMIT # ZSVO~ Operation Permit
Q New Installation E Septic Tank ❑ Repair IQ Nitrification Line ❑ Expansion
PROPERTY LOCATIONS oo y o , ~ UF:L__ ~
Name: (owner) SUBDIVISION LOT #
System Installer. &t1 hoc Registration #
Basement with plumbing: El Garage yBedrooms y
Type of Water Supply: ❑ Community Public ❑ Well Distance from well feet
System Type: ?s Dt1 ~t d~ ~S, y~,R, Tura 116 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.
Ims system /hassbbeen 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.
IR `1 V j
f`►Z J
berck
o[euiT rnun~nnur.
wnvnw11.
1. Performance:
II. Monitoring:
III. Maintenance:
IV. Operation:
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.
V. Other:
Following are the specifications for the sew disposal system on the above captioned property. g 4U4"
Type of system: ❑ Conventional Other 2' 7/o IM-0 QGrz.b,)-~ Septic Tank: L 7 QQ gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches- of each ditch feet ditches ?J feet ditches Z 8 inches
French Drain Required: Linear feet
Authorized State Age Date r(- ZZ - 9
e
u
V
f ~ nom. Z
44
t
~ d` x T o ~-f S ?
40- 44
'Pit I
y 3~ ~f
41
4 h ..i... yC.~ WF t - -'~1cn3~3`- ~f+Y,Ap~ y 4. •J A'~o- 1
' -
15
fr fi
41,
4, ~y
e