OPHTE# �>-,_ 10 Harnett County Department of Public Health
PERMIT # 6 7 / 0 ep ration Permit 22680
C� New Installation Septic Tank Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: /5&7
Name: (owner) I / s SUBDIVISION ?i LOT # Z
System Installer: F es.. M a — Registration #
Basement with plumbing: ❑ Garage Number of Bedrooms 3
Type of Water Supply: ❑ Community 2* Public ❑ Well Distance from well feet
System Type: 15% It—, =r 6 J 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 $rolina General Statutes, Rules for Sewage Treatment and Disposal, and[all conditions of the
PERMIT CONDITIONS:
I. Performance:
ll. Monitoring:
111. Maintenance:
IV. Operation:
V. Other:
.e'
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.
Permit and Construction Authorization.
❑ D -Box ❑ Pump ❑ Alarm ❑ H2OLine ❑ PWR Line
Following are the specifications for the sew5e disposal system on the above captioned property.
Type of system: ❑ Conventional X Other 25% i Septic Tank: ^J 400 gallons Pump Tank: gallons
Subsurface No. of �F exact length width of depth of
Drainage Field ditches 7 of each ditch feet ditches feet ditches L inches
French Drain Required: Linear feet
to
Authorized State gent ^`° Date ?_ f 3
07 -5 -16958 (1)
07 -5 -16958 (2)
07 -5 -16958 (3)
07 -5 -16958 (4) 07 -5 -16958 (5)
07 -5 -16958 (6)
07 -5 -16958 (7)
07 -5 -16958 (8)
07 -5 -16958 (9)