OP RHTE# D-7 - ~ a. Harnett County Department of Public Health 19899
PERMIT # 2~ Operation Permit
S New Installation ~ Septic Tank ❑ Repair Nitrification Line ❑ Expansion
PROPERTY LOCATION: 1 2 2 `1
Name: (owner) SUBDIVISION LOT
System Installer. : , c V_
Registration #
Basement with plumbing: ❑ Garage 1j"umber of Bedrooms
Type of Water Supply: ❑ Community ~ Public ❑ Well Distance from well feet
System Type: _ kA { 2 F l EKD\1 Types Y and VI Systems expire in S years.
(In accordance with Table Y a) Owner must contact Health Department 6 months prior to expiration for permit renewal.
This system has been installed in
~j ~
with aWicable North (arohna Gewal smtm kles for
G~L
Treabnertt and Uisposat, and al conditions of the knprovement Permit and fonstaktion Audwiution.
ti,k-
''1o
PERMIT CONDITIONS:
L Performance: System shall perform in accordance with Rule .1961.
II. Monitoring: As required by Rule .1961.
III. Maintenance: As required by Rule .1961. Other.
Subsurface system operator required? Yes ❑ No
If yes, see attached sheet for additional operation co
IV. Operation:
Y. Other.
D
v
F
O 1' A i ,(t- `t 1
maintenance and reporting.
37Z~
Following are the specifications for the sewage disposarMtem on the above captioned property.
Type of system: ❑ Conventional Other _ _ YY A! `20 ~ -1 'C I Ol size of tank: Septic Tank: P9 J J J
Subsurface No. of gallons Pump Tank: gallons
3 exact length width of depth of
Drainage Field ditches of each ditch ~00- feet ditches _ feet ditches _ b inches
French Drain Required: Linear feet
Authorized State Agent Date CA
" - c7 (j