OPHTE# ~ ~j 757,~ Harnett County Department of Public Health 2 0 9 0 9
PERMIT # L3j" Operation Pe It
[Rf New Installation 1 Septic Tank ❑ Repair [/Nitrification Line ❑ Expansion
PROPERTY LOCATION: 1vd3
Name: (owner) Y470CZ4 SUBDIVISION ~ LOT # 52
System Installer: 1-jL. Registration #
Basement with plumbing: ❑ Garage Vpublic umber of Bedrooms Type of Water Supply: ❑ Community ❑ Well Distance from well feet
System Type: 5% >2ac$tS s _ j.?, _$i4 X011 j Types V and VI Systems expire in 5 years.
(In accordance with Table V a) wig Owner must contact Health Department 6 months prior to expiration for permit renewal.
finis system has been installed in compliance with applicable North Carolina General Statutes, Rules for Sewage Treatment and Disposal, and all conditions of the Improvement Permit and Construction Authorization.
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PERMIT CONDITIONS:
I. Performance: System shall perform in accordance with Rule .1961.
11. 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:
V. Other.
Following are the specifications for the se~wa,7disposal system on the above captioned property.
Type of system: El Conventional L~ Other Septic Tank: ! 00 t> gallons Pump Tank: 1066 allons
Subsurface No. of exact length width of g
depth of
Drainage field ditches y of each ditch (Ib feet ditches feet ditches ;rd y8 inches
French Drain Required: Linear feet
Authorized State ent
Date 3-9-10
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