OPHTE#OC1 S~aati-71 Harnett County Department of Public Health 21345
PERMIT # ~:15ti0,0 Operation Permit
New Installation X Septic Tank ❑ Repair' Nitrification Line ❑ Expansion
PROPERTY LOfATION: 62.N-, e Q,
Name: (owner) _ Mwz.~ + Amy NA-AM$ SUBDIVISION G r~t.i LOT # I
System Installer: o Registration #
Basement with plumbing ❑ Garage 'X Number of Bedrooms 3
Type of Water Supply: ❑ Community ❑ Public X Well Distance from well t 00 feet
System Type: Types V and VI Systems expire in 5 years.
(In accordance with Table V a) Owner must contact Health Department 6 months prior to expiration for permit renewal.
tms system nas been installed to compliance with applicable Nort
h Carolina General Statutes, Rules for Sewage Treatment and Disposal, and all conditions of the Im
s 6,5
provement Permit and Construction Authorization.
_ PA2~ ~a L
acalo I
I ~oucT
I
,
4'1: ti 26PA~cz
.3a
~►a
.
Pori _
3 s Eortioo th
'Arj
►
-o 0
.t
)Payl O 1
9 I V
t
1
►65
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 conditions, maintenance and reporting.
IV. Operation:
V. Other.
Following are the specifications for the sewage disposal system on the above captioned property.
Type of system: ❑ Conventional Other V7Z n,,,,
Subsurface No. of exact length Septic Tank: ►ob y gallons Pump Tank: gallons
of each ditch width of depth of
Drainage Field ditches
150 feet ditches 3 feet ditches a!} inches
French Drain Reouired:
Authorized State
Date 311, ',11 -0
9~ pp r ~
Yk-
4 , , b F
x~t ba
i k k!' h'i r'+. Y t
t - p
Al,
0~.-S_
F
wV i '
l K +t
K