OP RHTE# Harnett County Department of Public Health 19882
PERMIT Operation Permit
New Installation ~1 Septic Tank ❑ Repair q Nitrification Line ❑ Expansion
PROPERTY LOCATION:
Name: (owner) ~JtA---r Qc~ SUBDIVISION 5v~ r~ 5 : r.1 c, c- LOT # 4 Z
System Installer. $ 3T Registration #
Basement with plumbing. ❑ Garage Number of Bedrooms
Type of Water Su ly: ❑ Community AW
ell Distance from well feet
System Type: V \-k AA Types V a
nd VI Systems expire in S years.
(In accordance with Table a) Owner must contact Health Department 6 months prior to expiration for permit renewal.
thn system has been mstM in compkance with applin* KwO Urohm Gen" Statutes, Rules for Sew Treatment and Dispoul, and al conditiom of the knprovernent Permit and fomttucbon Audwriution,
I
PERMIT CONDITIONS:
1. 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 t
IV. Operation: Y P, Qi(:.(- c ~ Dry
V. Other.
maintenance and reporting.
Following are the specifications for the sewa disposa"tem on the a ve captioned property.
Type of system: ❑ Conventional Other ~(v ~ L w Size of tank: Septic Tank: J gallons Pump Tank: 00 ) O gallons
Subsurface No. of exact length width of depth of
Drainage field d!~-_`khwr of each ditch- feet ditches feet ditches inches
french Drain Required: feet
Authorized State Agent ~ P--11 Date aA IA