OP RHTE# U i -.5'- 2",a9 ?,'2 Harnett County Department of Public Health 2 0 71 1
PERMIT # Z 'r- ° t Operation Permit
L-1-New Installation >t'Septic Tank ❑ Repair 4 Vitrification Line ❑ Expansion
//JJ PROPERTY LOCATION: t .~d
Name: (owner) ~e e n c a~~ SUBDIVISION e_ nc6 LOT #
System Installer: ea 8sow✓~ Registration #
Basement with plumbing: ❑ Garage ❑ Number of Bedrooms
Type of Water Supply: ❑ Community ~-.~ublic ❑ Well Distance from well feet
System Type: 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 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.
'IOt _
t
f o fi
r,~Q G
t
a
e `
ll
Q
A
r
17 41
~avj~
J
I
I e"
LN711 wnurnv113.
1. Performance:
II. Monitoring:
III. Maintenance:
IV. Operation:
V. Other:
System shall perform in accordance with Rule .1961.
As required by Rule .1961.
As required by Rule .1961. Other:
Subsurface system operator required? Yes ❑ No K
If yes, see attached sheet for additional operation conditions, maintenance and reporting
Following are the specifications for the sewage disposals stem on the a~bojve captioned property.
Type of system: ❑ Conventional Other s ltV'" C 7 Septic Tank: gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches 3 of each ditch ~d feet ditches feet ditches a 3 p inches
French Drain Required: Linear feet
le9
Authorized State Age ~,r~c•.
~ Date /2-6 oy
T-
d .
f
r ~ 't
- r
,ate
aa
.fit"
}
i M,
}
a" Yt
4:4
a
` . ~ ~ } r Lyys 3
y .
a
is ~ a
CSC
1
t,.
F7 71; ,