OPHTE# oS-S-a3NIg Harnett County Department of Public Health 21 2 2 6
PERMIT # Operation Permit
New Installation Septic Tank ❑ Repair Nitrification Line ❑ Expansion
PROPERTY LOCATION: M
Name: (owner) K N~~ ❑urnr.~.acs SUBDIVISION Asti5ggzQLn LOT #
System Installer: p c.s Ssa,c ~~P~ o Registration #
Basement with plumbing: ❑ Garage Number of Bedrooms 3
Type of Water Supply: ❑ Community Public ❑ Well Distance from well y0 feet
System Type: 7-01-140 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.
r
t (50
t~5
way 4
r..~aG- 5 ~ "x39
,occ,.rc
t P u rsQ ^Sa c?S% ~ f
I I
I 2.G{~u~'rttltJ 28t°a~2/
1~6C ti~ny~ tzC
ncewr rAh-1 111
, ~nnu wnvnivn~.
1. Performance:
II. Monitoring:
III. Maintenance:
System shall perform in accordance with Rule .1961.
As required by Rule .1961.
As required by Rule .1961. Other.
IV. Operation:
Y. Other.
Subsurface system operator required? Yes ❑ NoX
If yes, see attached sheet for additional operation conditions, maintenance and reporting
Following are the specifications for the sewage disposal system on the above captioned property.
Type of system: ❑ Conventional Other P- M4 1 o EZ fr t. Septic Tank: t O 4 O gallons Pump Tank: bn O gallons
Subsurface No. of exact length width of depth of
Drainage field ditches of each ditch f & b feet ditches 3 feet ditches I inches
French Drain Required: Lair rar feet
Authorized State Agent Date Ia l a' -I
MIF IV
fps
d -cr r t
7ti F 1WW. •r 4 v
Y
IZA
3 r . ;4. jrt, r
1
jll
1
O`1-
4
k
3~
r
r
<
haq `.'z2
t
^
r_
tr _ t p
,JOE_
1'7 j
fr
fi a
t4ro
~ 66V
N
e
r
k '
d
3
f -
a"1 - -),3 ~ A.-I