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OP RHTE#09 "J- System shall perform in accordance with Rule .1961. As required by Rule .1961. As required by Rule .1961. Other. PERMIT Operation Permit X New Installation :R Septic Tank ❑ RepairX Nitrification Line ❑ Expansion PROPERTY LOCATION: LN*,3L 92,p Name: (owner) Qjo,.sant SUBDIVISION Viers y.orz tien LOT # _ System Installer. Co.nor"'4 Registration # Basement with plumbing: ❑ Garage ❑ Number of Bedrooms Type of Water Supply: ❑ Community X Public ❑ Well Distance from well , _00 feet System Type: G 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. Ihts 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. I fL~.pA ~n, I r iCf' C.l.d~l?v ro,. Liz Lt~ ~ V L DLRMIT MkInfri UC 1. Performance: II. Monitoring: III. Maintenance: IV. Operation: Harnett County Department of Public Health 2 0 81 1 Subsurface system operator required? Yes ❑ No K If yes, see attached sheet for additional operation conditions, maintenance and reporting V. Other. F~z~SySC _ ~1'~ oiq F',u \rvet uoftJ~ via LW" SPtrc gy ~wrr ©w~pl~e~ Aa-c - 6 ocx Following are the specifications for the sewage disposal system on the above captioned p erty. Type of system: ❑ Conventional ' Other yia-r- %CLL \'Z Septic Tank: `6©d gallons Pump Tank: gallons Subsurface No. of exact length width of depth of Drainage Field ditches of each ditch feet ditches 3 feet ditches 1 inches French Drain Reouired: A 1. i Ikv, Authorized State Agents Date r u yy ' y _ 1 ! 77- lot, ~G t Ilk g { dc~ -5- ?J~L1 war ~ . fi n: Y f A ~ i C. X11 5". c 7'Q t This load of lira chips Is from the Fuel Grade location and meets the Nc spaciflcatlon as stated In Innovative Wastewater system approval IWWS•2002.03R tot fire chip ( 9ubsNf an for Rock Agpteprafe In Nitrification Fields. i + l A 0 i Ihis load of fire chips is from ttiA Fu01 Grade location and meets the Nc specifica#lon as slc,,6 i7 innUvahvo Wastewatar systom approval I Subsd#u#ion for RoGc A rv ra#o In W `2002-gAA°r fire chlp ~p Q WtIficolon Fie,