OPNTE# n5-S - .73/72. Harnett County Department of Public Health 2 0 91 7
PERMIT # Zs'7o3 Operation Permit
New Installation Septic Tank ❑ Repair /Nitrification Line ❑ Expansion
PROPERTY LOCATION:,~*r zpa3 rk< , izp
Name: (owner) 444" L-- TvA.,, SUBDIVISION LOT #
System Installer: Registration #
Basement with plumbing. ❑ Garage Number of Be rooms 5~
Type of Water Supply: ❑ Community 0 Public Well Distance from well /aa feet
System Type: ZS-6/6 ~ ~27Z 60 Types V and VI Systems expire in 5 years.
(In accordance with Table V a) Owner mast contact Health Department 6 months prior to expiration for permit renewal.
This system has been installed in compliance with applicable Noah Carolina General Statutes Rules for Sewage Treatment and Disposal and all conditions of the Improve
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PERMIT CONDITIONS:
I. Performance: System shall perform in accordance with Rule .1961.
11. Monitoring: As required by Rule .1961.
111. 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 sew3ge disposal system on the above captioned property.
Type of system: ❑ Conventional Other LV fr, cl~Grts t S.,~hs-3- Septic Tank: j 7-o1) gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches t of each ditch IGD feet ditches 3 feet ditches 19 f'3 inches
trench Drain Required: Linear feet
Authorized State A Date 3 - L s - tv
Permit and Construction Authorization.
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