OPHTE# o~-sue- k ~11'1~ Harnett County Department of Public Health 19974
PERMIT # 2 5 ~J Operation Permit
New Installation l d5 Septic Tank ❑ Repair 1~' Nitrification Line ❑ Expansion
PROPERTY LOCATION:_I t
Name: (owner) LOT #
) SUBDIVISION Fu[1tr7 k)
System Installer. C C (a r -'r Registration # a L L
Basement with plumbing: ❑ Garage( Number of Bedrooms
Type of Water Suply: h Eommumty Public ❑ Well Distance from well 4) feet
System Type: I-& i ~N' - << t ~'f (q~ types V and VI Systems expire in S years.
(In accordance with Table V a) Owner must contact Health Department 6 months prior to expiration for permit renewal.
ims system nu Dw mstmeo to
wnn apphcabte North tarohna General Statutes, Wks for Sewage Trutmeo and
a
t
and al condition of the hnprotement Permit and Comtnxtion kdroriutix
J
lz~ /I
PERMIT rALIMAYt•
Performance: System shall perform in accordance with Rule .1961.
Monitoring. As required by Rule .1961.
Maintenance: As required by Rule .1961. Other.
Subsurface system operator required? Yes ❑ No ❑
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
IV. Operation:
V. Other.
Following are the specifications for the sew dispos system on the above captioned property.
Type of system: ❑ Conventional Other Size of tank: Septic Tank: DDJ gallons Pump Tank: gallons
Subsurface No, of VVVVVV exact length width of depth of g Drainage Field ditches of each ditch- feet ditches feet ditches 1 y
b z inrhoc
yen ram quire : linear feet
Authorized State Agent r~ Date Z.'