OPHTE# o -5 a % Harnett County Department of Public Health 2 0 8 5 0
PERMIT # Operation Permit
New Installation '~k Septic Tank ❑ Repair_X Nitrification Line ❑ Expansion
PROPERTY LOCATION: _Tx~., c L
Name: (owner) _\4r r,,-Y c2 ~w . Co . ~N G SUBDIVISION Sv-,.syz (Z ,,vG E LOT # Q\.
System Installer: M q.(:' S-~ rne5oT-1 Registration #
Basement with plumbing: ❑ Garage ~K Number of Bedrooms
Type of Water Supply: ❑ Community K Public ❑ Well Distance from well Q)0 feet
System Type: Types V and VI Systems expire in S years.
(In accordance with Table V a) Owner must contact Health Department 6 months prior to expiration for permit renewal.
Ims 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.
1
103
PVrnp COnn L-AIdNbi..
9EPpsS CL kZE-4,
S1$~
U Al-~
LvNE
CO tea'
as
D
3 2
I
v
I.t cEr~ 2:D
PERMIT CONDITInNC-
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 sewage disposal system on the above captioned property.
Type of system: ❑ Conventional Other R m p ~rl 1 k9k GA PS d
Septic Tank: ► O o o gallons Pump Tank: 10O gallons
Subsurface `No. exact length width of depth of
Drainage Field ditches of each ditch feet ditches 3 feet ditches inches
French Drain Reauired:
Authorized State Agent\~~A~~~ bras Date 5 3 ~l Z~
c ~j r
L T ~
y
t° ~ 3
K C
~ t
O v -
I
t
j, <