OP RHTE# Q7-5 q )-7R Harnett County Department of Public Health 21373
PERMIT Operation Permit
ew Installation Septic Tank ❑ Repair(:P~ Nitrification Line ❑ Expansion
PROPERTY LOCATION:
Name: (owner} SUBDIVISION n v'~ LOT
System Installer: Registration #
Basement with plumbing: ❑ Garage S- Number of Bedrooms_
Type of Water Suppl . , ❑ Community F2f- Public ❑ Well Distance from welllc~~--> feet
System Type: f `.2c cam, p , Types V and VI Systems expire in 5 years.
(In accordance with Table V} 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.
E
DCDUIT rn11r11T1n 11f.
I. Performance:
II. Monitoring:
III. Maintenance:
System shall perform in accordance with Rule .1961.
As required by Rule .1961.
As required by Rule .1961. Other:
IV. Operation:
V. Other:
Subsurface system operator required? Yes ❑ No ❑
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
Following are the specifications for the sewage disposal jy~tgm on the move captioned property.
Type of system: El Conventional Other rte Septic Tank: j
gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage field ditches of each ditch feet ditches feet ditches t~ r7 inches
french Drain Required: Linear feet
Authorized State Agent ' Date
L
0
63
x
%
i
Y' Y LL
si
ems: + Y,t
p~yE~Mpy
r
r
~urs+
C ~ ~F
T~,I
j 1 E
r S` p~ q
S
~i
~ r r
Y x
as es
~s
' il~lrP'°Ye'°c
~i
l
f
5
vB'
~
i
j k
-
E
~ i
W
r
r.
h
i
. ro ' .;~fFJn.
q
Kr
V
l
x
a.
kk
h!
ev
t;
S; t 4?
a
v
u
~u
u ~
z
- £ e4
`odd
0
a u
s _
• NZ I
N
r s
s 1
4
S• [l
~ par f
d O
O C OC
a
o-p a
rv Q~
i