OP RNTE#Of- 57- Z Z35:5 j Harnett County Department of Public Health 20913
PERMIT # 2:208 J Operation Pe It
L~ New Installation Se tic Tank El Repair [/Nitrification
P Line ❑ Expansion
PROPERTY LOCATION:.c16,~,3~ e 46
Name: (owner) 711 SUBDIVISION Z,>ol-, LOT # 5
System Installer: 07~ a .cw Registration #
Basement with plumbing: ❑ Garage umber a ms_
Type of Water Supply: El Community ublic We Distance from well /6O 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.
This Ttem 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 Authorrzation
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PERMIT CONDITIONS:
I. Performance:
II. Monitoring:
III. Maintenance:
IV. Operation:
V. Other.
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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 sews disposal system on the above captioned property.
Type of system: ❑ Conventional Other Z$°/v IlG-~uGr~r}~ S t Ls_._ Septic Tank: / Z-00 gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage field ditches _ 3 of each ditch feet ditches_ feet ditches Z - V inches
French Drain Required: linear feet
Authorized State Agetif~'~_~ d
Date 3-27- ID
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