OPHTE #.13 ^S-` 3f68 Harnett County Department of Public Health
PERMIT # Operation Pe nit / 22696
2/New Installation Septic Tank Q Nitrification Line ❑ Repair ❑ Expansion
PROPERTY LOCATION:49t /Ii
Name: (owner) SUBDIVISION fiL9 A- LOT # If 6
System Installer: Registration #
Basement with plumbing: ❑ Garage umber of edrooms
Type of Water Supply: ❑ Community ublic ❑ Well Dis nce from ell feet
System Type: °i a- yes V and VI Systems expire in 5 years.
(In accordance with Table V a) Owner must c ct Ith Department 6 months prior to expiration for permit renewal.
This system has been installed in compliance with applicable orth Carolina General Statutes, Rules for Sewage Trea ent and osal, and all conditions of the Improvement Permit and Construction Authorization.
y� 7 -7
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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 sews disposal system on the above captioned property.
Type of system: ❑ Conventional Other Septic Tank: @ C O gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches of each ditch feet ditches 3 feet ditches 71 inches
French Drain Reauired: Linear feet
Authorized State As?At Date 2,° 1
13 -5 -31585 (1)
13 -5 -31585 (2)
13 -5 -31585 (3)
13 -5 -31585 (4) 13 -5 -31585 (5)
13 -5 -31585 (6)
13 -5 -31585 (7)
13 -5 -31585 (8)
13 -5 -31585 (9)