OPHTE# &-5 - 2-14,j?j Harnett County Department of Public Health 2 0 8 7 5
PERMIT # 7-5-130 Operation Pg6lt
/New Installation t_✓1 Septic Tank 1:1 Repair /Nitrification Line ❑ Exoanslon
PROPERTY LOCATION: sc /YS'd Hall2b
Name: (owner) bF1~~ SUBDIVISION --7314C~ />7e t s~ LOT # .S
System Installer: Registration #
Basement with plumbing: ❑ Garage umber of Bedrooms
Type of Water Su ply: ❑ Community Public ❑ Well Distance from well feet
System Type: Z G r-'z 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.
This system has been in ailed in compliance with applicahle North Carolina General Statutes, Rules for Sewage Treatment and Disposal, and all conditions of the improvement Permit and fonstru(ction Authorization.
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PERMIT CONDITION . t
1. Performance: stem shall perform in accordance with Rule .1961. o
II. Monitoring: As equired by Rule .1961.
III. Maintenance: As re ired by Rule .1961. Other.
Subsurfa ' system operator required? Yes ❑ No ❑ i
If yes, see attached sheet for additional operation conditions, maintenan(e and reporting.
IV. Operation:
V. Other.
Following are the specifications for the sew a disposal system on the above captioned property.
Type of system: ❑ Conventional Other Z0%6[W ~W Septic Tank: / z°i~' gallons Pu p Tank: gallons
Subsurface No. of exact lengthwidth of d th of
Drainage Field ditches of each ditch 11 feet ditches feet di ches Z $ inches
French Drain Required: Linear feet
Authorized State Ag4z~~a ---1 i V (A~h Date "Z1 -b I
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