OP - new permit based on 4 bedrooms see IPAC permit #27361HTE #—j 797 , Harnett County Department of Public Health
PERMIT # Z � ° -0 �3 ®w Operation Per it ," 22653
�f t E2 New Installation Z Septic Tank L� Nitrification line ❑ Repair ❑ Expansion
} � PROPERTY LOCATION:. �W eL red /4.3
Name: (owner) 44 - 51 SUBDIVISION LOT # t
System Installer: i.aa d ®/LiCXPR�%d Registration #
Basement with plumbing: ❑ Garage C umber of Be ooms q _
Type of Water Supply: ❑ Community l� Public Well '7 Distance from well feet
System Type: t1 f1z+. i Ii 5 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.
PERMIT CONDITIONS:
I. Performance:
11. Monitoring:
111. 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 ❑
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
F-1 D -Box ❑ Pump ❑
Following are the sp fications for the sewage disposal system on the above captioned property.
Type of system: Conventional ❑ Other
Subsurface No. of exact length
Drainage Field ditches �_ of each ditch ! I -i` feet
French Drain Required: Linear feet
Alarm ❑
H2OLine ❑
PWR Line
Septic Tank: / 1W gallons Pump Tank: gallons
width of depth of
ditches 3 feet ditches inches
Authorized State Amt — Date 2 �'