OPHTE#O`i°11 b Harnett County Department of Public Health 2 0 7 9 2
PERMIT # Operation Permit
New Installation 1~ Septic Tank ❑ Repair, Nitrification Line ❑ Expansion
PROPERTY LOCATION: duo V '1\
Name: (owner) No,~,~L-cow ~utw~st Ic. SUBDIVISION Gass M~6ZAE Q~~AG LOT #
System Installer: R,~ A t Registration #
Basement with plumbing: ❑ Garage '4 Number of Bedrooms 3
Type of Water Supply: ❑ Community >q Public ❑ Well Distance from well i o o feet'
System Type: -I= of 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.
nm giiem nas oeen msraneo in
with applicable north larolma General Statutes, Rules for Sewage Treatment and Disposal and all conditions of the Improvement Permit and Construction Authorization.
~Go<sJ6^t\UNAL.
5oa
~7- Sao'
55U
i
D[o►e1T rr11rA1T1A\IC
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:
Subsurface system operator required? Yes ❑ No)K~
If yes, see attached sheet for additional operation conditions, maintenance and reporting
V. Other.
Following are the specifications for the sewage disposal system on the above captioned property.
Type of system: ❑ Conventional VI Other `~,cg-_ C-o Septic Tank: loc)a gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage field ditches 3 of each ditch I COfeet ditches fppt ditrhot i~~he<
French Drain Required: ar feet
Authorized State Agent G,,4,7Ca_ ~
Date a
I
.a
'Ilk
s,
s
I S ~b
.N. x Won=
~ t1
Allj 9' c
t
~V
wy I
« r
3a - si. K
IT
e
Y
"
1 J
[ ra E.; r 2 400I 431)f,
,~tJa.f~ 1`!f_i~.t?x CrJ(di"V ~<CJdC~
_
I" ntNrr,t~r H '9 ?f,
! int j; l7l:c f> Ili 1~~.
I_I'l 11 VhAl, t'laiituk'l W±;
Trr~c:l:.s. f NT(=-3ifM 1
st?dp.'3 tr0 t. -P M [it m4flual Wt
't;<~nt~yr~t a 71r fvl.1S7't3l~i~.l~
'
'
tl~ti:J.4f?0I_I~.
rick
r u{ _k
rype% ott
` til a+ Glfl Vin'
TION OVII C1II
4 ,
y
1.1 j
r` flt~ 1i11r-
),)f Bair
r
.
60.11.5
Libby CAm~roya
Ceadal the t>~Ipt N boil`s }hi FVol Grath (eta dh and
stat
I
f
F
a o
~teelf I
n innovative Wostewoter system oAprOvrl:
s Ne f~it~lta~
I
S
V
WI
ubstIlutlon for Rock Appregrole
S200203k for tjfj chip In Nitrification fi
l
e
ds.
Lw
.-.--,:-emu-, -
-•---~-.--~-.~-.:r-
_
.
.
.
-
r
-
_ --r