OPHTE#/0~ Harnett County Department of Public Health 212 8 4
PERMIT # 7R7 Operation Permit
New Installation VSeptic Tank ❑ Repair PI"Nitrification Line ❑ Expansion
PROPERTY LOCATION: L
Name: (owner) 4- SUBDIVISION F,-ms~ 7---0 : fr L 0 T # f
System Installer: o„4ty ~~tt~•• Registration #
Basement with plumbing: ❑ Garage ❑ Number of Bedrooms 3
Type of Water Supply: ❑ Community 10"Public ❑ Well Distance from well 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 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:
L renormance: )ystem snail perform in accordance with Rule .1961.
II. 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 seewwa'disposal system on the bove phoned roperty.
Type of system: ❑ Conventional I~ Other Q~:e ~ C r C"- Septic Tank: gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of f~
Drainage Field ditches of each ditch 00 feet ditches ~ feet ditches d7 inches
French Drain Required: Linear feet
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Authorized State Agen J`~~ Date 2-°/0
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