OPHTE# 13` "*S--3d T6 Harnett County Department of Public Health
PERMIT /Operation Permit 22685
New Installation Septic Tank Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: 2
Name: (owner) SUBDIVISION LOT #
System Installer: Registration #
Basement with plumbing: ❑ Age ❑ Kimber of Bedrooms 3
Type of Water Supply: ❑ Community Public ❑ Well Distance from well feet
System Type: 25% j ' 5 % � 6 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.
PERMIT CONDITIONS:
I. Performance:
II. Monitoring:
III. Maintenance:
IV. Operation:
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.
V. Other:
❑
D -Box ❑
Pump ❑
Alarm ❑ H2OLine ❑ PWR Line
Following are the specifications for the sewa disposal system on the above captioned property.
Type of system:
❑ Conventional 2
Other 15%
Septic Tank: 100 b gallons Pump Tank: gallons
Subsurface
Drainage Field
No. of
ditches =
exact length
of each ditch � C0 feet
width of depth of
ditches � feet ditches Z � —) � inches
French Drain Required: Linear feet
Authorized State Age Date
r
13 -5 -31584 (1)
13 -5 -31584 (2)
13 -5 -31584 (3)
13 -5 -31584 (4)
13 -5 -31584 (5)
13 -5 -31584 (6)
13 -5 -31584 (11)
13 -5 -31584 (7)
13 -5 -31584 (8)
13 -5 -31584 (9)
13 -5 -31584 (10)