OPHTE# Harnett County Department of Public Health 21117
PERMIT # D'S57 Operation Permit
New Installation 'N Septic Tank El Repair Nitrification Line 0 Expansion
PROPERTY LOCATION: f'eNy~tos le.~ L
Name: (owner) t`~ k Q eNe,4 n , l~ SUBDIVISION CeRpi--~etQ, SEA>o~~ LOT # _
System Installer: To R>" "j,► Registration #
Basement with plumbing: ❑ Garage `5~ Number of Bedrooms it
Type of Water Supply: ❑ Community X Public ❑ Well Distance from well ib0 feet
System Type: -rtTa 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.
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PERMIT rnunlTIALK
1. Performance: System shall perform in accordance with Rule .1961.
11. Monitoring: As required by Rule .1961.
111. Maintenance: As required by Rule .1961. Other.
Subsurface system operator required? Yes ❑ No, l
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
IV. Operation:
V. Other.
Following are the specifications for the sewage disposal system on the above captioned property.
Type of system: ❑ Conventional Other f:~v , cac• Lt CA km %6-9- Septic Tank: IOP O gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches 3 of each ditch 50 feet ditches feet ditches inches
French Drain Required: _linPPr
Authorized State Agent_ P.L1a5 Date ,alb