OPHTE# J3' —'-IW Harnett County Department of Public Health
PERMIT # Z7 3-7 Operation PPer't 22690
2New Installation L' Septic Tank [?""Nitrification Line ❑ Repair ❑ Expansion
_ PROPERTY LOCATION :1w 5°� J /,l3
Name: (owner) ��, L// SUBDIVISION LOT #
System Installer: Registration #
Basement with plumbing: ❑ Garage ❑ Number of Bedrooms
Type of Water Supply: ❑ Community Z' Public ❑ Well Distance from well feet
System Type: 'zM G kT� . ar 6 ° F2±!7 Types V and VI Systems expire in 5 years.
7
(In accordance with Table V a) 1 Owner must contact Health Department 6 months prior to expiration for permit renewal.
rC
This system has been installed in compliance with applicable North Carolina General St ewage r a men an isposa, an a conditions of the Imp Yemen ermit and Construction Authorization.
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.
❑ D -Box ❑ Pump ❑ Alarm ❑ H2OLine ❑
Following are the specifications for the sewage disposal system on the above captioned property.
Type of system: El Conventional Rr Other Zip ' Septic Tank: 160 gallons Pump Tank:
Subsurface No. of exact length width of depth of
Drainage Field ditches Z— of each ditch feet ditches -3 feet ditches s
French Drain Required: Linear feet
Authorized State Aee 1. / Date -1 "7, i V
PWR Line
gallons
inches
13 -5 -31284 (1)
13 -5- 31284(2)
13 -5 -31284 (6)
13 -5 -31284 (7)
13 -5- 31284(3)
13 -5 -31284 (8)
13 -5 -31284 (11) 13 -5 -31284 (12) 13 -5 -31284 (13)
13 -5 -31284 (4)
13 -5 -31284 (5)
13 -5 -31284 (9)
13 -5 -31284 (10)