OPHTE# ,13- 5-31077 Harnett County Department of Public Health
PERMIT # I? qjV Operation Permit 22938
ZNew Installation 0"'-Septic Tank Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION: ;,,,, --
Name: (owner) <fo�er A.; ( /J:.s SUBDIVISION J ,,V LOT # 166
System Installer: Gam, -dtier A'p- ;IL Registration #
Basement with plumbing: El Garage El Number of Bedrooms S~
Type of Water Supply: ❑ Community 0— Public ❑ Well Distance from well feet
System Type: 77E fit" 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.
I is system has been Installed In compliance With applicable North Larolma t,eneral )tatutes, Mies for Newage treatment and Ulsposal, and all Conditions or the Improvement rermit and lonstruction AUtnorizatlon.
PFRMIT rONnITIONF
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I. Performance: System shall perform in accordance with Rule .1961.
II. Monitoring: As required by Rule .1961.
III. 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:
❑ 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 Z Other G,�,- 1L' c/ Ckc-^^ -he- Septic Tank: Q 5—G gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches of each ditch /20 feet ditches feet ditches -A ' aY inches
French Drain Required: Linear feet
Authorized State Agen ��-- ��� Date 2 alb
1. Geld fCa,p
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. 2
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w t aR-- f),-.
I. Performance: System shall perform in accordance with Rule .1961.
II. Monitoring: As required by Rule .1961.
III. 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:
❑ 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 Z Other G,�,- 1L' c/ Ckc-^^ -he- Septic Tank: Q 5—G gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches of each ditch /20 feet ditches feet ditches -A ' aY inches
French Drain Required: Linear feet
Authorized State Agen ��-- ��� Date 2 alb
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