OP RHTE#_D&.s0 ► 513 M Harnett County Department of Public Health 2 0 7 4 4
PERMIT # _a 33 9 5-
Operation Permit
C PrS New Installation,,~Septi( Tank ❑ Repair Nitrification Line ❑ Expansion
n PROPERTY LKATION: 17 C,
Name: (owner) SUBDIVISION \ ~-1• LOT # 71
System Installer: 220< tZ -c Registration #
Basement with plumbing ❑ Garage 4 Number of Bedrooms ~ C9 2
Type of Water Supply; L1 Community Public ❑ Well Distance from well _ feet S t^3' ` ti
System Type: -r-4 'C'7 l~(7a- \ ~ 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 nas peen mstauea in compliance wan applicable North laronna beneral Statutes, Rules for Sewage Treatment and Disposal, and all conditions of the Improvement Permit and Construction Authorization.
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ICY
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I. Performance:
11. Monitoring:
III. Maintenance:
System shall perform in accordance with Rule .1961.
As required by Rule .1961.
As required by Rule .1961. Other.
IV. Operation:
V. Other.
Subsurface system operator required? Yes ❑ No ❑
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
Following are the specifications for the sewage dispos system on the above captioned property.
Type of system: ❑ Conventional Other 'InO Catt a JAS Septic Tank: gallons Pump Tank: t7~ J gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches of each ditch feet ditches- feet ditches r inches
french Drain Required: Linear feet
Authorized State Agent Date
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