OP RRHTE# J0 - Z5-42k t Harnett County Department of Public Health
PERMIT # Z,7 Operation Permit 22695
New Installation Septic Tank LI' Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION:
Name: (owner) a #111 be., 144-7 SUBDIVISION LOT #
System Installer: OU Registration #
Basement with plumbing: ❑ Gara ❑ Number of Bed r oms -
Type of Water Supply: ❑ Community ❑ Public Well Distance from well t ' feet
System Type: i �'Z Types V and VI Systems expire in 5 years.
(In accordance with Table V a) Owner must cont t Health Department 6 months prior to expiration for permit renewal.
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This system has been installed in compliance with applicable North Carolina General Statutes, R)les for Sewage Treatment and Disposal, and all conditions of the Improvement Permit and'onstruction Authorization.
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PERMIT CONDITIONS:
I. Performance: System shall perform in accordance with Rule .1961.
11. 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 sewage disposal system on the above captioned property.
Type of system: ❑ Conventional LEI/ -Other .P1-Q s Septic Tank: z) gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches 3 of each ditch (°60 feet ditches -3 feet ditches `Z &-1 inches
French Drain Required: Linear feet
Authorized State A Date
10- 5- 25626RR (1)
10 -5- 25626RR (2)
10- 5- 25626RR (3)
10- 5- 25626RR (4)
10 -5- 25626RR (5)
10 -5- 25626RR (6)
10 -5- 25626RR (11)
10 -5- 25626RR (7)
10 -5- 25626RR (8)
10- 5- 25626RR (9)
10- 5- 25626RR (10)