OPHTE #- -3Q>0—r Harnett County Department of Public Health
PERMIT # Operation Permit
22625
I New Installation �V Septic T nk )K' Nitrification line ❑ Repair ❑ Expansion
PROPERTY LOCATION: "mac o u
Name: (owner) t�, C v� &-c PROPERTY
System Installer: LOT #
Basement with plumbing: #
El Garage ❑ Number of Bedrooms _ `� _
Type of Water Supply: ❑ Community Public
El Distance from well t
System Type: Public
(In accordance with Table V a) Types V and VI Systems expire in 5 years.
Owner must contact Health Department 6 months prior to expiration for permit renewal.
This system hac h— io«,Iled ;., ..__r.___. _ .� .. ..
PERMIT CONDITIONS:
1. Performance: System shall perform in accordance with Rule .1961.
II. Monitoring: As required by Rule .1961.
III. Maintenance: As required by Rule .1961. Other
Subsurface system operator required? Yes ❑ No
If yes, see attached sheet for additional operatio
IV. Operation: n conditions, maintenance and reporting.
V. Other.
❑ D -Box ❑ Pump ❑
Alarm
Following are the specifications for the sewage disposal tem on the above captioned property,
Type of system: ❑ Conventional '15< Other -. %-1_c3 w
Subsurface No. of exact length
Drainage Field ditches_ of each ditch ' O
French Drain Reauiredi— feet
Authorized State Agen
Permit and Construction Authorization.
❑ 1-12O1-ine ❑ PWR Line
Septic Tank: 1606
gallons Pump lank: gallons
width of `3 depth of
ditches feet ditches —k;:Ls inches
Date _ 3 hs h 3