OPHTE# C)" Harnett County Department of Public Health 2 0 7 8 8
PERMIT # St-S Operation Permit
New Installation 4 Septic Tank ❑ Repair` Nitrification Line ❑ Expansion
` PROPERTY LOCATION: ►-~~-.vEy
Name: (owner) ~AV S NL j 1 R ~C9 Q~~, aQ - SUBDIVISION FoQ c~ Oc,~~ LOT # %36_
System Installer: flG Crr E Registration #
Basement with plumbing. ❑ Garage Number of Bedrooms
Type of Water Supply: ❑ Community X Public ❑ Well Distance from well t bo feet
System Type: - =\Z C. 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.
Inns 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.
Q &P
\ r
/ Sots
~ v APE
~S x14
l~.
L~
6Z
r corn I wnun Nna.
1. Performance:
System shall perform in accordance with Rule .1961.
If. Monitoring:
As required by Rule .1961.
Ill. Maintenance:
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 disposal system on the above captioned property.
Type of system: ❑ Conventional 'X Other -rI ct.C G+ \P 5 Septic Tank: 1000 gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches 'i of each ditch a 40 feet ditches 3 feet ditches I J,-c) Lt inches
French Drain Required: 'haoar feet
Authorized State Agent
Date
N~=-
- - Ell
{
Y c
} i 1 iRP' ~ '!P .1