OP RHTE# /D-~--235_75W Harnett County Department of Public Health 21 0 2 8
PERMIT # Z5 -7 1 9 Operation Permit
2 /New Installation E✓1 Septic Tank ❑ Repair Nitrification
line ❑ Expansion
PROPERTY LOCATION..5;z t7o,T- al D
Name: (owner) SUBDIVISION LOT #
System Installer: Z-pv A Registration #
Basement with plumbing: ❑ Garage ❑ Number of BOOM 3
Type of Water Supply: ❑ Community Public Well Distance from well /04) ' feet
System Type: JW `7 Types V and VI Systems expire in 5 years.
(In accordance with Table V a) Owner must contact Health Department 6 months pri to explraAton or permit renewal.
This system has been installed in compliance with applicable North Carolina General Statutes, Rules for
F-0 11 s~»r~to8 n^-
NODS 3/L P,,,
S_ 96
ra 3E rp;-pct -
h1ft VD -1
Z)/~
y
f
L 5 % y `rz ` .9~rc ra- Z"
75, to 0-f- -
PERMIT CONDITIONS:
I. Performance:
II. Monitoring:
III. Maintenance:
IV. Operation:
V. Other:
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 ZOther Zj )a Zf -O u c-+-Lt-.. Septic Tank:
Subsurface No. of exact length width of
Drainage Field ditches of each ditch (PD-- feet ditches _
French Drain Required: Linear feet
Authorized State
and Construction Authorization.
/
/oo
Treatment and Disposal, and all conditions of
! D a C-) gallons Pump Tank gallons
depth of
feet ditches Z4P- inches
Date y - ZZ - /ri
i
WAS
$ 1
]y
S 4
~ • 1 1
11 L i~
4~
1 ~1
ilk,
3 fag ~ A~~`. ~ » ,
~i 4 1
.~k G
x.
r.
r ~
t ~ x
aM
N * T
w
~ sa
4w
F t s'l v r '
Ilk
i
o, s g
y~y
a ''R
to
t
Y
N
O
Q
ti
N
w
i
J
w
a