OPHTE# 07-5' /9osI Harnett County Department of Public Health 19859
PERMIT # ZggZ9 Operation Per it
!Q New Instillation Septic Tank El Repair Id Nitrification Line ❑ Expansion
PROPERTY LOCATION: srz/ysyjc,~
Name: (owner) Sri?iY -r--o ,,s SUBDIVISION ~1111As,>,Fllll ~
System Installer. LOT # z~_
Registration #
Basement with plumbing: ❑ Garage tuber of Bedrooms 3
Type of Water Supply: El Community [a Public ❑ Well Distance from well feet
System Type: rt,6,DfuZ,.,._
6 '4*7- Types Y 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.
This system has been installed in compliance with aocabh North Carolina General Statutes, him (or Sew Treatment std
Disposal, and aM cortdtiort of the
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PERMIT CONDITIONS.
1. Performance: System shall perform in accordance with Rule .196E
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 conditions, maintenance and reporting.
IV. Operation:
Other.
Permit and (Omtndon Authonzation.
following are the specifications for the sewn disposal system on the above captioned property.
Type of system: ❑ Conventional C~1" Other "0 E
_1
S 0 4- Size of tank: Septic Tank: 1006 gallons Pump Tank: allons
ubsurface No. of exact length width of g
Drainage field ditches of each ditch 300 3 depth of
feet ditches feet ditches l& - z y inches
French Drain Required: Unear feet
Authorised State A t f M&O 4 Date 2 Z~j - Q $