OPfm# fly- ► n Harnett County Department of Public Health 19 913
PERMIT # `l~ ~1 Operation Permit
New Installation 19 Septic Tank ❑ Repair 2 Nitrification Line ❑ Expansion
PROPERTY LOCATION:..
j .1 \ ~ (;r , s~
Name: (owner)~~ht-n >k n n (fir u v-~t,~ SUBDIVISION
System Installer. U \ H~ LOT
Basement with Plumbing. Garage Registration #
10- Number of Bedrooms ~ L
Type of Water Su ❑ Community X Public ❑ Well Distance from well ~ feet
System Type:
Types Y and VI Systems expire in S years. ,--Y
(In accordance with Table Y a) Owner must contact Health Department 6 months prior to expiration for permit renewal. t , 7
This has been msuw in can vice with North Caroina Geskrat Stouter, Wks for Sew Tmaonmt and
Disposal, - - - con6fiorrs of the o ensdrt t4rrtnt and Concwc0on AushaiAtron
rt ~
PERMIT CONDITIONS:
I. Performance:
II. Monitoring
III. Maintenance:
IY. 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.
Following are the specifications for the sewage disposal tem on the above captioned property.
Type of System: ❑ Conventional ~rL Other , ( v, `f
Subsurface No. of exact length Site of tank: Septic Tank: Z.) J gallons Pump Tank: gallons
Drainage Field ditches 1-4 width of depth of
French Drain of each ditch S feet ditches 3_ feet ditches
Required: Linear feet- inches
Authorized State Agent `1 ~s• Date 1 J